2023
Uterine Neoplasms, Version 1.2023, NCCN Clinical Practice Guidelines in Oncology.
Abu-Rustum N, Yashar C, Arend R, Barber E, Bradley K, Brooks R, Campos S, Chino J, Chon H, Chu C, Crispens M, Damast S, Fisher C, Frederick P, Gaffney D, Giuntoli R, Han E, Holmes J, Howitt B, Lea J, Mariani A, Mutch D, Nagel C, Nekhlyudov L, Podoll M, Salani R, Schorge J, Siedel J, Sisodia R, Soliman P, Ueda S, Urban R, Wethington S, Wyse E, Zanotti K, McMillian N, Aggarwal S. Uterine Neoplasms, Version 1.2023, NCCN Clinical Practice Guidelines in Oncology. Journal Of The National Comprehensive Cancer Network 2023, 21: 181-209. PMID: 36791750, DOI: 10.6004/jnccn.2023.0006.Peer-Reviewed Original ResearchMeSH KeywordsAdenocarcinoma, Clear CellCarcinoma, EndometrioidCarcinosarcomaEndometrial NeoplasmsFemaleHumansUterine NeoplasmsConceptsUterine neoplasmsNCCN guidelinesNCCN Clinical Practice GuidelinesPure endometrioid carcinomasUterine cancer casesClinical practice guidelinesFemale genital tractMesenchymal sarcomaEndometrial histologyEndometrioid cancerCommon malignancyEndometrial carcinomaUncommon subtypeEndometrioid carcinomaUterine cancerGenital tractCancer casesPractice guidelinesCarcinomaNeoplasmsCancerGuidelinesAdenocarcinomaEndometriumSarcomaThe Impact of Racial Disparities on Outcome in Patients With Stage IIIC Endometrial Carcinoma
Patrich T, Wang Y, Elshaikh M, Zhu S, Damast S, Li J, Fields E, Beriwal S, Keller A, Kidd E, Usoz M, Jolly S, Jaworski E, Leung E, Taunk N, Chino J, Russo A, Lea J, Lee L, Albuquerque K, Hathout L. The Impact of Racial Disparities on Outcome in Patients With Stage IIIC Endometrial Carcinoma. American Journal Of Clinical Oncology 2023, 46: 114-120. PMID: 36625449, DOI: 10.1097/coc.0000000000000975.Peer-Reviewed Original ResearchMeSH KeywordsChemotherapy, AdjuvantEndometrial NeoplasmsFemaleHumansLymph NodesNeoplasm StagingRetrospective StudiesConceptsStage IIIC endometrial carcinomaRecurrence-free survivalNon-black patientsParaaortic lymph nodesGrade 3 tumorsBlack patientsOverall survivalEndometrial carcinomaWorse OSLymph nodesNonendometrioid histologyPositive paraaortic lymph nodesRetrospective multi-institutional studyKaplan-Meier methodMulti-institutional studySPSS version 27Adjuvant chemotherapyConcurrent chemoradiotherapyHazard ratioRFS ratesClinical outcomesRandomized trialsNonsignificant trendPatientsPrognostic covariates
2022
Radiation therapy in the definitive management of medically inoperable endometrial cancer
Chin C, Damast S. Radiation therapy in the definitive management of medically inoperable endometrial cancer. International Journal Of Gynecological Cancer 2022, 32: 323-331. PMID: 35256419, DOI: 10.1136/ijgc-2021-002532.Peer-Reviewed Original ResearchMeSH KeywordsBrachytherapyEndometrial NeoplasmsFemaleHumansImaging, Three-DimensionalMagnetic Resonance ImagingRadiotherapy DosageRadiotherapy Planning, Computer-AssistedConceptsMultiparametric magnetic resonance imagingInoperable patientsEndometrial cancerImage-guided brachytherapyRadiation therapySystemic anti-tumor immune responseAnti-tumor immune responseThree-dimensional image-guided brachytherapyInoperable endometrial cancerDefinitive radiation therapyPoor surgical candidatesNovel systemic agentsRecent consensus guidelinesHigh-volume centersExtent of tumorRates of obesityMagnetic resonance imagingMedical inoperabilityLate morbiditySurgical candidatesSystemic agentsClinical stagingDefinitive managementOngoing trialsUterine size
2021
A phase 2 evaluation of pembrolizumab for recurrent Lynch‐like versus sporadic endometrial cancers with microsatellite instability
Bellone S, Roque DM, Siegel ER, Buza N, Hui P, Bonazzoli E, Guglielmi A, Zammataro L, Nagarkatti N, Zaidi S, Lee J, Silasi D, Huang GS, Andikyan V, Damast S, Clark M, Azodi M, Schwartz PE, Tymon‐Rosario J, Harold JA, Mauricio D, Zeybek B, Menderes G, Altwerger G, Ratner E, Alexandrov LB, Iwasaki A, Kong Y, Song E, Dong W, Elvin JA, Choi J, Santin AD. A phase 2 evaluation of pembrolizumab for recurrent Lynch‐like versus sporadic endometrial cancers with microsatellite instability. Cancer 2021, 128: 1206-1218. PMID: 34875107, PMCID: PMC9465822, DOI: 10.1002/cncr.34025.Peer-Reviewed Original ResearchConceptsObjective response rateImmune checkpoint inhibitorsProgression-free survivalEndometrial cancerWhole-exome sequencingSporadic endometrial cancerOverall survivalEnd pointPhase 2 pilot studyPrimary end pointSecondary end pointsTumor mutation burdenPhase 2 evaluationLarger confirmatory studiesAntigen processing/presentationProcessing/presentationCheckpoint inhibitorsSurgical resectionICI resistanceDMMR patientsPrognostic significanceDMMR tumorsMechanisms of resistanceLocal treatmentSporadic MSIDoes Prophylactic Paraortic Lymph Node Irradiation Improve Outcomes in Women With Stage IIIC1 Endometrial Carcinoma?
Yoon J, Fitzgerald H, Wang Y, Wang Q, Vergalasova I, Elshaikh MA, Dimitrova I, Damast S, Li JY, Fields EC, Beriwal S, Keller A, Kidd EA, Usoz M, Jolly S, Jaworski E, Leung EW, Donovan E, Taunk NK, Chino J, Natesan D, Russo AL, Lea JS, Albuquerque KV, Lee LJ, Hathout L. Does Prophylactic Paraortic Lymph Node Irradiation Improve Outcomes in Women With Stage IIIC1 Endometrial Carcinoma? Practical Radiation Oncology 2021, 12: e123-e134. PMID: 34822999, DOI: 10.1016/j.prro.2021.10.002.Peer-Reviewed Original ResearchMeSH KeywordsEndometrial NeoplasmsFemaleHumansLymph NodesNeoplasm Recurrence, LocalNeoplasm StagingRadiotherapy, AdjuvantRetrospective StudiesConceptsStage IIIC1 endometrial cancerPelvic radiation therapyOverall survivalEndometrial cancerRadiation therapySurvival outcomesFirst recurrenceHazard ratioRFS ratesCommon siteRecurrence-free survival ratesMulti-institutional retrospective studyPropensity scoreCox proportional hazards modelImproved survival outcomesKaplan-Meier methodProportional hazards modelInternational FederationNew therapeutic approachesAdjuvant chemotherapyDistant recurrenceSystemic chemotherapyImprove OutcomesClinical outcomesDistant metastasisPrognostic impact of mismatch repair deficiency in high- and low-intermediate-risk, early-stage endometrial cancer following vaginal brachytherapy
Li JY, Park HS, Huang GS, Young MR, Ratner E, Santin A, Damast S. Prognostic impact of mismatch repair deficiency in high- and low-intermediate-risk, early-stage endometrial cancer following vaginal brachytherapy. Gynecologic Oncology 2021, 163: 557-562. PMID: 34602287, DOI: 10.1016/j.ygyno.2021.09.018.Peer-Reviewed Original ResearchConceptsRecurrence-free survivalEndometrioid endometrial cancerVaginal brachytherapyPMMR patientsOverall survivalEEC patientsEndometrial cancerExact testThree-year recurrence-free survivalEarly-stage endometrial cancerCox proportional hazards regressionPoor recurrence-free survivalAdjuvant vaginal brachytherapyThree-year OSMultivariable Cox regressionLympho-vascular invasionSignificant prognostic variablesProportional hazards regressionLog-rank testKaplan-Meier estimatesDeficient mismatch repairMismatch repair statusFisher's exact testMismatch repair deficiencyDMMR statusNCCN Guidelines® Insights: Uterine Neoplasms, Version 3.2021.
Abu-Rustum NR, Yashar CM, Bradley K, Campos SM, Chino J, Chon HS, Chu C, Cohn D, Crispens MA, Damast S, Diver E, Fisher CM, Frederick P, Gaffney DK, George S, Giuntoli R, Han E, Howitt B, Huh WK, Lea J, Mariani A, Mutch D, Nekhlyudov L, Podoll M, Remmenga SW, Reynolds RK, Salani R, Sisodia R, Soliman P, Tanner E, Ueda S, Urban R, Wethington SL, Wyse E, Zanotti K, McMillian NR, Motter AD. NCCN Guidelines® Insights: Uterine Neoplasms, Version 3.2021. Journal Of The National Comprehensive Cancer Network 2021, 19: 888-895. PMID: 34416706, DOI: 10.6004/jnccn.2021.0038.Peer-Reviewed Original ResearchA phase II evaluation of pembrolizumab in recurrent microsatellite instability-high (MSI-H) endometrial cancer patients with Lynch-like versus MLH-1 methylated characteristics (NCT02899793)
Bellone S, Roque DM, Siegel ER, Buza N, Hui P, Bonazzoli E, Guglielmi A, Zammataro L, Nagarkatti N, Zaidi S, Lee J, Silasi D, Huang GS, Andikyan V, Damast S, Clark M, Azodi M, Schwartz PE, Tymon-Rosario J, Harold J, Mauricio D, Zeybek B, Menderes G, Altwerger G, Ratner E, Alexandrov LB, Iwasaki A, Kong Y, Song E, Dong W, Elvin J, Choi J, Santin AD. A phase II evaluation of pembrolizumab in recurrent microsatellite instability-high (MSI-H) endometrial cancer patients with Lynch-like versus MLH-1 methylated characteristics (NCT02899793). Annals Of Oncology 2021, 32: 1045-1046. PMID: 33932502, PMCID: PMC9465821, DOI: 10.1016/j.annonc.2021.04.013.Commentaries, Editorials and LettersA Multi-Institutional Analysis of Adjuvant Chemotherapy and Radiation Sequence in Women With Stage IIIC Endometrial Cancer
Hathout L, Wang Y, Wang Q, Vergalasova I, Elshaikh MA, Dimitrova I, Damast S, Li JY, Fields EC, Beriwal S, Keller A, Kidd EA, Usoz M, Jolly S, Jaworski E, Leung EW, Donovan E, Taunk NK, Chino J, Natesan D, Russo AL, Lea JS, Albuquerque KV, Lee LJ. A Multi-Institutional Analysis of Adjuvant Chemotherapy and Radiation Sequence in Women With Stage IIIC Endometrial Cancer. International Journal Of Radiation Oncology • Biology • Physics 2021, 110: 1423-1431. PMID: 33677053, DOI: 10.1016/j.ijrobp.2021.02.055.Peer-Reviewed Original ResearchConceptsStage IIIC endometrial carcinomaOverall survivalEndometrial carcinomaRadiation therapyAdjuvant chemotherapyAdjuvant therapyPALN recurrenceSystemic chemotherapyRFS ratesMulti-institutional retrospective cohort studyStage IIIC endometrial cancerRecurrence-free survival ratesLymph node recurrenceSequential radiation therapyAdjuvant radiation therapyRetrospective cohort studyGrade 3 tumorsAdjuvant treatment regimensKaplan-Meier methodVaginal cuff brachytherapyHigh rateSequence of treatmentChemotherapy concurrentNodal radiationNode recurrence
2020
Radiation for Cancers of the Uterine Corpus and Cervix: Incremental Steps, and Glimmers of the Future
Chino J, Damast S, Kidd E, Harkenrider M, Albuquerque K, Kamrava M. Radiation for Cancers of the Uterine Corpus and Cervix: Incremental Steps, and Glimmers of the Future. International Journal Of Radiation Oncology • Biology • Physics 2020, 108: 839-845. PMID: 33069345, DOI: 10.1016/j.ijrobp.2020.06.012.Peer-Reviewed Original ResearchStage III uterine serous carcinoma: modern trends in multimodality treatment
Li JY, Young MR, Huang G, Litkouhi B, Santin A, Schwartz PE, Damast S. Stage III uterine serous carcinoma: modern trends in multimodality treatment. Journal Of Gynecologic Oncology 2020, 31: e53. PMID: 32266802, PMCID: PMC7286763, DOI: 10.3802/jgo.2020.31.e53.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrachytherapyEndometrial NeoplasmsFemaleHumansHysterectomyMiddle AgedNeoplasm StagingRadiotherapy, AdjuvantRetrospective StudiesConceptsUterine serous carcinomaExternal beam RTVaginal brachytherapyOverall survivalHuman epidermal growth factor receptorModern treatment eraSentinel node samplingRegional nodal recurrenceKaplan-Meier estimatesLog-rank testCox proportional hazardsExternal beam radiotherapyEpidermal growth factor receptorERA treatmentGrowth factor receptorUSC patientsFree survivalNodal recurrenceTreatment eraMultimodality treatmentPatient characteristicsPerioperative periodRegional nodalSerous carcinomaNode sampling
2019
Outcomes and relapse patterns of stage IB grade 2 or 3 endometrial cancer treated with adjuvant vaginal brachytherapy
Hochreiter A, Kelly JR, Young MR, Litkouhi B, Black JD, Stromberger C, Higgins S, Schwartz PE, Damast S. Outcomes and relapse patterns of stage IB grade 2 or 3 endometrial cancer treated with adjuvant vaginal brachytherapy. International Journal Of Gynecological Cancer 2019, 30: 48. PMID: 31722964, DOI: 10.1136/ijgc-2019-000675.Peer-Reviewed Original ResearchConceptsDisease-free survivalLower uterine segment involvementPelvic recurrence-free survivalStage IB grade 2Uterine segment involvementLymph node dissectionRecurrence-free survivalEndometrial cancerRisk factorsVaginal brachytherapyOverall survivalGrade 2Endometrioid histologyNode dissectionPelvic recurrenceSegment involvementLymph nodesMyometrial invasionMultivariable Cox proportional hazards regressionEarly-stage endometrial cancerUnderwent lymph node dissectionCox proportional hazards regressionReduced disease-free survivalAdjuvant vaginal brachytherapySole adjuvant therapy
2018
Extended duration of dilator use beyond 1 year may reduce vaginal stenosis after intravaginal high-dose-rate brachytherapy
Stahl JM, Qian JM, Tien CJ, Carlson DJ, Chen Z, Ratner ES, Park HS, Damast S. Extended duration of dilator use beyond 1 year may reduce vaginal stenosis after intravaginal high-dose-rate brachytherapy. Supportive Care In Cancer 2018, 27: 1425-1433. PMID: 30187220, DOI: 10.1007/s00520-018-4441-5.Peer-Reviewed Original ResearchConceptsVaginal stenosisEndometrial carcinomaMultivariable Cox proportional hazardsMultivariable Cox regression analysisVD useAcademic tertiary referral centerTertiary referral centerCox regression analysisLog-rank testCox proportional hazardsDevelopment of gradeDilator usePelvic radiotherapyReferral centerNoncompliant patientsPrimary outcomeAdjuvant brachytherapyEC patientsConclusionsThe riskRate brachytherapyProportional hazardsOptimal durationPatientsBrachytherapyStudy period
2017
Cost-effectiveness of adjuvant intravaginal brachytherapy in high-intermediate risk endometrial carcinoma
Stahl JM, Damast S, Bledsoe TJ, An Y, Verma V, Yu JB, Young MR, Lester-Coll NH. Cost-effectiveness of adjuvant intravaginal brachytherapy in high-intermediate risk endometrial carcinoma. Brachytherapy 2017, 17: 399-406. PMID: 29275078, DOI: 10.1016/j.brachy.2017.11.012.Peer-Reviewed Original ResearchConceptsQuality-adjusted life yearsIncremental cost-effectiveness ratioPay thresholdsAdjuvant intravaginal brachytherapyOne-way sensitivity analysesProbabilistic sensitivity analysesCost-effectiveness ratioBase-case analysisAverage cumulative costSocietal willingnessSensitivity analysisLife yearsTime horizonPORTEC-2 trialCumulative costsWillingnessPORTEC-1Medicare reimbursementCostHIR patientsMean costPreferred management optionMarkov modelCase analysisNet increaseImpact of vaginal cylinder diameter on outcomes following brachytherapy for early stage endometrial cancer
Qian JM, Stahl JM, Young MR, Ratner E, Damast S. Impact of vaginal cylinder diameter on outcomes following brachytherapy for early stage endometrial cancer. Journal Of Gynecologic Oncology 2017, 28: 0. PMID: 29027402, PMCID: PMC5641534, DOI: 10.3802/jgo.2017.28.e84.Peer-Reviewed Original ResearchMeSH KeywordsAdenocarcinomaAdultAgedAged, 80 and overBody Mass IndexBrachytherapyConstriction, PathologicDatabases, FactualEndometrial NeoplasmsFemaleGastrointestinal DiseasesGravidityHumansHysterectomyLymph Node ExcisionMiddle AgedNeoplasm StagingOvariectomyRadiation InjuriesRadiotherapy, AdjuvantSalpingectomyTreatment OutcomeVaginaVaginal DiseasesConceptsVaginal brachytherapyVaginal symptomsLate grade 3 toxicityEarly-stage endometrial cancerNormal body mass indexAdjuvant vaginal brachytherapyGrade 3 toxicityShorter vaginal lengthStage endometrial cancerEndometrial cancer patientsBody mass indexRate of recurrenceAcute gastrointestinalTreatment tolerabilityVaginal stenosisEndometrial cancerVaginal lengthMass indexRecurrence rateCancer patientsVaginal toxicityTreatment characteristicsHigh riskSide effectsPatientsAdjuvant Therapy Use and Survival in Stage II Endometrial Cancer
Lester-Coll NH, Young MR, Park HS, Ratner ES, Litkouhi B, Damast S. Adjuvant Therapy Use and Survival in Stage II Endometrial Cancer. International Journal Of Gynecological Cancer 2017, 27: 1904-1911. PMID: 28763364, DOI: 10.1097/igc.0000000000001095.Peer-Reviewed Original ResearchConceptsReceipt of chemotherapyEndometrioid endometrial carcinomaNational Cancer Data BaseImproved overall survivalRole of chemotherapyOverall survivalAdjuvant chemotherapyAdjuvant treatmentStage II endometrial cancerCox proportional hazards regressionPropensity scoreAdjuvant therapy useGrade 3 diseaseStage II patientsProportional hazards regressionWorse overall survivalMultivariable logistic regressionKaplan-Meier estimatesLog-rank testAdjuvant radiotherapyExcellent prognosisLymphovascular invasionObservational cohortEEC patientsEndometrial cancer
2016
Influence of robotic-assisted laparoscopic hysterectomy on vaginal cuff healing and brachytherapy initiation in endometrial carcinoma patients
Stahl JM, Park HS, Silasi DA, Azodi M, Damast S. Influence of robotic-assisted laparoscopic hysterectomy on vaginal cuff healing and brachytherapy initiation in endometrial carcinoma patients. Practical Radiation Oncology 2016, 6: 226-232. PMID: 27364883, DOI: 10.1016/j.prro.2015.09.015.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrachytherapyEndometrial NeoplasmsFemaleHumansHysterectomyMiddle AgedRoboticsVaginaConceptsRobotic-assisted laparoscopic hysterectomyVaginal cuff healingEndometrial carcinoma patientsIntravaginal brachytherapyAdjuvant intravaginal brachytherapyCuff healingLaparoscopic hysterectomyCarcinoma patientsEndometrial carcinomaTAH patientsHealing statusHealing timeEarly-stage endometrial carcinomaExternal beam radiation therapyVaginal cuff recurrenceTotal abdominal hysterectomyBeam radiation therapyAbdominal hysterectomySecondary outcomesConsecutive patientsLocal recurrencePrimary outcomeOncology evaluationMean intervalHysterectomyWho benefits from chemoradiation in stage III–IVA endometrial cancer? An analysis of the National Cancer Data Base
Lester-Coll NH, Park HS, Rutter CE, Corso CD, Young MR, Ratner ES, Litkouhi B, Decker RH, Yu JB, Damast S. Who benefits from chemoradiation in stage III–IVA endometrial cancer? An analysis of the National Cancer Data Base. Gynecologic Oncology 2016, 142: 54-61. PMID: 27151429, DOI: 10.1016/j.ygyno.2016.04.544.Peer-Reviewed Original ResearchConceptsAdvanced endometrial cancerImproved overall survivalNational Cancer Data BaseOverall survivalHistologic gradeEndometrial cancerCox proportional hazards regressionPropensity scoreMultivariable subgroup analysisSignificant OS benefitGrade 1 patientsProportional hazards regressionKaplan-Meier estimatesLog-rank testLack of benefitOS benefitAdjuvant therapyStage IIIAStage IVAFIGO stageAdjuvant CRTHazards regressionTumor sizeRegional radiotherapySubgroup analysis
2015
Factors Predictive of Improved Survival in Patients With Brain Metastases From Gynecologic Cancer
Gressel GM, Lundsberg LS, Altwerger G, Katchi T, Azodi M, Schwartz PE, Ratner ES, Damast S. Factors Predictive of Improved Survival in Patients With Brain Metastases From Gynecologic Cancer. International Journal Of Gynecological Cancer 2015, 25: 1711-1716. PMID: 26332394, PMCID: PMC4623851, DOI: 10.1097/igc.0000000000000554.Peer-Reviewed Original ResearchConceptsBrain metastatic diseaseEpithelial ovarian cancerBrain metastasesEndometrial cancerCervical cancerGynecologic cancerSurgical resectionTwo-year overall survival ratesLargest single-institution experienceSingle institution experienceOverall survival rateOverall survival dataMedian survival timeSignificant hazard ratioLong-term survivalHazard ratioMetastatic diseaseOverall survivalImproved survivalRetrospective reviewIntracranial metastasesPalliative carePoor prognosisCancer increasesFactors PredictivePredictors of vaginal stenosis after intravaginal high-dose-rate brachytherapy for endometrial carcinoma
Park HS, Ratner ES, Lucarelli L, Polizzi S, Higgins SA, Damast S. Predictors of vaginal stenosis after intravaginal high-dose-rate brachytherapy for endometrial carcinoma. Brachytherapy 2015, 14: 464-470. PMID: 25887343, DOI: 10.1016/j.brachy.2015.03.001.Peer-Reviewed Original ResearchConceptsVaginal stenosisDilator useIndependent predictorsEndometrial carcinomaTotal doseRate brachytherapyMultivariable logistic regression analysisExternal beam radiation therapyCommon Terminology CriteriaEffective adjuvant treatmentMonths of followupPost-treatment factorsBeam radiation therapyHigher total doseLogistic regression analysisTerminology CriteriaAdjuvant treatmentFollowup visitMean followupAdverse eventsLast followupMultivariable analysisRisk factorsRadiation therapyPatients