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Improving survival after endometrial cancer: the big picture
Janice S.Kwon 대한부인종양학회 2015 Journal of Gynecologic Oncology Vol.26 No.3
To improve survival in women with endometrial cancer, we need to look at the "big picture" beyond initial treatment. Although the majority of women will be diagnosed with early stage disease and are cured with surgery alone, there is a subgroup of women with advanced and high-risk early stage disease whose life expectancy may be prolonged with the addition of chemotherapy. Immunohistochemistry will help to identify those women with Lynch syndrome who will benefit from more frequent colorectal cancer surveillance and genetic counseling. If they happen to be diagnosed with colorectal cancer, this information has an important therapeutic implication. And finally, because the majority of women will survive their diagnosis of endometrial cancer, they remain at risk for breast and colorectal cancer, so these women should be counselled about screening for these cancers. These three interventions will contribute to improving the overall survival of women with endometrial cancer.
Hinkle, Janice L.,Becker, Kyra J.,Kim, Jong S.,Choi-Kwon, Smi,Saban, Karen L.,McNair, Norma,Mead, Gillian E. American Heart Association, Inc. 2017 Stroke Vol.48 No.7
<P>At least half of all stroke survivors experience fatigue; thus, it is a common cause of concern for patients, caregivers, and clinicians after stroke. This scientific statement provides an international perspective on the emerging evidence surrounding the incidence, prevalence, quality of life, and complex pathogenesis of poststroke fatigue. Evidence for pharmacological and nonpharmacological interventions for management are reviewed, as well as the effects of poststroke fatigue on both stroke survivors and caregivers.</P>
Bone health after RRBSO among BRCA1/2 mutation carriers: a population-based study
Helena Abreu do Valle,Paramdeep Kaur,Janice S. Kwon,Rona Cheifetz,Lesa Dawson,Gillian E. Hanley 대한부인종양학회 2022 Journal of Gynecologic Oncology Vol.33 No.4
Objective: Examine the risks of fractures and osteoporosis after risk-reducing bilateral salpingo-oophorectomy (RRBSO) among women with mutations. Methods: In this retrospective population-based study in British Columbia, Canada, between 1996 to 2017, we compared risks of osteoporosis and fractures among women withmutations who underwent RRBSO before the age of 50 (n=329) with two age-matched groups without known mutations: 1) women who underwent bilateral oophorectomy (BO) (n=3,290); 2) women with intact ovaries who had hysterectomy or salpingectomy (n=3,290). Secondary outcomes were: having dual-energy X-ray absorptiometry (DEXA) scan, and bisphosphonates use. Results: The mean age at RRBSO was 42.4 years (range, 26–49) and the median follow-up for women with mutations was 6.9 years (range, 1.1–19.9). There was no increased hazard of fractures for women with mutations (adjusted hazard ratio [aHR]=0.80; 95% confidence interval [CI]=0.56–1.14 compared to women who had BO; aHR=1.02; 95% CI=0.65–1.61 compared to women with intact ovaries). Among women who had DEXA-scan, those with mutations had higher risk of osteoporosis (aHR=1.60; 95% CI=1.00–2.54 compared to women who had BO; aHR=2.49; 95% CI=1.44–4.28 compared to women with intact ovaries). Women with mutations were more likely to get DEXA-scan than either control groups, but only 46% of them were screened. Of the women withmutations diagnosed with osteoporosis, 36% received bisphosphonates. Conclusion: Women with mutations had higher risk of osteoporosis after RRBSO, but were not at increased risk of fractures during our follow-up. Low rates of DEXA-scan and bisphosphonates use indicate we can improve prevention of bone loss.