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2.
PLoS One ; 17(8): e0271679, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35925976

RESUMEN

OBJECTIVE: In Botswana, cervical cancer is the leading cause of cancer death for females. With limited resources, Botswana is challenged to ensure equitable access to advanced cancer care. Botswana's capital city, Gaborone, houses the only gynecologic oncology multi-disciplinary team (MDT) and the one chemoradiation facility in the country. We aimed to identify areas where fewer women were presenting to the MDT clinic for care. METHODS: This cross-sectional study examined cervical cancer patients presenting to the MDT clinic between January 2015 and March 2020. Patients were geocoded to residential sub-districts to estimate age-standardized presentation rates. Global Moran's I and Anselin Local Moran's I tested the null hypothesis that presentation rates occurred randomly in Botswana. Community- and individual-level factors of patients living in sub-districts identified with higher (HH) and lower (LL) clusters of presentation rates were examined using ordinary least squares with a spatial weights matrix and multivariable logistic regression, respectively, with α level 0.05. RESULTS: We studied 990 patients aged 22-95 (mean: 50.6). Presentation rates were found to be geographically clustered across the country (p = 0.01). Five sub-districts were identified as clusters, two high (HH) sub-district clusters and three low (LL) sub-district clusters (mean presentation rate: 35.5 and 11.3, respectively). Presentation rates decreased with increased travel distance (p = 0.033). Patients residing in LL sub-districts more often reported abnormal vaginal bleeding (aOR: 5.62, 95% CI: 1.31-24.15) compared to patients not residing in LL sub-districts. Patients in HH sub-districts were less likely to be living with HIV (aOR: 0.59; 95% CI: 0.38-0.90) and more likely to present with late-stage cancer (aOR: 1.78; 95%CI: 1.20-2.63) compared to patients not in HH sub-districts. CONCLUSIONS: This study identified geographic clustering of cervical cancer patients presenting for care in Botswana and highlighted sub-districts with disproportionately lower presentation rates. Identified community- and individual level-factors associated with low presentation rates can inform strategies aimed at improving equitable access to cervical cancer care.


Asunto(s)
Neoplasias de los Genitales Femeninos , Neoplasias del Cuello Uterino , Instituciones de Atención Ambulatoria , Botswana/epidemiología , Estudios Transversales , Femenino , Humanos , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/terapia
3.
Curr Opin Oncol ; 34(5): 518-523, 2022 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-35900753

RESUMEN

PURPOSE OF REVIEW: To discuss the benefits of centralization of gynaecological cancer care on patients and the healthcare system and how to overcome its barriers. RECENT FINDINGS: Evidence demonstrates that adherence to clinical practice management guidelines is more likely; the risk of adverse events is lower; survival is improved; in young women fertility preservation is higher; and cost effectiveness is higher; in systems that employ centralized care for women with gynaecological cancer. Barriers to the uptake of centralized models include knowledge, attitude as well as deficient systems and processes, including a lack of governance and leadership. Collaborative centralization refers to a model that sees both elements (centralization and treatment closer to home) utilized at the patient level that addresses some of the barriers of centralized gynaecological cancer care. SUMMARY: Evidence supports centralized gynaecological cancer care, as it results in reduced risks of adverse events, improved survival and higher fertility rates at lower cost to funders. Collaborative centralization is a process that considers both the value of centralization and collaboration amongst healthcare professionals at primary, secondary and tertiary levels of healthcare to benefit patient outcomes.


Asunto(s)
Preservación de la Fertilidad , Neoplasias de los Genitales Femeninos , Femenino , Neoplasias de los Genitales Femeninos/terapia , Humanos
4.
J Obstet Gynaecol Res ; 48(8): 2224-2230, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35793911

RESUMEN

Leiomyosarcoma arising from the ovarian vein has rarely been reported. Herein, we report two cases from a single institute. Given their direct connections to ovarian vessels, both leiomyosarcomas were initially suspected to be gynecological malignancies. In one case, leiomyosarcoma was discovered incidentally without any clinical symptoms; it had a close connection with the ovarian vein, was removed surgically, and the patient has survived for over 12 years. In another case, bowel obstruction caused by the tumor helped to identify metastatic leiomyosarcoma. Blood flow was supplied by the ovarian artery and grew into the lumen of the ovarian vein without invading adjacent organs. After surgical resection, the patient underwent 18 months of chemotherapy prior to palliative care. We propose that leiomyosarcoma arising from the ovarian vein should be treated as a gynecologic malignancy, especially if it develops in the lower abdomen.


Asunto(s)
Neoplasias de los Genitales Femeninos , Leiomiosarcoma , Neoplasias Vasculares , Abdomen/patología , Femenino , Humanos , Leiomiosarcoma/diagnóstico , Leiomiosarcoma/patología , Leiomiosarcoma/cirugía , Pelvis/patología , Neoplasias Vasculares/diagnóstico , Neoplasias Vasculares/patología , Neoplasias Vasculares/cirugía
5.
Biomolecules ; 12(7)2022 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-35883480

RESUMEN

With the continuous advances in molecular biotechnology, many new cell death methods have been discovered. Pyroptosis is a programmed cell death process that differs from apoptosis and autophagy in cell morphology and function. Compared with apoptosis and autophagy, pyroptosis is primarily mediated by intracellular inflammasome and gasdermin D of the gasdermin protein family and involves the release of numerous inflammatory factors. Pyroptosis has been found to be involved in the occurrence and development of infectious diseases and other diseases involving the nervous system and the cardiovascular system. Recent studies have also reported the occurrence of pyroptosis in tumor cells. Accordingly, exploring its effect on tumors has become one of the research hotspots. Herein, recent research progress on pyroptosis is reviewed, especially its role in the development of gynecological tumors. As the pathogenesis of gynecological tumor is better understood, new targets have been introduced for the prevention and clinical treatment of gynecological tumors.


Asunto(s)
Neoplasias de los Genitales Femeninos , Piroptosis , Apoptosis , Muerte Celular , Femenino , Neoplasias de los Genitales Femeninos/terapia , Humanos , Inflamasomas/metabolismo
7.
Menopause ; 29(8): 926-931, 2022 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-35905470

RESUMEN

OBJECTIVE: The objective of this study is to identify factors associated with receiving surgical menopause counseling in gynecologic cancer patients, as well as patient and provider perspectives, regarding surgical menopause counseling and management. METHODS: We conducted a single-institution mixed-method study combining retrospective chart review and patient and provider surveys. Patients younger than 51 years who experienced surgical menopause after gynecologic cancer treatment from January 2017 to December 2019 were surveyed in April 2021 about experiences with menopause counseling, barriers to care, and quality of life. We then reviewed charts of only patients who fully completed surveys. All gynecologic oncology providers were surveyed about surgical menopause practices. Logistic regression identified factors associated with receiving counseling. RESULTS: Sixty-six of 75 identified met inclusion criteria and received survey invitations. Thirty-five (53%) completed surveys. Sixty percent had documented surgical menopause counseling. Patients who were counseled were younger (43 vs 48.5 years, P = 0.005), more likely to have referrals for menopause care (12 vs 9, P = 0.036), more likely to have menopause providers other than oncology providers (14 vs 8, P = 0.001), and had fewer comorbidities. Decreasing age at surgery increased odds of counseling. Most reported continued menopause symptoms and quality of life disturbances. Half were satisfied with menopause care. Majority preferred counseling from oncology providers. Most providers always counseled on surgical menopause but cited lack of time as the primary obstacle for complete counseling. CONCLUSIONS: Younger age at surgery increased odds of receiving surgical menopause counseling. Gynecologic cancer patients experienced significant menopause-related disturbances. Improved understanding of patient and provider preferences and greater emphases on surgical menopause and survivorship will improve care for gynecologic oncology patients.


Asunto(s)
Barreras de Comunicación , Consejo , Neoplasias de los Genitales Femeninos/psicología , Neoplasias de los Genitales Femeninos/cirugía , Menopausia Prematura/psicología , Factores de Edad , Consejo/métodos , Consejo/normas , Femenino , Enfermedades de los Genitales Femeninos/psicología , Enfermedades de los Genitales Femeninos/cirugía , Humanos , Calidad de Vida , Estudios Retrospectivos , Encuestas y Cuestionarios
8.
J Clin Pathol ; 75(8): 529-536, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35853653

RESUMEN

Cancer resection specimens are usually reported using standardised proformas that consist of a list of elements, which include core (required) and non-core (recommended) items. Although all elements are generally included in the reports, the clinical importance of a particular parameter often depends on a variety of factors, including the clinical setting, local management guidelines and other pathological parameters. In this review, we briefly outline how histopathology data are used to guide management of patients with endometrial and tubo-ovarian cancers, the most common gynaecological malignancies, and provide advice as to which data elements are important in particular scenarios.


Asunto(s)
Carcinoma , Neoplasias Endometriales , Neoplasias de los Genitales Femeninos , Neoplasias Ováricas , Neoplasias del Cuello Uterino , Neoplasias Endometriales/patología , Femenino , Neoplasias de los Genitales Femeninos/patología , Humanos , Neoplasias Ováricas/patología , Neoplasias del Cuello Uterino/patología
10.
Zhonghua Yi Xue Za Zhi ; 102(26): 1953-1955, 2022 Jul 12.
Artículo en Chino | MEDLINE | ID: mdl-35817717

RESUMEN

To further improve the survival rate of patients with gynecological malignancies, our paper currently propose to focus on the quality of diagnosis and treatment of gynecological malignancies. We suggest to promote the standardization of the diagnosis and treatment, to perform innovative clinical trial, and to construct a multidisciplinary model of diagnosis and treatment for patients with gynecological malignancies.


Asunto(s)
Neoplasias de los Genitales Femeninos , Ginecología , Femenino , Neoplasias de los Genitales Femeninos/diagnóstico , Neoplasias de los Genitales Femeninos/patología , Neoplasias de los Genitales Femeninos/terapia , Humanos , Tasa de Supervivencia
11.
Zhonghua Yi Xue Za Zhi ; 102(26): 1963-1966, 2022 Jul 12.
Artículo en Chino | MEDLINE | ID: mdl-35817720

RESUMEN

In recent years, the diagnosis and treatment of gynecologic cancer have entered a new era with the development of precision medicine. The diagnosis and treatment modes for ovarian cancer, cervical cancer, and endometrial cancer are constantly adjusted. The application of molecular targeted drugs and the progress of surgical concepts and technology have greatly improved the survival of patients with ovarian cancer. Immunotherapy and targeted therapy have become a new hot spot in the treatment of cervical cancer. More clinical research data have been accumulated on the comparison of laparoscopic and open radical hysterectomy in cervical cancer. The surgical management of endometrial cancer has been improved, and molecular diagnostics are increasingly used to guide the diagnosis and treatment of endometrial cancer. Meanwhile, it's necessary to realize the limitations and challenges of precision medicine in gynecologic cancer.


Asunto(s)
Neoplasias Endometriales , Neoplasias de los Genitales Femeninos , Laparoscopía , Neoplasias Ováricas , Neoplasias del Cuello Uterino , Neoplasias Endometriales/terapia , Femenino , Neoplasias de los Genitales Femeninos/terapia , Humanos , Histerectomía , Neoplasias Ováricas/cirugía , Medicina de Precisión , Neoplasias del Cuello Uterino/terapia
13.
Curr Oncol ; 29(7): 4632-4646, 2022 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-35877228

RESUMEN

Individuals with proven hereditary cancer syndrome (HCS) such as BRCA1 and BRCA2 have elevated rates of ovarian, breast, and other cancers. If these high-risk people can be identified before a cancer is diagnosed, risk-reducing interventions are highly effective and can be lifesaving. Despite this evidence, the vast majority of Canadians with HCS are unaware of their risk. In response to this unmet opportunity for prevention, the British Columbia Gynecologic Cancer Initiative convened a research summit "Gynecologic Cancer Prevention: Thinking Big, Thinking Differently" in Vancouver, Canada on 26 November 2021. The aim of the conference was to explore how hereditary cancer prevention via population-based genetic testing could decrease morbidity and mortality from gynecologic cancer. The summit invited local, national, and international experts to (1) discuss how genetic testing could be more broadly implemented in a Canadian system, (2) identify key research priorities in this topic and (3) outline the core essential elements required for such a program to be successful. This report summarizes the findings from this research summit, describes the current state of hereditary genetic programs in Canada, and outlines incremental steps that can be taken to improve prevention for high-risk Canadians now while developing an organized population-based hereditary cancer strategy.


Asunto(s)
Predisposición Genética a la Enfermedad , Neoplasias de los Genitales Femeninos , Colombia Británica , Femenino , Pruebas Genéticas , Neoplasias de los Genitales Femeninos/diagnóstico , Neoplasias de los Genitales Femeninos/genética , Neoplasias de los Genitales Femeninos/prevención & control , Humanos , Riesgo
14.
Mar Drugs ; 20(7)2022 Jul 11.
Artículo en Inglés | MEDLINE | ID: mdl-35877745

RESUMEN

The role of NLRP3 in the tumour microenvironment is elusive. In some cancers, the activation of NLRP3 causes a worse prognosis and in some cancers, NLRP3 increases chances of survivability. However, in many cases where NLRP3 has a protumorigenic role, inhibition of NLRP3 would be a crucial step in therapy. Consequently, activation of NLRP3 would be of essence when inflammation is required. Although many ways of inhibiting and activating NLRP3 in cancers have been discussed before, not a lot of focus has been given to chitin and chitosan in this context. The availability of these marine compounds and their versatility in dealing with inflammation needs to be investigated further in relation with cancers, along with other natural extracts. In this review, the effects of NLRP3 on gastrointestinal and gynaecological cancers and the impact of different natural extracts on NLRP3s with special emphasis on chitin and chitosan is discussed. A research gap in using chitin derivatives as anti/pro-inflammatory agents in cancer treatment has been highlighted.


Asunto(s)
Quitosano , Neoplasias de los Genitales Femeninos , Antiinflamatorios , Quitina/farmacología , Quitosano/farmacología , Femenino , Neoplasias de los Genitales Femeninos/tratamiento farmacológico , Humanos , Inflamasomas , Inflamación , Proteína con Dominio Pirina 3 de la Familia NLR , Microambiente Tumoral
15.
J Am Coll Surg ; 235(2): 306-314, 2022 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-35839408

RESUMEN

BACKGROUND: Perioperative venous thromboembolism (VTE) is a significant cause of morbidity and mortality after gynecologic cancer surgery. Here we report a quality improvement intervention to increase perioperative VTE chemoprophylaxis compliance. STUDY DESIGN: All operations performed by a gynecologic oncologist at a tertiary urban university medical center admitted to the hospital for at least one midnight were included. Using a pre/post design with a washout period, we sought to increase perioperative VTE chemoprophylaxis compliance from 22% in the historical control (HC) cohort to 90% in the quality improvement (QI) cohort. The perioperative VTE chemoprophylaxis process was standardized by addressing four domains: preoperative VTE chemoprophylaxis, surgical time-out, postoperative VTE chemoprophylaxis, and intervention education and compliance tracking. Pearson's chi-square test was used to compare HC vs QI cohort compliance. RESULTS: There were 130 surgical cases in the HC cohort and 131 in the QI cohort. Forty-two percent underwent laparotomy, and 57% had cancer at the time of operation. VTE chemoprophylaxis compliance improved from 22% in the HC cohort to 82% in the QI cohort (p < 0.001). Preoperative VTE chemoprophylaxis compliance improved from 76% in the HC cohort to 94% in the QI cohort (p < 0.001), and postoperative VTE chemoprophylaxis compliance improved from 27% to 87% (p < 0.001). Thirty-day postoperative VTE occurred in three patients (2%) in the HC cohort and none in the QI cohort (p = 0.08). CONCLUSIONS: A low-cost and low-technology QI initiative intervention improved perioperative compliance with VTE chemoprophylaxis.


Asunto(s)
Neoplasias de los Genitales Femeninos , Tromboembolia Venosa , Anticoagulantes/uso terapéutico , Quimioprevención/efectos adversos , Estudios de Cohortes , Femenino , Neoplasias de los Genitales Femeninos/complicaciones , Neoplasias de los Genitales Femeninos/tratamiento farmacológico , Neoplasias de los Genitales Femeninos/cirugía , Humanos , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Mejoramiento de la Calidad , Estudios Retrospectivos , Tromboembolia Venosa/tratamiento farmacológico , Tromboembolia Venosa/etiología , Tromboembolia Venosa/prevención & control
16.
BMC Cancer ; 22(1): 747, 2022 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-35804322

RESUMEN

BACKGROUND: The residual effects of cancer and its treatment can profoundly affect women's quality of life. This paper presents results from a multisite randomized controlled trial that evaluated the clinical benefits of an e-health enabled health promotion intervention (the Women's Wellness after Cancer Program or WWACP) on the health-related quality of life of women recovering from cancer treatment. METHODS: Overall, 351 women previously treated for breast, blood or gynaecological cancers were randomly allocated to the intervention (WWACP) or usual care arms. The WWACP comprised a structured 12-week program that included online coaching and an interactive iBook that targeted physical activity, healthy diet, stress and menopause management, sexual wellbeing, smoking cessation, alcohol intake and sleep hygiene. Data were collected via a self-completed electronic survey at baseline (t0), 12 weeks (post-intervention, t1) and 24 weeks (to assess sustained behaviour change, t2). The primary outcome, health-related quality of life (HRQoL), was measured using the Short Form Health Survey (SF-36). RESULTS: Following the 12-week lifestyle program, intervention group participants reported statistically significant improvements in general health, bodily pain, vitality, and global physical and mental health scores. Improvements were also noted in the control group across several HRQoL domains, though the magnitude of change was less. CONCLUSIONS: The WWACP was associated with improved HRQoL in women previously treated for blood, breast, and gynaecological cancers. Given how the synergy of different lifestyle factors influence health behaviour, interventions accounting for the reciprocity of multiple health behaviours like the WWACP, have real potential for immediate and sustainable change. TRIAL REGISTRATION: The protocol for this randomised controlled trial was submitted to the Australian and New Zealand Clinical Trials Registry on 15/07/2014 and approved on 28/07/2014 ( ACTRN12614000800628 ).


Asunto(s)
Neoplasias de los Genitales Femeninos , Telemedicina , Australia , Femenino , Neoplasias de los Genitales Femeninos/terapia , Humanos , Estilo de Vida , Calidad de Vida
17.
Semin Nucl Med ; 52(5): 628-634, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35842334

RESUMEN

Fibroblast activation protein (FAP) is ubiquitously present in healthy tissue, and additionally upregulated by cancer associated fibroblasts (CAFs) leading to high levels of FAP. Thus, neoplastic tissue, which is containing CAFs, characterized by a high presence of FAP. Moreover, in more than 90% of all epithelial tumors this phenomenon seems to occur, including many gynecological tumors, providing the foundation for a successful application of FAP-ligands. However, FAP upregulation, can also be initiated by benign conditions such as inflammation, hormonal-influence, and wound healing. Gynecological cancers seem to represent a field of interest for the utilization of FAPI-PET/CT to potentially improve staging, restaging and therapeutic management. First highly promising investigations demand further research in order to validate these preliminary findings.


Asunto(s)
Neoplasias de los Genitales Femeninos , Tomografía Computarizada por Tomografía de Emisión de Positrones , Femenino , Gelatinasas/metabolismo , Neoplasias de los Genitales Femeninos/diagnóstico por imagen , Humanos , Proteínas de la Membrana/metabolismo , Serina Endopeptidasas/metabolismo
18.
Anticancer Res ; 42(8): 4111-4117, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35896236

RESUMEN

BACKGROUND/AIM: This study aimed to evaluate the learning curve and perioperative outcomes of robot-assisted hysterectomy (RAH). PATIENTS AND METHODS: We retrospectively analyzed data from 45 patients who underwent RAH using the da Vinci Xi surgical system. The learning curve was evaluated using the cumulative summation method. Demographic data and various perioperative parameters, including total operative time, docking time, and console time, were obtained from the medical records. RESULTS: Cumulative summation analysis indicated that proficiency regarding hysterectomy time was reached after 33 cases. There were two unique phases of the learning curve for console time: the introduction phase identified by the bottom point in the curve, and the proficient phase, identified by an upward line after the bottom point in the curve. There were no significant differences between the two phases in terms of patient age and body mass index. Total operative time, docking time, and console time were significantly decreased in the proficient phase compared with those in the introduction phase. There was a significant reduction in blood loss during operation in the proficient phase. The perioperative complication rates were 12.1% in the introduction phase and 0% in the proficient phase (p=0.5606). No blood transfusion or conversion to laparotomy was required in either phase. CONCLUSION: The introduction and proficient phases identified by cumulative summation analysis demonstrated progressive improvement of surgical performance in surgeons carrying out RAH.


Asunto(s)
Neoplasias de los Genitales Femeninos , Histerectomía , Laparoscopía , Procedimientos Quirúrgicos Robotizados , Femenino , Neoplasias de los Genitales Femeninos/cirugía , Humanos , Histerectomía/efectos adversos , Histerectomía/métodos , Laparoscopía/métodos , Curva de Aprendizaje , Tempo Operativo , Estudios Retrospectivos , Procedimientos Quirúrgicos Robotizados/efectos adversos , Procedimientos Quirúrgicos Robotizados/métodos
19.
BMC Womens Health ; 22(1): 283, 2022 07 08.
Artículo en Inglés | MEDLINE | ID: mdl-35804312

RESUMEN

BACKGROUND: Changing in the sexual function is an important condition in women with gynecological cancers. A valid and reliable questionnaire is required to assess this condition. The aim of this study was to translate and validate the Persian version of the Sexual-Vaginal Function Changes Questionnaire (SVQ) in women with gynecologic cancers. METHODS: This methodological study with a psychometric design was conducted on 250 women with gynecologic cancers, who visited public and private medical centers in Tehran to receive follow-up services. Convenience sampling was conducted from April 2019 to May 2020. First, the Persian version of the Sexual Function-Vaginal Changes Questionnaire was developed and then, psychometric properties such as content validity, face validity, construct validity and criterion validity were assessed. Reliability of the instrument was assessed by Cronbach's alpha coefficient. RESULTS: Mean age of participants was 53.3 ± 11.8 and mean score of SVQ was 63.0 ± 9.1 in the possible range of 26-104. Content validity was tested through qualitative method and six items were revised as suggested by the expert panel. Cronbach's alpha coefficient was 0.71 for the whole questionnaire and it was 0.93, 0.92, 0.89, 0.78, 0.88 and 0.78 for the 6 subscales, respectively, which shows the optimal internal consistency. Results of exploratory factor analysis revealed six factors as (1) intemacy and sexual interst, (2) arousal, (3) changes in intemacy and sexual interst after cancer, (4) vaginal changes after cancer, (5) vaginal bleeding during coitus, (6) and sexual worry and dissatisfaction after cancer. explained 70.09% of the variance observed. Criterion validity test of the questionnaire showed a significant correlation between the total SVQ scores and the total Female Sexual Function Index (FSFI) scores as well as between SVQ dimensions and dimensions of FSFI (P < 0.001). CONCLUSIONS: The findings from this study indicated that the Persian version of the SVQ is a valid and reliable instrument to assess sexual function-vaginal changes in women with gynecologic cancers.


Asunto(s)
Neoplasias de los Genitales Femeninos , Traducciones , Femenino , Neoplasias de los Genitales Femeninos/complicaciones , Neoplasias de los Genitales Femeninos/diagnóstico , Humanos , Irán , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
20.
BMC Womens Health ; 22(1): 300, 2022 07 19.
Artículo en Inglés | MEDLINE | ID: mdl-35854346

RESUMEN

BACKGROUND: There is increasing recognition that prehabilitation is important as a means of preparing patients physically and psychologically for cancer treatment. However, little is understood about the role and optimal nature of prehabilitation for gynaecological cancer patients, who usually face extensive and life-changing surgery in addition to other treatments that impact significantly on physiological and psychosexual wellbeing. REVIEW QUESTION: This scoping review was conducted to collate the research evidence on multimodal prehabilitation in gynaecological cancers and the related barriers and facilitators to engagement and delivery that should be considered when designing a prehabilitation intervention for this group of women. METHODS: Seven medical databases and four grey literature repositories were searched from database inception to September 2021. All articles, reporting on multimodal prehabilitation in gynaecological cancers were included in the final review, whether qualitative, quantitative or mixed-methods. Qualitative studies on unimodal interventions were also included, as these were thought to be more likely to include information about barriers and facilitators which could also be relevant to multimodal interventions. A realist framework of context, mechanism and outcome was used to assist interpretation of findings. RESULTS: In total, 24 studies were included in the final review. The studies included the following tumour groups: ovarian only (n = 12), endometrial only (n = 1), mixed ovarian, endometrial, vulvar (n = 5) and non-specific gynaecological tumours (n = 6). There was considerable variation across studies in terms of screening for prehabilitation, delivery of prehabilitation and outcome measures. Key mechanisms and contexts influencing engagement with prehabilitation can be summarised as: (1) The role of healthcare professionals and organisations (2) Patients' perceptions of acceptability (3) Factors influencing patient motivation (4) Prehabilitation as a priority (5) Access to prehabilitation. IMPLICATIONS FOR PRACTICE: A standardised and well evidenced prehabilitation programme for women with gynaecological cancer does not yet exist. Healthcare organisations and researchers should take into account the enablers and barriers to effective engagement by healthcare professionals and by patients, when designing and evaluating prehabilitation for gynaecological cancer patients.


Asunto(s)
Neoplasias de los Genitales Femeninos , Ejercicio Preoperatorio , Femenino , Neoplasias de los Genitales Femeninos/cirugía , Personal de Salud , Humanos , Investigación Cualitativa
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