Gynecologic Patients Research Articles (Page 1)

Factors that affect engagement with physical activity for patients who have received radiotherapy as part of their gynaecological cancer treatment - A rapid review.

To develop Deubiquitinase-Associated Signatures (DAS) to predict the prognosis of gynecological cancer patients. Using a Cox-Lasso regression model, we have developed deubiquitinase-associated signatures for Cervical, Ovarian, and Uterine cancers. Developed DAS were validated in TCGA and GEO datasets. Survival analysis was carried out to know the effect of factors Like menopausal stage and grade on DAS. The Survival prediction accuracy of DAS was analyzed using ROC curves. Immune infiltration scores of 22 immune subtypes were explored using theCIBERSORT package in risk groups classified by DAS. Further, to target the unfavorable deubiquitinases (DUBs), compounds were identified using CMap database. Three DAS were developed for Cervical, Ovarian, and Uterine cancer types. DAS was able to predict Survival and classify patients into two groups in TCGA and GEO datasets. DAS is an independent predictor of Survival irrespective of tumor grade and menopausal stage. DAS, along with the clinical features, improves the accuracy of predictions. CIBERSORT analysis has shown that immune cell infiltration is associated with risk groups divided by DAS. Using CMap, 52 compounds were identified to target unfavorable DUBs. DAS is a good predictor of survival, and targeting unfavorable DUBs may reduce tumor progression in gynecological cancers.

Relationship between preoperative nutritional status with postoperative IL-10 and neopterin in gynecologic oncology patients.

Gynecological cancers present a major global health challenge, with malnutrition recognized as a significant factor worsening prognosis. Extensive surgical procedures and chemotherapy often compromise nutritional status, leading to delayed recovery and poor outcomes. This review aimed to assess the role of nutritional interventions in improving postoperative prognosis among gynecological cancer patients. Following PRISMA guidelines, PubMed, ScienceDirect, and Google Scholar were searched up to August 2025. Eligible randomized trials, cohort, and feasibility studies evaluated nutritional interventions, including early oral feeding, oral supplements, parenteral nutrition, prehabilitation, coffee, and gum chewing. Risk of bias was assessed using Cochrane RoB 2.0 and ROBINS-I. Data were narratively synthesized, with random-effects meta-analysis performed where appropriate. This study has been registered with PROSPERO (CRD420251071481). A total of 13 studies (randomized and observational) were included. Pooled analyses showed no overall difference in hospital stay between nutritional interventions and standard care (MD -0.56days; 95% CI -1.34 to 0.22), though subgroup analysis revealed that early oral feeding (EOF), coffee, and gum chewing significantly shortened hospitalization, while total parenteral nutrition (TPN) prolonged it. Nutritional interventions did not significantly reduce postoperative complications overall (OR 0.85; 95% CI 0.55-1.32), but EOF and gum chewing lowered infective and ileus-related morbidity in some studies. Gastrointestinal recovery was consistently accelerated with EOF, coffee, and gum chewing, whereas TPN delayed recovery. Oral nutritional supplements (ONS) improved nutritional indices, and prehabilitation shortened the time to chemotherapy. Survival outcomes were rarely reported, with malnutrition predicting poor prognosis. Overall, interventions were safe and well-tolerated. Nutritional interventions, particularly EOF, coffee, gum chewing, and ONS, enhance recovery and nutritional status in gynecologic oncology, whereas TPN should be reserved for selected malnourished patients.

We aimed to evaluate vaginal microbiota distribution before and after laser therapy for gynecologic patients with stress urinary incontinence (SUI) and genitourinary syndrome of menopause (GSM). Fifty patients undergoing CO₂ vaginal laser treatment were enrolled. The primary outcomes included UDI-6, IIQ-7, OABSS, and VSQ-21 scores before and at 1, 2, and 3 months after laser treatment, as well as vaginal microbiota diversity before and 1 month after laser treatment. UDI-6, IIQ-7, OABSS, and VSQ-21 scores for patients who received CO₂ laser therapy all showed significant improvement at 1, 2, and 3 months post-treatment. Vaginal pH showed no significant change after laser treatment. Overall, 91 samples were successfully sequenced. Alpha diversity showed significant differences in the menopause (p = 0.034) and GSM (p = 0.004) groups, but not between pre- and post-laser treatment samples. PERMANOVA revealed differences in microbiota composition associated with menopause (p = 0.009) and SUI (p = 0.026). Beta diversity analysis showed no significant treatment effect due to high inter-individual variability. The six most abundant vaginal bacterial genera included Lactobacillus (40.4%), Gardnerella (8.4%), Prevotella (7.4%), Escherichia-Shigella (6.0%), Streptococcus (5.6%), and Bifidobacterium (3.2%), with changes in Lactobacillus dominance observed in some patients post-treatment. Network analysis revealed that Gardnerella disappeared post-laser treatment, as Lactobacillus increased in abundance. CO₂ laser treatment may improve SUI and GSM, and be associated with shifts in microbiota.

Pelvic radiotherapy (RT) causes tissue injury which could lead to vaginal problems including dryness, shortening, and tightening of the vagina, causing discomfort, and affect sexual activity. In this longitudinal, prospective study, the association between pelvic RT and sexual function were studied in primary cervical cancer and in primary uterine tumor patients. This prospective longitudinal cohort study comprised patients with primary cervical cancer and primary uterine tumors with pelvic radiotherapy (RT). Seventy-nine cervical cancer and 43 uterine tumor patients were included from May 2014 to February 2019. Patients completed questionnaires for global health status and sexual functioning before RT start and at 3 and 12months after RT. In primary cervical cancer patients, the sexual activity was significantly higher in patients with pelvic RT alone compared to patients with pelvic RT + cervical brachytherapy/boost at 3months (P = 0.007, 34.6% vs. 73.3%) and12 months after RT (P = 0.054, 45.7% vs. 76.9%). No significant relationship was found in primary uterine tumor patients. At 12months after RT, 52.5% of the cervix and 42.3% of the primary uterine tumor patients were sexually active. Of the cervical cancer patients, 81.8% reported symptoms as dry vagina 12months after RT. Local estrogens did not improve the sexual activity in cervical cancer or uterine tumor patients after RT. In cervical cancer patients, the sexual activity was significantly higher with pelvic RT alone compared to pelvic RT + cervical brachytherapy/boost. Better medical interventions are needed to reduce the sexual symptoms. Reduced sexual activity in gynecological cancer survivors with curative pelvic RT. For the future, improved medical interventions are needed to decrease the sexual symptoms.

ObjectiveThis study applied the Society Ecosystems Theory to investigate Fear of Progression (FoP) prevalence and predictors in gynecological malignancy patients. By constructing and comparing three machine learning models, we sought to identify the optimal scientifically validated predictive tool for FoP risk in clinical practice, thereby enabling early identification of high-risk populations and informing evidence-based targeted interventions.MethodsA convenience sample of 330 patients diagnosed with gynecological malignancies was recruited from a tertiary hospital in China between September 2023 and August 2024. Data were collected through validated instruments: the General Information Questionnaire, Fear of Progression Questionnaire-Short Form, Comprehensive Scores for Financial Toxicity, Chinese Dyadic Coping Inventory, Perceived Social Support Scale, and Chinese Memorial Symptom Assessment Scale. The dataset was partitioned into training (70%, n = 231) and testing sets (30%, n = 99) using stratified random sampling. Patients were classified into FoP and non-FoP groups based on diagnostic criteria. Three machine learning algorithms, logistic regression (LR), support vector machine (SVM), and random forest (RF) were implemented to develop FoP prediction models. Model performance was compared using accuracy, recall, precision, F1-score, and area under the ROC curve (AUC-ROC) to select the optimal model.ResultsThis study included 330 patients with gynecological malignancies, with a FoP incidence of 52.7% (n = 174). All three models identified social support, dyadic coping, mindset bias, and elevated tumor markers as significant predictors of FoP (P< 0.05). Additionally, symptom distress and financial toxicity demonstrated significant predictive value in the SVM and RF models. Comparative analysis revealed that the RF model outperformed the LR and SVM models in overall predictive performance.ConclusionsThe Random Forest-based prediction model exhibited optimal performance, demonstrating high accuracy and reliability in identifying FoP risk among gynecological malignancy patients. It can provide a scientific foundation for early FoP detection and personalized intervention strategies. These findings underscore the clinical utility of combining machine learning approaches with social-ecological theory to advance precision nursing practices in psycho-oncology care.

Background:Cancer-related fatigue (CRF) is a persistent, distressing, subjective sense of physical, emotional, or cognitive tiredness or exhaustion disproportionate to recent activity and interferes with normal functioning. Jing Si herbal tea (JSHT) has shown several pharmacological actions in preclinical and clinical models. We aimed to investigate the effect of JSHT on alleviating CRF in patients with gynecological cancer.Methods:A randomized controlled trial was conducted at our hospital from March 1, 2021 to December 31, 2023. Participants aged 20 to 80 years with gynecologic cancer and moderate-to-severe CRF were randomly categorized into 2 groups. The intervention group was given JSHT twice daily for 6 weeks, while the control group was given a placebo for 3 weeks and JSHT for the following 3 weeks. The primary outcomes were fatigue and quality of life, which were evaluated using the brief fatigue inventory-total (BFI-T) and functional assessment of cancer therapy-general 7 scale. The secondary outcomes included white blood cells and differential counts.Results:Among the 19 participants, there was no significant difference in CRF (BFI-T) and quality of life (functional assessment of cancer therapy-general 7) improvement between the intervention group (n = 9) and the control group (n = 10). However, both groups showed significant improvements in BFI-T: global fatigue score, BFI-T: fatigue intensity, and BFI-T: fatigue interference after treatment (P < .05). The difference in monocyte count was statistically significant after treatment in both groups (P < .001), with the intervention group showing a significant decrease in monocyte count compared to the control group at the beginning of cycle 2 (P < .05).Conclusion:Both intervention and control groups improved fatigue and decreased monocyte counts. Further research is needed to explore these findings and their clinical relevance.

This study aimed to examine the level of spiritual experience and the impact of socio-demographic and clinical features, anxiety and depression, and spiritual well-being on the spiritual experiences of hospitalized patients with gynecological cancer. This cross-sectional study was conducted with 192 patients in a university-affiliated hospital in the west of Turkey. The participants completed self-assessment tools, including the Daily Spiritual Experience Scale, the Functional Assessment of Chronic Illness Therapy--Spiritual Well-Being Scale, and the Hospital Anxiety and Depression Scale. According to the results of the hierarchical linear regression analysis, the statistically significant factors affecting spiritual experience among patients with gynecologic cancer were age (β = -.219), anxiety (β = .208), depression (β = .172), and faith (β = -.312). Meaning and peace subdimensions of spiritual well-being were not found to be a significant predictor of spiritual experience. This indicates that when the subdimensions contaminating the construct of spiritual well-being are removed, the faith subdimension predicts spiritual experience more strongly. Gynecological cancer patients may have spiritual issues, so health professionals should provide spiritual support.

To compare the survival difference between 2018 International Federation of Gynecology and Obsterics (FIGO) stage IIB cervical cancer (CC) patients with Unilateral parametrial invasion (UL) and Bilateral parametrial invasion (BL) disease and explore the significant role of parametrial invasion (PI) in prognosis prediction. A total of 506 stage IIB CC patients were identified from the multi-center study and patients were divided into UL and BL groups according to gynecological and radiological examination. Survival outcomes were estimated and compared between two groups before and after Propensity Scoring Matching (PSM). The role of upper 2/3 vaginal invasion (VI) in impacting survival probability was also assessed. The random forest (RF) model was constructed and validated to select important features related to survival outcomes and predict prognosis for these patients. The SHapley Additive exPlanation (SHAP) was further introduced to provide better understanding towards the findings from RF model. Significant better 5-year overall survival (OS) was observed among patients with UL disease whether before [BL : 61.7% (95%CI : 57.0%-66.4%); UL : 84.8% (95%CI : 82.4%-87.2%); HR = 2.83, 95%CI : 1.90-4.20, P < 0.001] or after PSM [BL : 61.3% (95%CI : 56.6%-66.0%); UL : 81.2% (95%CI : 77.3%-85.1%); HR = 2.51, 95%CI : 1.56-4.04, P < 0.001]. Similar findings could also be observed in terms of progression free survival (PFS). The presence of VI didn't significantly impair the survival probability whether in UL or BL group (All P > 0.05). RF model was constructed, which possessed decent predictive ability both in the training (AUC = 0.893; 95%CI : 0.874-0.912) and validation cohort (AUC = 0.879; 95%CI : 0.801-0.957). PI was identified to be the paramount feature in affecting the survival outcomes for stage IIB CC patients through the Beeswarm summary plot and bar chart in SHAP analysis. Our findings demonstrated that 2018 FIGO stage IIB CC patients with BL disease had worse prognosis than those with UL disease and PI was the most significant feature in prognosis prediction for these patients.

PurposeInsomnia places significant physical and psychological burdens on female cancer patients undergoing chemotherapy, affecting their quality of life. This study aimed to investigate the prevalence of insomnia and its associated factors in female outpatients receiving chemotherapy.Patients and MethodsA cross-sectional study was conducted with female cancer patients receiving chemotherapy. The questionnaire included items assessing sociodemographic and clinical characteristics. Insomnia was measured using the Insomnia Severity Index.ResultsA total of 206 female patients undergoing chemotherapy were included, with a mean age of 56.1 years (SD ± 11.7). The most common cancer types were breast (57.3%), gastrointestinal (22.8%), and gynecological malignancies (19.9%). Based on the Insomnia Severity Index (ISI), 34.0% of participants had subclinical insomnia and 17.0% had clinical insomnia. Increasing age was significantly associated with lower insomnia severity (aOR: 0.971; 95% CI: 0.945–0.998; p = 0.038). Among gynecological cancer patients, insomnia was more prevalent in those receiving treatment for metastatic disease (76.2% vs 35.0%). Psychiatric conditions (depression and/or anxiety) requiring medication and the presence of pain were both significantly associated with higher rates of insomnia (p < 0.001 for both).ConclusionInsomnia was highly prevalent among female cancer patients undergoing chemotherapy. Younger age, presence of pain, psychiatric comorbidities (particularly depression and/or anxiety), and metastatic disease status emerged as significant correlates. Considering the relationship between insomnia and physical and psychological distress, it is anticipated that regular screening and treatment approaches for insomnia will contribute to the holistic cancer care process by improving patient quality of life.

Objective: To clarify the impact of systematic nursing on preventing lower limb deep venous thrombosis after obstetricsand gynaecology surgery.Method: The study was conducted at the Nanjing Women and Children's Healthcare Hospital, Nanjing, China, fromNovember 2020 to November 2022, and comprised women inpatients who had undergone caesarean section. The subjectswere randomised into control group CG and observation group OG. CG subjects underwent conventional nursing, whileOG subjects received systematic nursing intervention, including preoperative, intraoperative and postoperative nursing.Negative emotions, nursing satisfaction, complication incidence and lower limb status were compared between the groups.Data was analysed using SPSS 27.Results: Of the 100 subjects, 50(50%) women were in CG group with mean age 29.41±1.34 years, while 50(50%) were inOG group with mean age 29.55±1.35 years. Post-intervention, negative emotion scores were lower, nursing satisfactionscores were higher, the incidences of lower limb deep venous thrombosis and pulmonary embolism were fewer, and thescores of lower limb status were lower in OG group compared to CG (p&lt;0.05).Conclusion: The application of systematic nursing intervention in obstetrics and gynaecology patients undergoing surgerycould effectively prevent lower limb deep venous thrombosis, reduce the incidence of pulmonary embolism, improvepatients’ lower limb status and negative emotions, and increase satisfaction level with nursing.Keywords: Lower limb, Deep venous thrombosis, Obstetrics and gynaecology, Systematic nursing.

Nutcracker syndrome (NS) is a rare pathology that occurs when the left renal vein (LRV) is compressed between the aorta and the superior mesenteric artery. This anomaly is rarely diagnosed due to low awareness and polymorphism of clinical manifestations, but the consequences of phlebohypertension in the left renal vein system (left-sided varicocele, left-sided pudendal varices, hematuria, proteinuria and, in some cases, renal failure) constitute a significant medical and social problem. Right-sided NS is an even rarer variant of the group of abdominal vascular compression syndromes (AVCS). Pregnancy is a determining factor contributing to right-sided NS due to extravasal compression of the right renal vein by the gravid uterus. The aim of our study was to analyze an unusual clinical case of right-sided NS with an atypical clinical picture, which confirms the need for physicians to be aware of AVCS. An example of a complex diagnosis of right-sided NS with an atypical clinical manifestation in a 24-year-old patient who was urgently hospitalized in the surgical department with a clinic of acute appendicitis on the 3rd day after delivery is presented. The patient underwent a preoperative ultrasound examination of the abdominal cavity and pelvic organs – multiple hypoechoic masses in the right iliac region measuring 1.5 – 1.7 cm were visualized. Intraoperatively, a large varicose, tortuous, thrombosed right ovarian vein was verified, which was removed in its entirety along with the right appendages. The postoperative period was without complications. She was discharged on the 7th day. According to the control ultrasound examination on the 5th day after the intervention, no pathology was detected. There are no clinical symptoms in the long-term postoperative period. Pelvic phlebostasis is a pathology that occurs mainly in women of reproductive age, but to date there is no data on its impact on the occurrence of idiopathic forms of infertility, pregnancy, the course of childbirth, the occurrence and course of gynecological pathology. It is known that pelvic varicose veins not only accompany various gynecological diseases, but also cause chronic pelvic pain (pelvic congestion syndrome). Pelvic varices have until now been more often considered an incidental diagnostic finding. At a young age, asymptomatic forms of the disease are more often diagnosed, in which organic changes in the venous system of the small pelvis are detected only when using additional research methods. At the same time, about 10 % of gynecological patients suffer from chronic pelvic pain. These patients have been unsuccessfully examined and treated for years for chronic inflammatory processes of the appendages, genital endometriosis. According to various data, the cause of pelvic venous congestion in 74 % of cases is NS, in 17 % – May-Turner syndrome, in 9 % – a combination of these two causes. The pronounced polymorphism of clinical manifestations significantly complicates the diagnosis and management of vascular compression syndromes, decompensated forms of pelvic venous congestion require a multidisciplinary approach and timely adequate surgical treatment.

BackgroundTo investigate the predictive role of a risk assessment model constructed using Caprini score combined with D‐dimer in gynecological postoperative patients for the occurrence of deep vein thrombosis.MethodsPatients scheduled for gynecological surgery at our hospital between January 2018 and April 2024 were included. This study included 136 patients, with 35 cases in the DVT group and 101 cases in the non‐DVT group. General information, intraoperative parameters, D‐dimer levels, Caprini Score, lower extremity Doppler ultrasonography, and intervention methods were collected. Logistic regression analysis and a combined model were employed to analyze the factors influencing the occurrence of DVT.ResultsCompared to non‐DVT patients, the DVT group had a significantly older age (p = 0.035), higher hypertension prevalence (p = 0.025), and more complex surgeries (p = 0.004). Pre‐discharge D‐dimer levels and pre‐/postoperative Caprini scores were markedly elevated in DVT patients (p < 0.05). Critically, logistic regression identified pre‐discharge D‐dimer levels (p < 0.001), preoperative Caprini score (p = 0.003), and postoperative Caprini score (p < 0.001) as independent risk factors for DVT. The combined prediction model integrating these factors achieved an AUC of 0.812, demonstrating high discriminative power for postoperative DVT occurrence.ConclusionThe predictive value of the DVT prediction model constructed using the Caprini score in combination with D‐dimer for the occurrence of DVT is high. The combined predictive model can be further promoted in clinical practice to take appropriate preventive measures to reduce the likelihood of DVT occurrence and to intervene promptly in existing risk factors.

Optimizing the screening and management of preoperative anemia prior to gynecologic oncology surgery (OPRA1): A quality improvement initiative.

Assessment of probiotic and prebiotic use in gynecologic cancer patients: a systematic review.

The impact of brachytherapy on sexual life in patients with gynecological cancer.

We investigated the employment status of patients who received tri‒weekly TC therapy as primary treatment for initial ovarian cancer and uterine cancer at the time of starting treatment and were receiving wages from work. Six patients continued working at the time chemotherapy started, and the carcinomas were ovarian cancer in 2 cases and uterine cancer in 4 cases. The 6 patients who continued working completed the planned course. There was no postponement of treatment due to side effects during the planned treatment period. Six out of 6 patients had Grade 2 peripheral neuropathy. The fact that there was no work that was hindered by peripheral neuropathy is thought to be the reason why chemotherapy could be continued without quitting or taking a leave of absence.

The price of delay: Insurance-related treatment delays in patients with gynecologic cancer receiving immunotherapy.

354 Background: Financial toxicity (FT) affects at least one quarter of cancer patients starting treatment. One potential strategy to decrease FT is to provide upfront financial education to help patients manage costs of care. With extensive stakeholder input, we developed one such strategy, i.e., the Proactive Costs of Care (PCOC) intervention. Here we present results of its pilot trial. Methods: This randomized pilot study included newly diagnosed breast, gynecologic, and colorectal cancer patients at the University of Alabama at Birmingham. Participants were randomized to usual care (UC) or PCOC, i.e. a one-time session near treatment initiation with a trained lay educator to review cost-related informational materials, including: (1) “Insurance, Employment, and Financial Assistance Flyer” e.g., about insurance benefits, medical bills, federal job protection and supplemental income benefits; (2) “Cost Tracker” with a glossary of potential out-of-pocket (OOP) costs and space to track them; (3) “Cost Infographic” with cancer/stage-specific average OOP costs from published studies. The primary outcome was 6-month change in FT (Comprehensive Score for financial Toxicity [COST]; score 0-44, lower score worse FT, and FT positive if COST score &lt; 26) and anxiety (Generalized Anxiety Disorder [GAD]-7, score 0-21, higher score higher anxiety, and moderate/severe anxiety if GAD score ≥10). Intention to treat (ITT) analyses were conducted using linear mixed-effects models for repeated measures. Results: The 60 randomized participants (29 PCOC, 31 UC) were on average 55 years old (SD 11), 49% Black, 43% married/partnered, 51% college educated, 52% with incomes ≥$60,000, 38% employed, and 76% privately insured. In the PCOC arm, most met with the educator (83%) and reviewed all materials (69%). Results are presented in Table 1. COST score improved significantly over 6 months for PCOC vs. UC group (p = 0.02). Conclusions: This educational, minimal touch, PCOC intervention has the potential to reduce FT. These results support the need for a larger study to demonstrate effectiveness of PCOC on FT. Clinical trial information: NCT05939440 . Outcome PCOC Baseline N = 29 PCOC6 months N = 23 UC BaselineN= 31 UC6 monthsN = 26 PCOC Estimated least squares change(6 months − baseline) a Mean(95% CI) P value UC Estimated least squares change(6 months − baseline) a Mean(95% CI) P value Absolute change differencePCOC vs UC a Mean(95% CI) P value COST score mean (SD) 20.8 (10.78) 24.0 (10.12) 23.4 (9.65) 22.6(10.61) 4.1(1.14, 7.09) 0.008 -0.78(-3.59, 2.02) 0.58 4.9 (0.81, 8.98) 0.020 FT % 58.6 60.9 58.1 50.0 OR 0.94(0.25, 3.47) 0.92 OR 0.68(0.20, 2.27) 0.52 OR 1.38(0.23, 8.19) 0.72 GAD-7 scoremean (SD) 6.3(6.00) 4.9(5.80) 5.3(5.16) 4.3 (4.33) -1.5(-3.45, 0.40) 0.12 -1.1(-2.95, 0.69) 0.22 -0.4(-3.04, 2.25) 0.77 Mod/sev anxiety % 27.6 17.4 22.6 15.4 OR 0.53(0.13, 2.19) 0.37 OR 0.60(0.15, 2.46) 0.47 OR 0.88(0.12, 6.53) 0.90 OR: Odds Ratio; a From linear mixed-effects models.