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Fertility preserving treatment for gynecologic malignancies: a review of recent literature
Purpose of review A significant number of women diagnosed with a gynecologic malignancy meet criteria for fertility-sparing treatment. Women are continuing to delay childbearing; the importance of fertility-sparing therapy is, therefore, increasing. It is imperative that physicians understand the options for, and limitations of, these treatments. Recent findings Recent research has demonstrated improved outcomes for endometrial cancer by adding targeted hysteroscopic resection to progestin therapy. Cervical cancer research has focused on oncologic and pregnancy outcomes following management with radical trachelectomy,...
Source: Current Opinion in Obstetrics and Gynecology - January 3, 2020 Category: OBGYN Tags: GYNECOLOGIC CANCER: Edited by Gottfried E. Konecny Source Type: research

Endometrial cancer in the morbidly obese: a review
This article also reviews bariatric surgery and endometrial cancer as well as new updates in radiation, chemotherapy and hormonal therapy research in the obese population. Summary The current article reviews therapeutics and surgery in the morbidly obese for the treatment of endometrial cancer. (Source: Current Opinion in Obstetrics and Gynecology)
Source: Current Opinion in Obstetrics and Gynecology - January 3, 2020 Category: OBGYN Tags: GYNECOLOGIC CANCER: Edited by Gottfried E. Konecny Source Type: research

Mechanisms of PARP inhibitor resistance in ovarian cancer
Purpose of review To summarize recently discovered PARP inhibitor resistance mechanisms and highlight the clinical relevance of these findings to date. Recent findings A predominant mechanism of acquired PARP inhibitor resistance in homologous recombination-deficient cancers is the acquisition of homologous recombination proficiency as a consequence of secondary genetic or epigenetic events, such as secondary mutations in BRCA1 or BRCA2, or reversal of BRCA1 promoter methylation that restores homologous recombination and leads to PARP inhibitor resistance. Multiple other potential mechanisms of acquired resistance to ...
Source: Current Opinion in Obstetrics and Gynecology - January 3, 2020 Category: OBGYN Tags: GYNECOLOGIC CANCER: Edited by Gottfried E. Konecny Source Type: research

Multimodality screening and prevention of cervical cancer in sub-Saharan Africa: a collaborative model
Purpose of review Although cervical cancer continues to decrease in incidence throughout the developed world because of rigorous screening and vaccination campaigns, the disease remains a major cause of cancer-related morbidity and mortality in resource-limited regions including sub-Saharan Africa. This review summarizes current efforts to implement cost-effective and widespread cervical cancer education, screening, and community-based interventions in Africa and the challenges faced by local healthcare workers. Recent findings Effective screening with cytology (with or without high-risk human papillomavirus [HPV] DNA...
Source: Current Opinion in Obstetrics and Gynecology - January 3, 2020 Category: OBGYN Tags: GYNECOLOGIC CANCER: Edited by Gottfried E. Konecny Source Type: research

Changing treatment landscape for early cervical cancer: outcomes reported with minimally invasive surgery compared with an open approach
Purpose of review The aim of the article is to review recent studies that compare the oncologic efficacy of minimally invasive radical hysterectomy with that of open radical hysterectomy. Recent findings The Laparoscopic Approach to Cervical Cancer (LACC) trial, a randomized study design to test the hypothesis that minimally invasive radical hysterectomy is not inferior to open radical hysterectomy, was stopped early by the data and safety monitoring committee after enrolling 631 of a planned 740 patients. The disease-free survival rate at 4.5 years was 86% among women assigned to minimally invasive surgery and 96.5% ...
Source: Current Opinion in Obstetrics and Gynecology - January 3, 2020 Category: OBGYN Tags: GYNECOLOGIC CANCER: Edited by Gottfried E. Konecny Source Type: research

Latest clinical evidence of maintenance therapy in ovarian cancer
Purpose of review To summarize the data supporting the use of maintenance therapy in ovarian cancer treatment. Recent findings Since December 2016, the United States Food and Drug Administration has approved four drugs for six different ovarian cancer maintenance indications based on the results of clinical trials demonstrating efficacy and tolerability. These include antiangiogenesis and poly (adenosine diphosphate-ribose) inhibitors (PARP inhibitors). Four drugs are approved for use in maintenance therapy for recurrent ovarian cancer, including bevacizumab (GOG-0213 and OCEANS), niraparib (NOVA), olaparib (Study 19 ...
Source: Current Opinion in Obstetrics and Gynecology - January 3, 2020 Category: OBGYN Tags: GYNECOLOGIC CANCER: Edited by Gottfried E. Konecny Source Type: research

New treatment standards for vulvar cancer 2020
Purpose of review To highlight the recent advances regarding molecular mechanisms and therapeutic strategies in vulvar squamous cell carcinoma (VSCC), a rare but continuously rising disease. Recent findings Clinical research focuses on deescalation especially with regard to surgery. Recurrence patterns have been analyzed to further understand the course of disease showing a persistent risk for local recurrence even several years after the initial diagnosis. The main focuses of recent translational research are the distinct molecular mechanisms behind human papillomavirus (HPV)-positive and -negative VSCC. Next-generat...
Source: Current Opinion in Obstetrics and Gynecology - January 3, 2020 Category: OBGYN Tags: GYNECOLOGIC CANCER: Edited by Gottfried E. Konecny Source Type: research

Optimizing immunotherapy for gynecologic cancers
Purpose of review This review will provide an update on the most recent clinical developments in immuno-oncology in advanced gynecologic cancers and will also highlight ongoing studies in this field. Recent findings Although immune checkpoint blockade (ICB) therapy is rapidly altering the treatment landscape in a myriad of solid tumors, the efficacy of ICB therapy with antibodies directed against CTLA-4, PD-1, and PD-L1 in advanced gynecologic cancers has been limited. The exception has been the PD-1 inhibitor pembrolizumab in microsatellite instability high (MSI-H) or mismatch repair-deficient (dMMR) advanced endomet...
Source: Current Opinion in Obstetrics and Gynecology - January 3, 2020 Category: OBGYN Tags: GYNECOLOGIC CANCER: Edited by Gottfried E. Konecny Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Obstetrics and Gynecology)
Source: Current Opinion in Obstetrics and Gynecology - January 3, 2020 Category: OBGYN Tags: EDITORIAL INTRODUCTIONS Source Type: research

Old wine into new wineskins: an update for female stress urinary incontinence
Purpose of review To review minimally invasive modifications of traditional surgeries for female stress urinary incontinence (SUI) in light of increased demand. Recent findings Prior to the synthetic mid-urethral sling (MUS), traditional procedures were used to correct SUI. Often these were retropubic colposuspension procedures for a hypermobile urethra and fascial slings for sphincter deficiency but fell out of favor because of increased morbidity compared with synthetic MUS. As controversy rages over use of mesh in female pelvic reconstructive surgery, more women desire nonmesh alternatives. Traditional approaches h...
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: UROGYNECOLOGY: Edited by Kavita Mishra Source Type: research

Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women
Purpose of review To describe the principles of pelvic floor physical therapy (PFPT), review the evidence for PFPT as a treatment for pelvic floor dysfunction, and summarize the current recommendations for PFPT as a first-line conservative treatment option for pelvic floor disorders. Recent findings Pelvic floor dysfunction can cause voiding and defecation problems, pelvic organ prolapse (POP), sexual dysfunction, and pelvic pain. PFPT is a program of functional retraining to improve pelvic floor muscle strength, endurance, power, and relaxation in patients with pelvic floor dysfunction. Based on the available evidenc...
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: UROGYNECOLOGY: Edited by Kavita Mishra Source Type: research

Historic transvaginal meshes and procedures: what did my patient have done?
Purpose of review Transvaginal mesh kits were widely used to treat pelvic organ prolapse for over a 10-year period in the early 2000s. Due to safety concerns and FDA regulations, these mesh kits are no longer available for use. Thus, current Obstetricians and Gynecologists are likely to encounter these meshes, but may have no previous experience or exposure to the devices making it difficult to adequately monitor, counsel, and care for patients that underwent these types of procedures. This review highlights the most commonly used transvaginal mesh kit types, provides insight into signs and symptoms related to transvagin...
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: UROGYNECOLOGY: Edited by Kavita Mishra Source Type: research

Asymptomatic microscopic hematuria in women
Purpose of review The purpose of this review is to summarize the problem of asymptomatic microscopic hematuria (AMH) in women and the most recent publications on the topic. Recent findings Urologic malignancy is rarely associated with AMH in low-risk women. Screening for urologic malignancy includes upper urinary tract imaging and cystoscopy. Renal ultrasound is a cost-effective first-line imaging modality in patients with AMH. Multiphasic computed tomography (CT) urography increases healthcare costs, the risk of secondary malignancy due to cumulative radiation exposure, and the discovery of incidental benign findings...
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: UROGYNECOLOGY: Edited by Kavita Mishra Source Type: research

Injectable contraception: emerging evidence on subcutaneous self-administration
Purpose of review Injectable contraception is a widely available and popular family planning method globally. It has evolved to allow for subcutaneous self-injection (DMPA-SC, Depo medroxyprogesterone acetate-subcutaneous). In this review, we will focus on research evaluating DMPA-SC, with specific regard to continuation rates, safety, and satisfaction among users. Recent findings Emerging evidence from the United States, Malawi, Uganda, and Senegal has established safety and higher continuation rates among self-inject users, compared with provider-inject users. Continuation is 10–28% higher among DMPA-SC self-injec...
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: FAMILY PLANNING: Edited by Paul D. Blumenthal Source Type: research

Mobile technology for family planning
Purpose of review To evaluate the recent literature on mobile health applications available to patients for contraception and abortion care. Recent findings Women are increasingly interested in contraceptive tools utilizing mobile technology, and a majority of women expect them to be science-based. The largest number of available mobile apps supports natural family planning methods, which is recognized as the least effective contraceptive method. Many available apps cannot be relied on for accurate, science-based pregnancy prevention methods. Further, there is a paucity of data regarding use of mobile technology for w...
Source: Current Opinion in Obstetrics and Gynecology - November 8, 2019 Category: OBGYN Tags: FAMILY PLANNING: Edited by Paul D. Blumenthal Source Type: research