Background The incidence of metastatic breast cancer is rising, but few studies have analyzed Asian American women with a focus on screening and obesity rates.Methods Data from the U.S. Cancer Statistics were examined for trends and incidence rates of breast cancer. Using the Center for Disease Control data mammogram compliance and obesity rates in Asian women were analyzed.Results Over our 18-year study period, the incidence of postmenopausal metastatic breast cancer increased by 2.19% annually in Asian women compared to only 1.03% in White women. Asians also had higher rates of mammogram non-compliance compared to other racial groups. Of Asians, the rates of obesity in postmenopausal women were highest in those aged 65–74 years.Conclusions Compared to other races, Asians have the highest increase in the incidence of metastatic breast cancer with lower rates of screening mammograms. Further research is needed to better understand these disparities.
e18765 Background: An estimated 94,000 women have newly diagnosed gynecologic cancer (ovarian, uterine, cervical, and vulvovaginal) annually–with rates increasing over the last 20 years. Surgical site infections (SSIs) complicate up to 4% of all hysterectomies in the United States. Other surgical sequelae, such as operative length, estimated blood loss, wound dehiscence, and 30-day readmission, further complicate the post-surgical course of this vulnerable population. Methods: A quality improvement initiative was conducted in a large academic health system between January to June 2022 to investigate whether implementing an SSI bundle, defined as a set of 11 evidence-based practices performed collaboratively, can reduce intraoperative and postoperative complications. The study population included women who received gynecologic oncologic surgery. To evaluate trends following the implementation of an SSI prevention bundle, we studied two time periods: 1/1/22-3/31/22 and 4/1/22-6/30/22. Trends were analyzed using chi-squared and a two-sample t-test. Results: Over our six-month study period, 233 patients underwent primary gynecologic oncologic surgery. Robotic-assisted hysterectomies were the most common (27.89%, n = 65), followed by total abdominal hysterectomies (21%, n = 49), laparoscopic hysterectomies (7.72%, n = 18), and supracervical hysterectomies (3%, n = 7). An invasive, abdominal approach was needed for less than half of the surgeries for whom intraoperative and postoperative outcomes were measured (46.35%, n = 108). Following the implementation of our SSI bundle, there was a rise in estimated blood loss (134.49 to 252.67 mL), operative length (199.24 to 227.23 min), and length of stay (1.58 to 2.20 days). Yet, there was a decline in the SSI rate from 4.62% to 3.7% (p = 0.97) and 30-day all-cause readmission from 12.96% to 7.4% (p < 0.05). The overall incidence of 30-day wound dehiscence also declined over six months from 3.7% to 1.85% (p = 0.74). Upon intersectional analysis, patients with SSI were older (55.93 vs. 62, p = 0.39) and were more likely to be obese (BMI 27.04 vs. 31.06, p < 0.05). Individuals with functional status limitations, ECOG score > 2, had longer lengths of stays (4.7 vs. 1.76 days, p < 0.05), estimated blood loss (230 vs. 185.9 mL, p = 0.12), and operative length (374 vs. 205.2 min, p < 0.001). Those with a supracervical hysterectomy also had a longer length of stays (4 days, p < 0.05), blood loss (921.43 mL, p < 0.001), and operative lengths (315.14 min, p < 0.001). Conclusions: Following the implementation of an evidence-based SSI quality improvement project, cancer patients had fewer SSI, hospital readmissions, and wound dehiscence. High ECOG scores, supracervical hysterectomies, and obesity were all associated with worse postoperative outcomes. Prospective studies on postoperative surgical quality are needed to improve care for our most vulnerable patients.
Chinese were defined as individuals from Taiwan. SEER*Stat and Joinpoint regression programs were used for analyses.
Objectives One of the major changes in the revised 2018 FIGO-staging system is the addition of stage IIIC, which includes patients with pelvic and/or para-aortic lymph node metastases. Therefore, we evaluated the prognostic value of positive pelvic and/or para-aortic lymph nodes in patients with cervical cancer. Methods A nationwide retrospective cohort study was performed by identifying all patients diagnosed with stage IB-IVA between 2005-2018 from the Netherlands Cancer Registry. Data was converted to the FIGO 2018 stage based on the TNM-classification. 5-year and overall survival rates (OS) were estimated with the Kaplan-Meier method. Results Of the included 6,082 patients, 1,740 patients, had pelvic and/or para-aortic lymph node metastases. For patients with FIGO 2009 stage IB-IB1-IIA-IIA1 with pelvic and/or para-aortic lymph node metastases 5-year survival is 77% and OS is 70%, without lymph node metastases survival rates are 92% and 87% (p<0.001). For FIGO 2009 stage IB2-IIA2-IIB, with pelvic and/or para-aortic lymph node metastases 5-year survival is 67% and OS is 62%, without lymph node metastases survival rates are 74% and 65% (p=0.009). FIGO 2009 stage IIIA-IIIB and IVA survival rates are not significantly influenced by pelvic and/or para-aortic lymph node metastases (p=0.640, p=0.939). Patients with FIGO 2018 stage IIIC have a 5-year survival of 65% and OS of 59%. Conclusions Patients with FIGO 2009 stage IB-IB1-IIA-IIA1-IB2-IIA2-IIB cervical cancer with positive pelvic and/or paraaortic lymph node metastases have a significant impaired survival compared to patients without metastases. Survival rates of patients with FIGO 2009 stage IIIA-IIIB-IVA are not significant affected by lymph node metastases.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.