bluuebunny/crossref_metadata_2025_split huggingface dataset:
Beneficial effect of repeated participation in breast cancer screening upon survival.
Authors: Smith Robert A. , Duffy Stephen W , Yen Amy Ming-Fang , Tabár László , Lin Abbie Ting-Yu , Chen Sam Li-Sheng , Hsu Chen-Yang , Dean Peter , Chen Tony Hsiu-Hsi 
Published: June 2023

552 Background: The benefit of mammography screening in reducing population mortality from breast cancer is well established. However, the effect of repeated participation at scheduled screens on case survival is less well documented. Methods: In this retrospective analysis of breast cancer survival, we analyzed incidence and survival data on 37,079 women ages 40-69 from nine Swedish counties who had between one and five invitations to mammography screening and were diagnosed with breast cancer between 1992 and 2016. Of these, 4,564 subsequently died of breast cancer. For each breast cancer diagnosed in each county’s period of observation, we obtained data on previous screening history, and subsequent death (or not) from breast cancer. Formal comparisons of survival with respect to numbers of screening exams attended prior to a diagnosis of breast cancer were carried out using Cox proportional hazards regression with time-varying covariates, ie, cumulative numbers of screens, yielding hazard ratios and 95% confidence intervals (CI). We corrected for potential self-selection using the method of Duffy et al, which gives a corrected estimate based on the proportion of participants, the uncorrected estimate, and the relative risk of breast cancer death for non-participants compared to an uninvited population. Results: Depending on number of invitations, 58-73% (average 65%) participated in all scheduled screens, and 73-96% (average 91%) participated in at least one examination. There was successively better survival among women with increasing numbers of screening exams. For a woman with five previous screening invitations who participated in all five screening exams, the hazard ratio was 0.28 (95% CI 0.25-0.33, p<0.0001), a 72% risk of dying from breast cancer, compared to a woman attending none. Following a conservative adjustment for potential self-selection factors, the hazard ratio was 0.34 (95% CI 0.26-0.43, p<0.0001). Conclusions: For those women who develop breast cancer, regular prior participation in mammography screening confers significantly better survival. Most women will not develop breast cancer in their lifetime. These results indicate that for those who do, regular participation in screening considerably improves the probability of surviving it. The distinction between the general, population benefit of mammography screening, and the benefit of regular participation in mammography screening should be clearly articulated in breast cancer screening messaging and decision aids. [Table: see text]
The effects of the Covid-19 pandemic on practice patterns and outcomes in patients diagnosed with gynecologic malignancies in the United States.
Authors: Kohut Adrian , Lugo Santiago Nicole , Senguttuvan Rosemary , Han Ernest Soyoung , Cohen Joshua Garrett , Lee Stephen , Dellinger Thanh Hue , Lin Jeff Feng-Hsu , Nelson Rebecca A. , Song Mihae , Tergas Ana Isabel 
Published: June 2023

5523 Background: The Covid-19 pandemic caused historic disruptions in the United States healthcare system due to many factors, including a lack of medical equipment and pharmaceutical availability, over-capacitated hospital censuses, and limited essential workers. The short- and long-term effects on patients diagnosed with gynecologic malignancies during this time have yet to be delineated. Methods: The National Cancer Database (NCDB) was queried for patients diagnosed with ovarian, uterine, and cervical malignancies from 2019 (pre-covid) to 2020 (covid). Descriptive statistics of practice patterns and outcomes were performed and compared using IBM SPSS Statistics (version 29.0). Results: Within the NCDB, 10,261 patients were diagnosed with ovarian cancer in 2019 compared to 8,501 in 2020. A significantly higher proportion of ovarian cancer patients were diagnosed with stage IV disease at diagnosis in 2020 (32.7%) compared to 2019 (30.9%), p = 0.007. Patients were less likely to undergo primary debulking surgery during covid (37.7%) compared to pre-covid (40.5%), p < 0.001. There was no significant difference in time from diagnosis to initiation of treatment (median: 9 vs. 9 days), nor was there a difference in the proportion of patients undergoing cytoreductive surgery to no gross residual disease (54.3 vs. 54.3%). 42,828 patients were diagnosed with uterine cancer in 2019 compared to 37,431 in 2020. A significantly higher proportion of uterine cancer patients were diagnosed with stage IV disease at diagnosis in 2020 (8.7%) compared to 2019 (8.2%), p = 0.016. The median time from diagnosis to initiation of treatment was 28 days in 2020 compared to 30 days in 2019, p < 0.001. The proportion of uterine cancer patients receiving primary radiation was higher during covid (1.7% vs. 0.5%), p < 0.001. Additionally, the proportion of uterine cancer patients receiving primary hormonal management was also higher during covid (2.5% vs. 2.1%, p < 0.001). 9,289 patients were diagnosed with cervical cancer in 2019 compared to 7,661 in 2020. A significantly higher proportion of cervical cancer patients were diagnosed with stage IV disease at diagnosis in 2020 (16.6%) compared to 2019 (14.9%), p = 0.0021. The median time from diagnosis to initiation of treatment was 31 days in 2020 compared to 32 days in 2019, p = 0.005. Conclusions: We identified significant variations in practice patterns and outcomes in patients diagnosed with gynecologic malignancies in the United States in 2020 (covid) compared to immediately before covid (2019). Notably, we found a significantly higher proportion of patients presenting with advanced disease stages in all queried ovarian, uterine, and cervical cancer patients. Long-term follow-up and survival outcomes are currently pending.
Association of HRD ovarian cancer by RAD51 with hot immune microenvironment: Translational analyses of MITO 16A/MaNGO-OV2 trial.
Authors: Pellegrino Benedetta , Capoluongo Ettore , Campanini Nicoletta , Musolino Antonino , Sikokis Angelica , Casartelli Chiara , Normanno Nicola , Arenare Laura , Serra Violeta , Llop-Guevara Alba , Nardelli Carmela , Beltrame Luca , Califano Daniela , D'Incalci Maurizio , Roma Cristin , Mezzanzanica Delia , Baldassarre Gustavo , Perrone Francesco , Marchini Sergio , Pignata Sandro 
Published: June 2023

5527 Background: Homologous recombination repair (HRR)-deficient Ovarian Cancer (OvC) is sensitive to PARP inhibitors and platinum salts. Genomic HRR-deficiency (HRD) tests (i.e. Myriad MyChoice) are currently used to guide treatment selection in the maintenance setting. However, they are showing a limited predictive value, they are expensive and static, i.e. unable to capture the restoration of the HRR functionality, as a mechanism of drug resistance. Methods: We performed the functional and dynamic RAD51 test on 164 patients with high-grade serious OvC, enrolled in the MITO16A/MANGO OV2 trial and treated with first-line therapy containing carboplatin, paclitaxel, and bevacizumab. The RAD51 assay included the immunofluorescence of gH2AX (as a marker of Double Strand Breaks DNA damage), BRCA1 and RAD51 nuclear foci. Stromal Tumor Infiltrating Lymphocytes (TIL) by Immunohistochemistry, and gene expression profile were performed on the same samples. Results: RAD51 assay was informative on 70% (115/164) of the samples. On evaluable samples, median gH2AX score was 57%. BRCA1 foci by immunofluorescence were detected on 55% (49/112) of the samples; 45% (63/112) of the tumors did not show BRCA1 foci likely due to germline or somatic BRCA1 mutations, or BRCA1 promoter hypermethylation. RAD51 identified 69% (79/115) of all tumors as HRD, with a median RAD51 score of 8.8%. HRD tumors presented a statistically significantly higher TIL content than HRR-proficient ones (p = 0.03). Conclusions: Our preliminary results confirmed the feasibility of the RAD51 functional assay on primary untreated OvC. The association between HRD by RAD51 and TIL content encouraged to investigate the efficacy, in clinical trials, of the combination of PARPi and immune-checkpoint inhibitors on selected patients (i.e. HRD by RAD51 and TIL high). Gene expression profile and comparison of the HRD status by RAD51 and genomic HRD (both Myriad MyChoice and academic) and correlations with clinical outcomes will be available for the meeting.
Development of cervical cancer patient reported clinical outcome assessment scale (CC-PRO137): A dedicated tool for multidimensional evaluation of treatment outcomes.
Authors: Wu Xin , Qiu Ling , Zhu Shurong , Feng Hao , Wang Hui , Hou Yingchun , Zhang Tao , Luo Shen , Yu Hailin , Zhao Junda , Li Ming , You Yanan , Qiao Danze , Ruan Yuanyuan , Du Yan , Jiang Hua 
Published: June 2023

5537 Background: Worldwide, cervical cancer ranks fourth among female malignant tumors in terms of both incidence and mortality. In addition, there is an increasing trend of cervical cancer incidence among younger women. Since the uterus is located at the center of vascular-neural traffic of the pelvic floor, cervical cancer surgery may damage the function of multiple systems such as urinary, digestive, neurological, endocrine, and pelvic floor muscles, and further lead to short- and long-term effects in the psychological domain including sexual status, anxiety, and depression. Therefore, we developed the current scale, Cervical Cancer Patient Reported Clinical Outcome Assessment Scale (CC-PRO137), aimed to construct a functional patient self-report system scale to conveniently and accurately quantify the quality of life of cervical cancer patients from multiple dimensions. Methods: Items included in the scale were proposed by gynecologic oncologist, and were evaluated and modified by experts in various specialties. This scale (CC-PRO137) includes 3 domains and 13 modules, including physiological systems, psychological related symptoms, social life status. A total of 304 participants were tested within 6 and 12 months postoperatively. Subgroup analyses were carried out for different time period, stages, surgical methods and adjuvant treatment plans. Results: The reliability analysis showed that the Cronbach's α in each module of the physiological domain was between 0.602-0.929, the composite reliability was between 0.226-0.946, and the test-retest reliability was between 0.660-0.829; the Cronbach’s α of the psychological domain were between 0.700-0.940, the composite reliability was between 0.584-0.950, and the test-retest reliability was between 0.697-0.807; the Cronbach’s α of the social domain was between 0.836-0.861, the composite reliability was between 0.777-0.886, the test-retest reliability was between 0.732-0.792, and the reliability of each module was optimal. The content validity adopted the expert judgment. Convergent validity (CV) analysis showed that the average variance extraction of each module in the physiological domain was between 0.382-0.706, in the psychological domain was between 0.433-0.801, and in the social domain was 0.440-0.616. The convergent validity of each module was acceptable. Conclusions: Our results showed the effectiveness of CC-PRO137 as a comprehensive assessment tool for cervical cancer patients' quality of life, suggesting that the scale can accurately measure subtle changes postoperatively. CC-PRO137 can be a useful tool to quantitatively assess cervical cancer patients.
SEER analysis of 9-year breast cancer specific mortality (BCSM) in patients (pts) with invasive lobular breast cancer (ILC) assessed by the 21-gene Breast Recurrence Score assay.
Authors: Geyer Charles E. , Bennett John , Tang Gong , Racz Jennifer M. , Russell Christy Ann , Byun Jung S. , Foldi Julia , Baehner Frederick L. , Petkov Valentina I. 
Published: June 2023

554 Background: Linking of the results of the 21-gene Breast Recurrence Score (RS) commercial assay to SEER registries provides opportunity to assess real world prognostic performance of the assay in important subgroups of early breast cancer (BC). ILC is less common than invasive ductal carcinoma (IDC) and the performance of the RS assay in ILC is of interest. The relationship between RS results and 5-year BCSM in patients with ILC was reported based on a linkage in 2015 at this meeting in 2017. Here we present a comparison of 9-year BCSM of ILC vs IDC from a linkage update in 2019. These results will be updated further based on a new linkage of RS data to be completed in April 2023. Methods: Eligible pts had 0-3 axillary nodes at initial surgery, were hormone receptor positive and HER2-negative with a RS result, had no prior malignancy, and were diagnosed between January 2004 and December 2012. Pts with ICD-O-3 code 8520 were categorized as ILC and those with code 8500 as IDC. 9-year BCSM of both cohorts was estimated using actuarial methods. Multivariable Cox proportional hazards models characterized association between RS results and BCSM. Results: Of 89818 pts, 9835 (11.0%) had ILC and 64669 (72.0%) had IDC. Among pts with ILC, median age was 60 years; 12.5% were N1 and 28.4%, 63.7% and 7.9% were grade 1, 2 and 3. Median follow-up was 84 months. Chemotherapy (CT) use and BCSM increased with increasing RS result in both cohorts. After adjusting for age, race, tumor grade, tumor size, nodal status, and histologic subtype, the RS result was independently associated with BCSM ( p < .001) in both ILC and IDC. Conclusions: In this linked SEER analysis of pts with ILC or IDC, the RS results were prognostic for 9-year BCSM, regardless of nodal status. [Table: see text]
Correlating expression of NaPi2b and FRa in high grade serous ovarian cancer (HGSOC).
Authors: Richardson Debra L. , Barve Minal A. , Hamilton Erika P. , Taylor Sara Kristina , Anderson Charles K , Buscema Joseph , Huang Marilyn , Arend Rebecca Christian , Hays John L. , Thaker Premal H. , Lakhani Nehal J. , Mosher Rebecca , Shaw Pamela , Bradshaw Chelsea , Lu Min 
Published: June 2023

5545 Background: Biomarker driven therapies are increasingly being used for gynecologic cancers, with mirvetuximab soravtansine, a Folate Receptor alpha (FRa) targeting antibody drug conjugate (ADC) being a recent FDA approved agent for patients with FRa positive PROC. Uptifitamab rilsodotin (UpRi) is a late-stage, first in class NaPi2b-targeting ADC with a novel scaffold-linker-payload that enables high drug to antibody ratio and a controlled bystander effect. Approximately 29% of HGSOC patients have FRa positive tumors (Roche VENTANA FOLR1 (FOLR-2.1) RxDx Assay. USPI 2022); ~59% have NaPi2b positive tumors (Okeke et al, USCAP 2022). With the high unmet medical need in PROC and the evolving landscape of available treatments, understanding biomarker expression and correlation between FRa and NaPi2b is critical. Here we evaluate NaPi2b and FRa RNA expression correlation in HGSOC. Methods: Tumor samples (N=84) from the Ph1b UpRi expansion (EXP) cohort were analyzed via Nanostring (770 immune-focus genes from IO 360 panel + 30 customized ADC-related genes) to evaluate the association between NaPi2b and FRa expression. The cutoff for NaPi2b RNA positive or negative was based on approximately 60% of HGSOC patients having NaPi2b positive tumors (top 60% of samples based on expression deemed NaPi2b positive; bottom 40% NaPi2b negative) and FRa RNA cutoff assumed that ~30% of samples were FRa positive. To correlate the NaPi2b expression level between RNA and IHC, the N=84 samples with known expression levels via IHC were analyzed via Nanostring. Results: When evaluating NaPi2b and FRa RNA expression correlation, 21% (N=18) of samples had both NaPi2b positive and FRa positive expression. 38% (N=32) samples were NaPi2b positive and FRa negative. No statistically significant association was observed (Chi-squared test, p=0.129). NaPi2b RNA and IHC expression was evaluated; a statistically significant association was observed (Kappa statistic, p=0.001). Results are in the Table below. Conclusions: Based on this analysis of a limited sample size, there does not appear to be an association between FRa and NaPi2b expression, with the majority of NaPi2b positive samples not being FRa positive. Additionally, general NaPi2b prevalence and the correlation of expression between RNA and IHC suggest that NaPi2b may be a rational biomarker to integrate in RNA tumor panel testing. This research underscores the importance of early, comprehensive testing of all relevant biomarkers to guide therapy selection, and suggests that additional research is needed to evaluate the potential association between FRa and NaPi2b expression via IHC. [Table: see text]
The impact of adjuvant platinum-based chemotherapy in early adult granulosa cell tumor of the ovaries: A meta-analysis of comparative studies.
Authors: Keerty Dinesh , Devarashetty Sindhu Priya , Haddad Philip A. 
Published: June 2023

5547 Background: Adult granulosa cell tumors (AGCT) are the most common type of malignant ovarian sex chord stromal tumors but only comprise 2 to 5 percent of all malignant ovarian neoplasms. Most granulosa cell tumors have an indolent growth pattern, and prognosis depends on the disease stage at diagnosis and the presence of residual disease after surgery. Though these tumors have metastatic potential, their tendency for late relapses is well documented. Despite the lack of supporting data, the National Cancer Centers Network recommends platinum-based adjuvant chemotherapy (AC) for Stage I with intermediate and high-risk features. Most studies have failed to show any benefit of AC with disease-free or overall survival. However, several of these studies were small, and some had short median follow-ups. Others included advanced stages and the juvenile variant of the disease. Therefore, we conducted this meta-analysis to evaluate the impact of AC on disease recurrence in a stage I enriched AGCT. Methods: A review of the medical literature was conducted using online databases. Inclusion criteria consisted of English language, diagnosis of AGCT, studies with a preponderance of stage I, comparative studies of AC versus none, and studies that reported recurrence rates. Studies that had a preponderance of advanced stages or juvenile variants were excluded. A meta-analysis using the fixed effects and random effects models was conducted. Results: Seven retrospective comparative studies with a total of 500 patients were included. The average median age was 47 years, and the average median follow-up was 58 months. Approximately 79% of the sample were stage I, and 79% of stage I were IC. Most AC regimens used were BEP and EP, though it varied among the regions. Platinum-based AC in early-stage AGCT failed to impact recurrence rates compared to clinical observation (HR=1.39, 95%CI 0.86-2.25, I2=48%, p=0.18). Conclusions: This is the first meta-analysis to show that adding platinum-based adjuvant chemotherapy to surgery does not improve the recurrence rate in early AGCT. Therefore, in the absence of evidence supporting any benefit of AC in this disease, recommendations to use AC should be re-evaluated, especially since the risk of platinum-based AC with or without Bleomycin is well-documented and carry potentially serious side effects.
Venous thromboembolism prophylaxis during neoadjuvant chemotherapy for patients with ovarian cancer.
Authors: McLaughlin Hannah Dysinger , Straubhar Alli M. , Rolston Aimee , McCool Kevin , Brackmann Melissa , Siedel Jean Hansen , McLean Karen , Reynolds R. Kevin , Uppal Shitanshu 
Published: June 2023

5552 Background: The primary objective was to assess the rate of venous thromboembolism (VTE) in patients with ovarian cancer who received neoadjuvant chemotherapy (NACT) following a quality improvement (QI) intervention of routine pharmacologic VTE prophylaxis compared to patients that did not receive prophylaxis. Methods: This is a retrospective cohort study of patients with pathologically confirmed ovarian cancer that received NACT between January 2009 to December 2021 from a single institution. Patients were excluded if VTE was diagnosed prior to initiating NACT. Routine pharmacologic VTE prophylaxis during NACT started in January 2017 following a QI initiative. VTE events were diagnosed by doppler scan of extremities or computed tomography of the chest ordered for symptomatic patients or diagnosed incidentally on routine treatment imaging. Patient factors and perioperative variates of interest were investigated for their association with VTE events through univariate and multivariate models. Results: A total of 290 patients with ovarian cancer received NACT and were included, with 106 of 290 patients (36.5%) receiving pharmacologic prophylaxis during NACT. Rate of VTE prophylaxis prior to the QI intervention was 3.68% (n=5) compared to 65.58% (n=101) after. The rate of VTE during NACT was 11.41% (n=21) without prophylaxis and 2.83% (n=3) with prophylaxis (p=0.013) (Table). The rate of any VTE event from the start of NACT through adjuvant chemotherapy was 20.11% (n=37) without prophylaxis and 4.72% (n=5) with prophylaxis (p<0.01). There was no difference in adverse bleeding events in those that received prophylaxis to those that did not (0% vs 1.32%, p=0.239). On univariate analysis, VTE prophylaxis was associated with a decreased risk of VTE during NACT (OR 0.23; 95% CI: 0.06-0.78) and any VTE during primary treatment (OR 0.19; 95% CI 0.07-0.52). On multivariate analysis, VTE prophylaxis remained significantly associated with reduced VTE rates during NACT and during primary treatment (p=0.02 and p=0.001, respectively). Conclusions: Routine administration of pharmacologic VTE prophylaxis during NACT for patients with ovarian cancer is associated with reduced risk of VTE during NACT and throughout primary treatment and is not associated with adverse bleeding events. [Table: see text]