Obstetrical and Oncological Outcomes Among Reproductive Age Women with Gynecological and Breast Cancer

患有妇科和乳腺癌的育龄妇女的产科和肿瘤结果

• 批准号: 10481831
• 负责人: Jose Alejandro Rauh-Hain
• 金额: $ 22.78万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-18 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10481831
• 关键词: 37 weeks gestation; Address; Age; Ambulatory Surgical Procedures; American Society of Clinical Oncology; Assisted Reproductive Technology; Award; Birth; California; Cancer Survivor; Centers for Disease Control and Prevention (U.S.); Characteristics; Clinic; Cohort Studies; Complement; Conceptions; Counseling; Cross-Sectional Studies; Data; Data Set; Data Sources; Databases; Decision Making; Development; Development Plans; Diagnosis; Discipline of obstetrics; Disease; Distress; Economics; Endometrial; Endometrial Carcinoma; Fertility; Follow-Up Studies; Foundations; Funding; Future; Gestational Age; Goals; Gynecologic Oncologist; Health Planning; Health Services; Hormonal Change; Hospital Records; Knowledge; Link; Live Birth; Low Birth Weight Infant; Malignant Female Reproductive System Neoplasm; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Malignant neoplasm of ovary; Measures; Methodological Studies; Microscopic; Observational Study; Operative Surgical Procedures; Outcome; Ovarian; Patients; Physicians; Population; Postpartum Period; Pregnancy; Pregnancy Outcome; Pregnancy Rate; Premature Birth; Quality of Care; Radiation therapy; Recording of previous events; Recurrence; Research; Research Personnel; Research Proposals; Residual state; Risk; Statistical Models; Surveys; Survival Rate; System; Time; Training; University of Texas M D Anderson Cancer Center; Uterine Cancer; Weight; Woman; Work; antenatal; breast cancer diagnosis; cancer diagnosis; cancer therapy; cancer type; career; career development; chemotherapy; comparative effectiveness; data registry; design; experience; fertility barrier; fertility preservation; innovation; inpatient surgery; interest; malignant breast neoplasm; neoplasm registry; novel; obstetric outcomes; obstetrical complication; patient oriented; patient population; peer; population based; pregnant; prevent; programs; prospective; psychosocial; reproductive; social; survival outcome; tumor; young woman

Project Summary Fertility is very important to many young women diagnosed with cancer. Surgery, chemotherapy, and radiotherapy can impact fertility and pregnancy outcomes. Conversely, pregnancy at the time of cancer diagnosis or after cancer treatment can impact survival. Despite the increasing number of young women with gynecological or breast cancer and the importance of accurate information in guiding counseling, evidence regarding the impact of pregnancy or assisted reproductive technologies (ART) on oncological and obstetrical outcomes following cancer treatment remains limited. To address these knowledge gaps, Dr. Rauh-Hain plans to conduct a population-based observational study to estimate fertility, obstetrical, and oncological outcomes in women age 18–45 years who are diagnosed with early-stage ovarian, uterine, cervical, or breast cancer and opt for fertility-sparing oncologic treatment. We propose a novel linkage of four unique data sources: 1) California Cancer Registry (CCR) data, which include information about tumor characteristics, primary cancer- directed therapy, and survival for all cancer cases diagnosed in California; 2) California Office of Statewide Health Planning and Development (OSHPD) Birth Data, which include maternal antepartum and postpartum hospital records for the 9 months prior to and 1 year after delivery; 3) California OSHPD inpatient and ambulatory surgery discharge data sets, which contain patient treatment data for all inpatient and ambulatory surgeries; and 4) the Centers for Disease Control and Prevention (CDC) National Assisted Reproductive Technologies (ART) Surveillance System data set, which includes all ART cycles initiated in U.S. fertility clinics. We will supplement these data with a cross-sectional survey to identify barriers preventing reproductive-age women from achieving successful pregnancies. This study will provide information about oncological, fertility, and obstetrical outcomes among women who become pregnant or underwent ART after a gynecological or breast cancer diagnosis and identify barriers that prevent reproductive-age women from achieving successful pregnancies leading to a live birth. Dr. Rauh-Hain is a gynecologic oncologist and health services researcher at The University of Texas MD Anderson Cancer Center. He has a particular interest in understanding the quality of care for reproductive-age women with cancer. His long-term career goal is to become an innovative and independently funded health services and comparative effectiveness researcher in gynecological cancer. The research program described here is designed to complement a career development plan that includes training in advanced statistical modeling and survey design and implementation. This award will lay the foundation for two follow-up studies: 1) a prospective multicenter cohort study to assess barriers to, and decision-making regarding, future pregnancies in this population and 2) the use of the linked databases to expand the study to a broader population of reproductive-age women with common cancers.

项目概要 生育能力对于许多被诊断患有癌症的年轻女性来说非常重要。手术、化疗和 放射治疗会影响生育能力和妊娠结局。相反，癌症发生时怀孕 诊断或癌症治疗后可能会影响生存。尽管患有这种疾病的年轻女性数量不断增加 妇科或乳腺癌以及准确信息在指导咨询、证据中的重要性 关于怀孕或辅助生殖技术 (ART) 对肿瘤和产科的影响 癌症治疗后的结果仍然有限。为了解决这些知识差距，Rauh-Hain 博士计划 进行一项基于人群的观察性研究，以估计生育率、产科和肿瘤结果 18-45 岁被诊断患有早期卵巢癌、子宫癌、宫颈癌或乳腺癌的女性，以及 选择保留生育能力的肿瘤治疗。我们提出了四个独特数据源的新颖链接：1) 加州癌症登记 (CCR) 数据，其中包括有关肿瘤特征、原发癌症的信息 加州诊断的所有癌症病例的定向治疗和生存率； 2) 加州全州办公室 健康规划和发展 (OSHPD) 出生数据，包括母亲产前和产后 产前 9 个月和产后 1 年的医院记录； 3) 加州 OSHPD 住院病人和 门诊手术出院数据集，其中包含所有住院患者和门诊患者的治疗数据 手术； 4) 美国疾病控制与预防中心 (CDC) 国家辅助生殖中心 技术 (ART) 监测系统数据集，其中包括美国生育力启动的所有 ART 周期 诊所。我们将通过横断面调查来补充这些数据，以确定阻碍 育龄妇女成功怀孕。这项研究将提供有关 怀孕或接受 ART 后妇女的肿瘤学、生育力和产科结果 妇科或乳腺癌诊断并确定阻止育龄妇女罹患癌症的障碍 成功怀孕并活产。 Rauh-Hain 博士是德克萨斯大学医学博士的妇科肿瘤学家和健康服务研究员 安德森癌症中心。他对了解育龄期护理质量特别感兴趣 患有癌症的女性。他的长期职业目标是成为一名创新且独立资助的健康 妇科癌症服务和比较有效性研究员。所描述的研究计划 这里旨在补充职业发展计划，其中包括高级统计培训 建模和调查设计与实施。该奖项将为两项后续研究奠定基础： 1) 一项前瞻性多中心队列研究，旨在评估未来的障碍和决策 该人群的怀孕情况以及 2) 使用链接数据库将研究扩展到更广泛的范围 患有常见癌症的育龄妇女人口。

项目成果

Modeling treatment outcomes for patients with advanced ovarian cancer: Projected benefits of a test to optimize treatment selection.

• DOI: 10.1016/j.ygyno.2018.02.007
• 发表时间: 2018-05
• 期刊: Gynecologic oncology
• 影响因子: 4.7
• 作者: Davis T. Weaver;Tiana J. Raphel;A. Melamed;J. Rauh-Hain;J. Schorge;Amy B. Knudsen;P. Pandharipande

Clinical research in ovarian cancer: consensus recommendations from the Gynecologic Cancer InterGroup.

• DOI: 10.1016/s1470-2045(22)00139-5
• 发表时间: 2022-08
• 期刊: LANCET ONCOLOGY
• 影响因子: 51.1
• 作者: Vergote, Ignace;Gonzalez-Martin, Antonio;Lorusso, Domenica;Gourley, Charlie;Mirza, Mansoor Raza;Kurtz, Jean-Emmanuel;Okamoto, Aikou;Moore, Kathleen;Kridelka, Frederic;McNeish, Iain;Reuss, Alexander;Votan, Benedicte;du Bois, Andreas;Mahner, Sven;Ray-Coquard, Isabelle;Kohn, Elise C.;Berek, Jonathan S.;Tan, David S. P.;Colombo, Nicoletta;Zang, Rongyu;Concin, Nicole;O'Donnell, Dearbhaile;Rauh-Hain, Alejandro;Herrington, C. Simon;Marth, Christian;Poveda, Andres;Fujiwara, Keiichi;Stuart, Gavin C. E.;Oza, Amit M.;Bookman, Michael A.
• 通讯作者: Bookman, Michael A.

Assessing gaps in motherhood after cancer: development and psychometric testing of the Survivorship Oncofertility Barriers Scale.

评估癌症后母亲的差距：生存肿瘤生育障碍量表的开发和心理测试。

• DOI: 10.1136/ijgc-2023-004302
• 发表时间: 2023
• 期刊: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
• 作者: Hoffman,Aubri;Denham,ChloeJosephine;Fu,Shuangshuang;Mendoza,Tito;Nitecki,Roni;Jorgensen,KirstenA;Garcia,Jose;Lamiman,Kelly;Woodard,TerriL;Rauh-Hain,JAlejandro
• 通讯作者: Rauh-Hain,JAlejandro

Potential survival benefits from optimized chemotherapy implementation in advanced ovarian cancer: Projections from a microsimulation model.

晚期卵巢癌优化化疗实施的潜在生存获益：微观模拟模型的预测。

• DOI: 10.1371/journal.pone.0222828
• 发表时间: 2019
• 期刊: PloS one
• 影响因子: 3.7
• 作者: Lietz,AnnaP;Weaver,DavisT;Melamed,Alexander;Rauh-Hain,JoseAlejandro;Wright,JasonD;Wright,AlexiA;Knudsen,AmyB;Pandharipande,PariV
• 通讯作者: Pandharipande,PariV