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  • 1
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    Online Resource
    Timing of interval debulking surgery and postoperative chemotherapy after neoadjuvant chemotherapy in advanced epithelial ovarian cancer: a multicenter real-world study
    Springer Science and Business Media LLC ; 2023
    In:  Journal of Ovarian Research Vol. 16, No. 1 ( 2023-06-27)
    Details
    In: Journal of Ovarian Research, Springer Science and Business Media LLC, Vol. 16, No. 1 ( 2023-06-27)
    Abstract: To investigate the prognostic relevance of the time to interval debulking surgery (TTS) and the time to postoperative adjuvant chemotherapy (TTC) after the completion of neoadjuvant chemotherapy (NACT). Methods A retrospective real-word study included 658 patients with histologically confirmed advanced epithelial ovarian cancer who received NACT at seven tertiary hospitals in China from June 2008 to June 2020. TTS was defined as the time interval from the completion of NACT to the time of interval debulking surgery (IDS). TTC was defined as the time interval from the completion of NACT to the initiation of postoperative adjuvant chemotherapy (PACT). Results The median TTS and TTC were 25 (IQR, 20–29) and 40 (IQR, 33–49) days, respectively. Patients with TTS  〉  25 days were older (55 vs. 53 years, P  = 0.012) and received more NACT cycles (median, 3 vs. 2, P  = 0.002). Similar results were observed in patients with TTC  〉  40 days. In the multivariate analyses, TTS and TTC were not associated with PFS when stratified by median, quartile, or integrated as continuous variables (all P   〉  0.05). However, TTS and TTC were significantly associated with worse OS when stratified by median ( P  = 0.018 and 0.018, respectively), quartile ( P  = 0.169, 0.014, 0.027 and 0.012, 0.001, 0.033, respectively), or integrated as continuous variables ( P  = 0.018 and 0.011, respectively). Similarly, increasing TTS and TTC intervals were associated with a higher risk of death ( P trend = 0.016 and 0.031, respectively) but not with recurrence ( P trend = 0.103 and 0.381, respectively). Conclusion The delays of IDS and PACT after the completion of NACT have adverse impacts on OS but no impacts on PFS, which indicates that reducing delays of IDS and PACT might ameliorate the outcomes of ovarian cancer patients treated with NACT.
    Type of Medium: Online Resource
    ISSN: 1757-2215
    URL: Article
    DOI: 10.1186/s13048-023-01164-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2455679-8
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  • 2
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    Oncological big data platforms for promoting digital competencies and professionalism in Chinese medical students: a cross-sectional study
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 9 ( 2022-09), p. e061015-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 9 ( 2022-09), p. e061015-
    Abstract: Advancements in big data technology are reshaping the healthcare system in China. This study aims to explore the role of medical big data in promoting digital competencies and professionalism among Chinese medical students. Design, setting and participants This study was conducted among 274 medical students who attended a workshop on medical big data conducted on 8 July 2021 in Tongji Hospital. The workshop was based on the first nationwide multifunction gynecologic oncology medical big data platform in China, at the National Union of Real-World Gynecologic Oncology Research & Patient Management Platform (NUWA platform). Outcome measures Data on knowledge, attitudes towards big data technology and professionalism were collected before and after the workshop. We have measured the four skill categories: doctor‒patient relationship skills, reflective skills, time management and interprofessional relationship skills using the Professionalism Mini-Evaluation Exercise (P-MEX) as a reflection for professionalism. Results A total of 274 students participated in this workshop and completed all the surveys. Before the workshop, only 27% of them knew the detailed content of medical big data platforms, and 64% knew the potential application of medical big data. The majority of the students believed that big data technology is practical in their clinical practice (77%), medical education (85%) and scientific research (82%). Over 80% of the participants showed positive attitudes toward big data platforms. They also exhibited sufficient professionalism before the workshop. Meanwhile, the workshop significantly promoted students’ knowledge of medical big data (p 〈 0.05 ), and led to more positive attitudes towards big data platforms and higher levels of professionalism. Conclusions Chinese medical students have primitive acquaintance and positive attitudes toward big data technology. The NUWA platform-based workshop may potentially promote their understanding of big data and enhance professionalism, according to the self-measured P-MEX scale.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2022-061015
    DOI: 10.1136/bmjopen-2022-061015.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2599832-8
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  • 3
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    Development and validation of a nomogram to predict overall survival of epithelial ovarian cancer patients: a population-based study (381)
    Elsevier BV ; 2022
    In:  Gynecologic Oncology Vol. 166 ( 2022-08), p. S194-S195
    Details
    In: Gynecologic Oncology, Elsevier BV, Vol. 166 ( 2022-08), p. S194-S195
    Type of Medium: Online Resource
    ISSN: 0090-8258
    URL: Article
    DOI: 10.1016/S0090-8258(22)01603-1
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 1467974-7
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  • 4
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    Does the primary treatment sequence affect post‐relapse survival in recurrent epithelial ovarian cancer? A real‐world multicentre retrospective study
    Wiley ; 2022
    In:  BJOG: An International Journal of Obstetrics & Gynaecology Vol. 129, No. S2 ( 2022-11), p. 70-78
    Details
    In: BJOG: An International Journal of Obstetrics & Gynaecology, Wiley, Vol. 129, No. S2 ( 2022-11), p. 70-78
    Abstract: To explore the impact of the primary treatment sequence (primary debulking surgery, PDS, versus neoadjuvant chemotherapy and interval debulking surgery, NACT‐IDS) on post‐relapse survival (PRS) and recurrence characteristics of recurrent epithelial ovarian cancer (REOC). Design Real‐world retrospective study. Setting Tertiary hospitals in China. Population A total of 853 patients with REOC at International Federation of Gynaecology and Obstetrics stages IIIC–IV from September 2007 to June 2020. Overall, 377 and 476 patients received NACT‐IDS and PDS, respectively. Methods Propensity score‐based inverse probability of treatment weighting (IPTW) was performed to balance the between‐group differences. Main Outcome Measures Clinicopathological factors related to PRS. Results The overall median PRS was 29.3 months (95% CI 27.0–31.5 months). Multivariate analysis before and after IPTW adjustment showed that NACT‐IDS and residual R1/R2 disease were independent risk factors for PRS ( p   〈  0.05). Patients with diffuse carcinomatosis and platinum‐free interval (PFI) ≤ 12 months had a significantly worse PRS ( p   〈  0.001). Logistic regression analysis revealed that NACT‐IDS was an independent risk factor for diffuse carcinomatosis (OR 1.36, 95% CI 1.01–1.82, p  = 0.040) and PFI ≤ 12 months (OR 1.59, 95% CI 1.08–2.35, p  = 0.019). In IPTW analysis, NACT‐IDS was still significantly associated with diffuse carcinomatosis (OR 1.29, 95% CI 1.05–1.58, p  = 0.015) and PFI ≤ 12 months (OR 1.90, 95% CI 1.52–2.38, p   〈  0.001). Conclusions The primary treatment sequence may affect the PRS of patients with REOC by altering the recurrence pattern and PFI duration.
    Type of Medium: Online Resource
    ISSN: 1470-0328 , 1471-0528
    URL: Issue
    URL: Article
    DOI: 10.1111/bjo.v129.s2
    DOI: 10.1111/1471-0528.17329
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2036469-6
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  • 5
    Online Resource
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    The first Chinese National Union of Real‐world Gynaecological Oncology Research and Patient Management Platform: A retrospective study
    Wiley ; 2022
    In:  BJOG: An International Journal of Obstetrics & Gynaecology Vol. 129, No. S2 ( 2022-11), p. 60-69
    Details
    In: BJOG: An International Journal of Obstetrics & Gynaecology, Wiley, Vol. 129, No. S2 ( 2022-11), p. 60-69
    Abstract: To produce high‐quality, real‐world evidence for oncologists by collating scattered gynaecologic oncology (GO) medical records in China. Design Retrospective study. Setting The National Union of Real‐world Gynaecological Oncology Research and Patient Management Platform (NUWA platform). Sample Patient‐centred data pool. Methods The NUWA platform integrated inpatient/outpatient clinical, gene and follow‐up data. Data of 11 456 patients with ovarian cancer (OC) were collected and processed using 91 345 electronic medical records. Structured and unstructured data were de‐identified and re‐collated into a patient‐centred data pool using a predefined GO data model by technology‐aided abstraction. Main Outcome Measures Recent treatment pattern shifts towards precision medicine for OC in China. Results Thirteen first‐tier hospitals across China participated in the NUWA platform up to 7 December 2021. In total, 3504 (30.59%) patients were followed up by a stand‐alone patient management centre. The percentage of patients undergoing breast cancer gene ( BRCA ) mutation tests increased by approximately six‐fold between 2017 and 2018. A similar trend was observed in the administration rate of poly(ADP‐ribose) polymerase inhibitors as first‐line treatment and second‐line treatment after September 2018, when olaparib was approved for clinical use in China. Conclusion The NUWA platform has great potential to facilitate clinical studies and support drug development, regulatory reviews and healthcare decision‐making.
    Type of Medium: Online Resource
    ISSN: 1470-0328 , 1471-0528
    URL: Issue
    URL: Article
    DOI: 10.1111/bjo.v129.s2
    DOI: 10.1111/1471-0528.17328
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2036469-6
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  • 6
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    Sintilimab combined with bevacizumab in relapsed/persistent ovarian clear cell carcinoma (INOVA): an investigator-initiated, multicentre clinical trial—a study protocol of clinical trial
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 5 ( 2022-05), p. e058132-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 5 ( 2022-05), p. e058132-
    Abstract: Ovarian clear cell carcinoma (OCCC) has an abysmal prognosis with a median overall survival (OS) of 25.3 months because of a low response to chemotherapy. The 5-year disease-specific survival rate after recurrence is 13.2%, with more than two-thirds of the patients dying within a year. Therefore, it is urgent to explore new therapeutic options for OCCC. Based on the characteristic immune-suppressive tumour microenvironment derived from the gene expression profile of OCCC, the combination of immunoantiangiogenesis therapy might have certain efficacy in recurrent/persistent OCCC. This trial aims to evaluate the efficacy and safety of sintilimab and bevacizumab in patients who have failed platinum-containing chemotherapy with recurrent or persistent OCCC. Method and analysis In this multicentre, single-arm, open-label, investigator-initiated clinical trial, 38 patients will be assigned to receive sintilimab 200 mg plus bevacizumab 15 mg/kg every 3 weeks. The eligibility criteria include histologically diagnosed patients with recurrent or persistent OCCC who have been previously treated with at least one-line platinum-containing chemotherapy; patients with Eastern Cooperative Oncology Group (ECOG) performance status 0–2 with an expected survival greater than 12 weeks. The exclusion criteria include patients previously treated with immune checkpoint inhibitor and patients with contraindications of bevacizumab and sintilimab. The primary endpoint is the objective response rate. The secondary endpoints are progression-free survival, time to response, duration of response, disease control rate, OS, safety and quality of life. Statistical significance was defined as p 〈 0.05. Ethics and dissemination This trial was approved by the Research Ethics Commission of Tongji Medical College of Huazhong University of Science and Technology (2020-S337). The protocol of this study is registered at www.clinicaltrials.gov . The trial results will be published in peer-reviewed journals and at conferences. Trial registration number NCT04735861 ; Clinicaltrials. gov.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2021-058132
    Language: English
    Publisher: BMJ
    Publication Date: 2022
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  • 7
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    Development and validation of a nomogram to predict cancer-specific survival of mucinous epithelial ovarian cancer after cytoreductive surgery
    Springer Science and Business Media LLC ; 2023
    In:  Journal of Ovarian Research Vol. 16, No. 1 ( 2023-06-27)
    Details
    In: Journal of Ovarian Research, Springer Science and Business Media LLC, Vol. 16, No. 1 ( 2023-06-27)
    Abstract: Mucinous epithelial ovarian cancer (mEOC) is a relatively uncommon subtype of ovarian cancer with special prognostic features, but there is insufficient research in this area. This study aimed to develop a nomogram for the cancer-specific survival (CSS) of mEOC based on Surveillance, Epidemiology, and End Results (SEER) database and externally validate it in National Union of Real World Gynecological Oncology Research and Patient Management (NUWA) platform from China. Methods Patients screened from SEER database were allocated into training and internal validation cohort in a ratio of 7: 3, with those from NUWA platform as an external validation cohort. Significant factors selected by Cox proportional hazard regression were applied to establish a nomogram for 3-year and 5-year CSS. The performance of nomogram was assessed by concordance index, calibration curves and Kaplan-Meier (K-M) curves. Results The training cohort (n = 572) and internal validation cohort (n = 246) were filtered out from SEER database. The external validation cohort contained 186 patients. Baseline age, tumor stage, histopathological grade, lymph node metastasis and residual disease after primary surgery were significant risk factors ( p   〈  0.05) and were included to develop the nomogram. The C-index of nomogram in training, internal validation and external validation cohort were 0.869 (95% confidence interval [CI], 0.838-0.900), 0.839 (95% CI, 0.787–0.891) and 0.800 (95% CI, 0.738–0.862), respectively. The calibration curves of 3-year and 5-year CSS in each cohort showed favorable agreement between prediction and observation. K-M curves of different risk groups displayed great discrimination. Conclusion The discrimination and goodness of fit of the nomogram indicated its satisfactory predictive value for the CSS of mEOC in SEER database and external validation in China, which implies its potential application in different populations.
    Type of Medium: Online Resource
    ISSN: 1757-2215
    URL: Article
    DOI: 10.1186/s13048-023-01213-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2455679-8
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