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RISS 인기검색어
- 검색키워드
- 저자 : Chad Michener (검색결과 3 건)
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Kathryn Maurer,Chad Michener,Haider Mahdi,Peter G. Rose 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.4
Objective: To report on the incidence of nab-paclitaxel hypersensitivity reactions (HSRs) inpatients with prior taxane HSR. Methods: From 2005 to 2015, all patients who received nab-paclitaxel for a gynecologicmalignancy were identified. Chart abstraction included pathology, prior therapy, indicationfor nab-paclitaxel, dosing, response, toxicities including any HSR, and reason fordiscontinuation of nab-paclitaxel therapy. Results: We identified 37 patients with gynecologic malignancies with a history of paclitaxelHSR who received nab-paclitaxel. Six patients (16.2%) had a prior HSR to both paclitaxel anddocetaxel while the other 31 patients had not received docetaxel. No patients experienced aHSR to nab-paclitaxel. Median number of cycles of nab-paclitaxel was 6 (range 2–20). Twelvepatients received weekly dosing at 60 to 100 mg/m2. The remainder of patients received 135mg/m2(n=13), 175 mg/m2(n=9), or 225 mg/m2(n=3). Thirty four patients (91.9%) receivedreceived nab-paclitaxel in combination with carboplatin (n=28, 75.7%), IP cisplatin (n=1,2.7%), carboplatin and bevacizumab (n=3, 8.1%), or carboplatin and gemcitabine (n=2,5.4%). Reasons for discontinuing nab-paclitaxel included completion of adjuvant therapy(n=16), progressive disease (n=18), toxicity (n=1), and death (n=1). There were no grade4 complications identified during nab-paclitaxel administration. Grade 3 complicationsincluded: neutropenia (n=9), thrombocytopenia (n=4), anemia (n=1), and neurotoxicity (n=1). Conclusion: Nab-paclitaxel is well-tolerated with no HSRs observed in this series of patientswith prior taxane HSR. Given the important role of taxane therapy in nearly all gynecologicmalignancies, administration of nab-paclitaxel should be considered prior to abandoningtaxane therapy
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Haider Mahdi,Amelia Jernigan,Benjamin Nutter,Chad Michener,Peter G. Rose 대한부인종양학회 2015 Journal of Gynecologic Oncology Vol.26 No.3
Objective: To investigate the rate, predictors of lymph node metastasis (LNM) and pattern of recurrence in clinically early stage endometrial cancer (EC) with positive lymphovascular space invasion (LVSI). Methods: Women with clinically early stage EC and positive LVSI 2005 to 2012 were identified. Kaplan-Meier curves and logistic regression models were used. Results: One hundred forty-eight women were identified. Of them, 25.7% had LNM (21.7% pelvic LNM, 18.5% para-aortic LNM). Among patients with LNM who had both pelvic and para-aortic lymphadenectomy, isolated pelvic, para-aortic and both LNM were noted in 51.4%, 17.1%, and 31.4% respectively. Age and depth of myometrial invasion were significant predictors of LNM in LVSI positive EC. Node positive patients had high recurrence rate (47% vs. 11.8%, p<0.05) especially distant (60.9% vs. 7.9%, p<0.001) and para-aortic (13.2% vs. 1.8%, p=0.017) recurrences compared to node negative EC. LNM was associated with lower progression-free survival (p=0.002) but not overall survival (p=0.73). Conclusion: EC with positive LVSI is associated with high risk of LNM. LNM is associated with high recurrence rate especially distant and para-aortic recurrences. Adjuvant treatments should target prevention of recurrences in these areas.
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Laura Moulton Chambers,Roberto Vargas,Chad M. Michener 대한부인종양학회 2019 Journal of Gynecologic Oncology Vol.30 No.3
Objective: To determine patterns among gynecologic oncologists in sentinel lymph node mapping (SLNM) for endometrial cancer (EC) and cervical cancer (CC). Methods: A online survey assessing the practice of SLNM, including incidence, patterns of usage, and reasons for non-use was distributed to Society of Gynecologic Oncology candidate and full members in August 2017. Descriptive statistics and univariate analysis was performed. Results: The 1,117 members were surveyed and 198 responses (17.7%) were received. Of the 70% (n=139) performing SLNM, the majority reported use for both CC and EC (64.0%) or EC alone (33.1%). In those using SLNM in EC, the majority (86.6%) performed SLNM in >50% of cases for all patients (56.3%), International Federation of Gynecology and Obstetrics grade 1 (43.0%) and 2 (42.2%). Reported benefits of SLNM in EC were reduced surgical morbidity (89.6%), lymphedema (85.2%), and operative time (63.7%). Among those using SLNM for CC, the majority (73.1%) did so in >50% of cases. In EC, 77.2% and 21.3% reported that micro-metastatic disease (0.2–2.0 cm) and isolated tumor cells (ITCs) should be treated as node positive, respectively. In those not using SLNM for EC (n=64) and CC (n=105), concerns were regarding efficacy of SLNM and lack of training. When queried regarding training, 73.7% felt that SLNM would impact skill in full lymphadenectomy (LND). Conclusion: The SLNM is utilized frequently among gynecologic oncologists for EC and CC staging. Common reasons for non-uptake include uncertainty of current data, lack of training and technology. Concerns exist regarding impact of SLNM in fellowship training of LND.
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