Sexuality and Body Image After Uterine Artery Embolization and Hysterectomy in the Treatment of Uterine Fibroids: A Randomized Comparison

In this paper the effect of uterine artery embolization (UAE) on sexual functioning and body image is investigated in a randomized comparison to hysterectomy for symptomatic uterine fibroids. The EMbolization versus hysterectoMY (EMMY) trial is a randomized controlled study, conducted at 28 Dutch hospitals. Patients were allocated hysterectomy (n = 89) or UAE (n = 88). Two validated questionnaires (the Sexual Activity Questionnaire [SAQ] and the Body Image Scale [BIS]) were completed by all patients at baseline, 6 weeks, and 6, 12, 18, and 24 months after treatment. Repeated measurements on SAQ scores revealed no differences between the groups. There was a trend toward improved sexual function in both groups at 2 years, although this failed to reach statistical significance except for the dimensions discomfort and habit in the UAE arm. Overall quality of sexual life deteriorated in a minority of cases at all time points, with no significant differences between the groups (at 24 months: UAE, 29.3%, versus hysterectomy, 23.5%; p = 0.32). At 24 months the BIS score had improved in both groups compared to baseline, but the change was only significant in the UAE group (p = 0.009). In conclusion, at 24 months no differences in sexuality and body image were observed between the UAE and the hysterectomy group. On average, both after UAE and hysterectomy sexual functioning and body image scores improved, but significantly so only after UAE

Saddle pulmonary embolus resulting in cardiovascular collapse requiring extracorporeal membrane oxygenation in a postoperative patient with endometrial cancer

Background: Venous thromboembolism after open gynecologic surgery is not uncommon, especially in the presence of other risk factors such as obesity, prolonged surgical time or gynecologic malignancy. Case: We present the case of a 62 y.o. patient who underwent open hysterectomy and surgical staging for uterine serous carcinoma. She was readmitted with lower extremity edema. During her workup, she underwent cardiovascular arrest secondary to saddle pulmonary embolus requiring cardiopulmonary resuscitation and extracorporeal membrane oxygenation. After systemic and catheter directed thrombolysis, and a long hospitalization, she was discharged home in stable condition. Conclusion: Saddle pulmonary embolus is a potentially catastrophic and fatal postoperative complication. This case demonstrates a successful implementation of directed thrombolysis, veno-arterial extracorporeal membrane oxygenation and multidisciplinary management in a case of postoperative saddle pulmonary embolus. Précis: We report a case of an endometrial cancer patient who sustained a massive postoperative pulmonary embolus and was successfully resuscitated using extracorporeal membrane oxygenation. Keywords: Pulmonary embolus, Extracorporeal membrane oxygenation, Thrombolysis, Endometrial cance

TP035/#1557 Phase 3 study assessing the efficacy of adding AL3818 (catequentinib dihydrochloride, anlotinib hydrochloride) to chemotherapies in subjects with platimum resistant and refractory ovarian carcinoma

ObjectivesAL 3818 is a novel, orally administered, small molecule tyrosine kinase inhibitor, that shows highly selective inhibition of fibroblast growth factor receptor (FGFR) and vascular endothelial growth factor receptor (VEGFR). The primary objective of this Phase 3 study is to evaluate the efficacy of AL3818 in combination with chemotherapy in patients with platinum resistant and refractory ovarian carcinoma.MethodsThe study is a phase 3, multi-center, randomized trial at 1:1 ratio with active control designed to evaluate the efficacy and safety of AL3818 plus background chemotherapy treatment (Active Arm) vs. background chemotherapy treatment alone (Control Arm), where one of three background treatments, weekly paclitaxel, pegylated liposomal doxorubicin (PLD), or topotecan is utilized. Patients with a diagnosis of platinum resistant or platinum refractory ovarian carcinoma requiring third line, or any further line treatment are eligible for enrollment. The regimen is a 21-day cycle with oral AL3818 at 8 mg administered on days 8–21, with days 1–7 off combining with one of the three chemotherapies in Active Arm. Maintenance monotherapy with AL3818 is an option if chemotherapy is discontinued. The primary objective of this study is to evaluate the efficacy between the Active Arm and Control Arm as measured by the primary endpoint of Progression Free Survival (PFS). The study is opening in US, UK, ES, IT and Asia. Clinical trial information: NCT02584478.ResultsThere are no available results at the time of submission.ConclusionsThere are no available results at the time of submission

The gynecologic oncology fellowship interview process: Challenges and potential areas for improvement

The application and interview process for gynecologic oncology fellowship is highly competitive, time-consuming and expensive for applicants. We conducted a survey of successfully matched gynecologic oncology fellowship applicants to assess problems associated with the interview process and identify areas for improvement. All Society of Gynecologic Oncology (SGO) list-serve members who have participated in the match program for gynecologic oncology fellowship were asked to complete an online survey regarding the interview process. Linear regression modeling was used to examine association between year of match, number of programs applied to, cost incurred, and overall satisfaction. Two hundred and sixty-nine eligible participants reported applying to a mean of 20 programs [range 1–45] and were offered a mean of 14 interviews [range 1–43]. They spent an average of $6000 [$0–25,000], using personal savings (54%), credit cards (50%), family support (12%) or personal loans (3%). Seventy percent of respondents identified the match as fair, and 93% were satisfied. Interviewees spent a mean of 15 [0–45] days away from work and 37% reported difficulty arranging coverage. Linear regression showed an increase in number of programs applied to and cost per applicant over time (p < 0.001) between 1993 and 2016. Applicants who applied to all available programs spent more (p < 0.001) than those who applied to programs based on their location or quality. The current fellowship match was identified as fair and satisfying by most respondents despite being time consuming and expensive. Suggested alternative options included clustering interviews geographically or conducting preliminary interviews at the SGO Annual Meeting