Browsing by Subject "Ovarian Neoplasms"
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Item BRCA1 and BRCA2: genes with frequent mutations that predispose to breast and ovarian cancer(1997-07-03) Taurog, Joel D.Item Developing and Evaluating the Efficacy and Feasibility of Delivering a Psychoeducational Individual Intervention to Women with Advanced Stage Ovarian Cancer: A Two Phase Study(2007-08-08) Doyle, Kimberly Cecile; Gershenfeld, HowardPURPOSE: The purpose of this study was to assess the psychosocial needs of women with ovarian cancer treated at Baylor University Medical Center Sammons Cancer Center, and to design and evaluate the feasibility and efficacy of an individual psychoeducational intervention on reported symptoms of depression, anxiety, and psychosocial adjustment to illness. Secondary aims included identifying the barriers to accessing group support services as well as identifying a mechanism to address those barriers. METHOD: This study was conducted in two phases. Phase I consisted of a psychosocial needs assessment (n = 15) to determine the appropriate elements necessary for inclusion in an individual intervention. Perceived barriers to participation in psychosocial services, including group support, were also assessed. The outcome of the needs assessment combined with an extensive literature review was used to develop the Phase II intervention. In Phase II, participants (n = 30) were recruited from the gynecologic oncology practice at Baylor Sammons Cancer Center. Participants were randomized to intervention (n = 15) vs. control (n=15) groups. Intervention sessions lasted 60 minutes and were conducted weekly over a period of 8 weeks. Sessions consisted of a combination of education and psychosocial support. Growth modeling was used to evaluate variation in within-individual rate of change in outcome measures during the treatment (weeks 1-8) and followup (weeks 16-48) periods of the study. Repeated measures ANOVA was used to evaluate average group differences in outcome measures during the treatment and follow-up periods of the study. RESULTS: No main effects of time, group, age, or education were observed with regard to rate of change of psychosocial adjustment to illness during the treatment period of the study using growth modeling. However, during the follow-up period of the study, time and group were significant predictors of within-individual variation in rate of change in psychosocial adjustment to illness. Similarly, repeated measures ANOVA yielded no main effects of time or group in psychosocial adjustment to illness during the treatment period of the study; however, a main effect of group (p<.05) and an interaction between group and time (p<.05) were noted during the follow-up period of the study with the most significant differences in group means occurring at week 48 (effect size = .70). Although not stable across all models created, time was the only significant predictor of within-individual variation in rate of change in depression symptoms during the treatment and follow-up periods. A main effect of time without consideration of group (p<.01) and an interaction between group and time (p<.01) with regard to depression symptoms was noted in the treatment phase of the study, most significantly at week 8. A main effect of group (p<.05), most significantly at week 48, was observed during the follow-up phase (effect size = .69). Similar to depression scores, withinindividual variation in anxiety symptom scores was significantly predicted by time during the treatment period of the study. Although no main effects of predictors were observed with regard to anxiety symptoms during the follow-up period of the study, the model with the greatest goodness of fit included the predictors education, group, and time. Repeated measures ANOVA suggest a main effect of time (p<.05) with regard to anxiety symptoms during the treatment period of the study but no main effect of group. However, during the follow-up period of the study, a main effect of time (p<.05) and group (p<.05) were noted with regard to differences in the average state anxiety symptom score between groups, with the most significant difference occurring at week 48 (effect size = .43). Cost analyses suggest minimal differences in the number of medical office visits and phone calls between groups and a moderate difference in usage of psychiatric and pain medication between groups. Treatment satisfaction was high across all intervention topics, with participants rating sessions 1 and 8 the most helpful. RESEARCH AND CLINICAL IMPLICATIONS: Concordant with the literature, the results of this study suggest that individual interventions with women with advanced stage ovarian cancer may help improve neurocognitive-related mood symptoms and anxiety during the initial phase of treatment and diagnosis. Decline in depression symptoms in intervention participants was primarily related to decline in neurocognitive complaints. A reduction in neurocognitive mood symptoms and anxiety likely contributed to the improvement in psychosocial adjustment to illness noted in the treatment group during the follow-up period of the study. The impact of psychosocial sequelae on cognitive functioning warrants attention by clinicians. ACKNOWLEDGEMENT OF FUNDING: Baylor University Medical Center Research FoundationItem Malignant Childhood Ovarian Cancer: A Ten-Year Retrospective Review(2024-01-30) Laboret, Bretton; Bonnyman, Claire; Murphy, Joseph T.BACKGROUND: Although pediatric ovarian cancer is rare (2.1-2.6/ 100,000 females per year), 10-30% of masses are malignant. Our primary aim was to confirm the incidence and type of ovarian malignant and borderline neoplasms over a ten-year period, and to describe their presentation and clinical characteristics. Furthermore, through analysis of pre-operative workups, we sought to elucidate better predictive indicators of malignancy to help guide future treatment. METHODS: Retrospective analysis of patients (<19 years old) who underwent surgery for borderline or malignant ovarian tumors from 01/01/2009 to 12/31/2018 was performed. Patient records were analyzed for age, presentation, serum marker levels, imaging findings, treatment (surgical plan and therapy), and patient outcomes. RESULTS: A total of 42 malignant and 7 borderline ovarian tumors were included in this study. Germ cell tumors were the most common malignancy (64%) followed by stromal tumors (31%), while one epithelial mucinous tumor and one small cell tumor were found (2% each). Of the borderline tumors, serous (71 %) were more common than mucinous tumors (29%). Average patient age was 13 ± 3.9 years, and the primary presenting symptoms were pain (45%) or abdominal distension (43%). Significant elevations in alpha fetoprotein, beta human chorionic gonadotropin, lactate dehydrogenase and cancer antigen-125 serum tumor markers were noted in malignancies. Eighty-eight percent of surgeries were performed as laparotomies, and the most common operation was salpingo-oopherectomy (67%). The average tumor size was 14.6 cm. ±6.6 cm. and the majority were characterized as heterogeneous (80%). All tumors were resected, and 21 (50%) malignant tumors received postoperative chemotherapy, while no borderline cases received therapy. Average postoperative follow-up time was 38.6 months, and forty-five (92%) patients were alive at the time of data collection. CONCLUSIONS: Germ cell tumors were confirmed as the most common pediatric ovarian malignancy, followed by stromal tumors. Very few epithelial tumors were noted, as compared to prior studies. Borderline neoplasms were uncommon and had favorable outcomes. In treating pediatric ovarian malignancy, we aim to maximize patient survival while preserving fertility. We recommend a standardized preoperative workup consisting of multi-modal imaging studies and a complete tumor marker panel for all patients presenting with suspicion for an ovarian tumor.Item Mapping the Landscape of Acquired Vulnerabilities in Ovarian Cancer(2013-06-05) Shields, Benjamin Baker; Castrillon, Diego H.; White, Michael A.; Altschuler, Steven J.; Brekken, Rolf A.Recent undertakings to identify the genetic lesions associated with ovarian cancer have noted the striking diversity of mutations occurring in this disease. This genetic diversity has complicated the search for novel therapies. However, recent data has suggested that one commonality of ovarian tumors might be ablation of miRNA biogenesis. Here I conducted a broad-scale gain-of-function microRNA (miRNA) screen in 16 ovarian cancer cell lines to annotate the functional landscape present in such a chaotic genetic background. miRNAs function as multigenic perturbations allowing for interrogation of maximal gene space with few experiments. This screen identified multiple miRNAs reducing cell viability with the majority of hits being toxic in only one or two lines screened. This surprising finding reflected the commonality of altered miRNA function in ovarian tumors while also suggesting that specifics of this alteration in function are unique to each tumor. To investigate more public vulnerabilities, I focused mechanistic studies on miRNAs displaying penetrance in greater than 5 cell lines. miR-517a reduced cell viability in over 30% of the panel and also reduced tumor burden in vivo. Functional analysis of the predicted targets of miR-517a revealed that expression of this miRNA reduced protein levels of ARCN1, a member of the coatamer complex, and that knockdown of ARCN1 reduced cell viability similar to miR-517a. Another penetrant miRNA, miR-124a, reduced cell viability in 37.5% of the panel and functional analysis of this miRNA revealed it promoted a cell differentiation program. Analysis of predicted targets revealed that expression of miR-124a reduced expression the homeodomain transcription factor SIX4, resulting in increased signaling along the tumor suppressive AMPK pathway and epithelial differentiation. Furthermore, SIX4 displayed increased expression in ovarian tumors and depletion of SIX4 expression reduced tumor cell viability in vitro and in vivo. Therefore, SIX4 overexpression might function to deflect cell differentiation in tumors. Thus, the common loss of miRNA function observed in ovarian tumors might serve to maintain an undifferentiated state, and engagement of cell fate determination programs via re-expression of miRNAs can result in catastrophic consequences for cancer cell viability.Item Ovarian cancer: a therapeutic model(1983-07-28) Hendler, Fred J.Item [Southwestern News](2001-10-18) Harrell, AnnItem [Southwestern News](1998-10-28) Harrell, AnnItem [Southwestern News](1999-12-27) Harrell, AnnItem [Southwestern News](1997-04-14) Harrell, Ann