2024
Saturday, July 13, 202411:30 AM - 12:30 PMGSOR01 Presentation Time: 11:30 AM A Prospective Clinical Trial Assessing Comfort of Brachytherapy with a Novel Tapered Vaginal Applicator
Mahal A, Yu J, Mahal R, Tien C, Adefres B, Damast S. Saturday, July 13, 202411:30 AM - 12:30 PMGSOR01 Presentation Time: 11:30 AM A Prospective Clinical Trial Assessing Comfort of Brachytherapy with a Novel Tapered Vaginal Applicator. Brachytherapy 2024, 23: s72-s73. DOI: 10.1016/j.brachy.2024.08.099.Peer-Reviewed Original ResearchVisual-analogue-scaleVaginal brachytherapyVaginal stretchingVaginal applicationEndometrial cancerAssociated with less painIr-192 seedsDose fall-offClinically significant responseProspective clinical trialPatient-centered evaluationVaginal introitusProspective trialsDose distributionSurface doseVaginal mucosaIr-192Less painNarrow introitusPaired t-testEC patientsConsenting patientsClinical trialsIntroitusPatients
2023
Prognostic Impact of Mismatch Repair Deficiency on Stage I-II Endometrioid Endometrial Cancer Treated with Adjuvant Radiation Therapy: A Multi-Institutional Analysis
Sherwani Z, Alegun J, Russo A, Damast S, Albuquerque K, Nwachukwu C, Dyer M, Fields E, Beriwal S, Horne Z, Vergalasova I, Ohri N, Taunk N, Chino J, Kidd E, Leung E, Song J, Hathout L. Prognostic Impact of Mismatch Repair Deficiency on Stage I-II Endometrioid Endometrial Cancer Treated with Adjuvant Radiation Therapy: A Multi-Institutional Analysis. International Journal Of Radiation Oncology • Biology • Physics 2023, 117: s8. DOI: 10.1016/j.ijrobp.2023.06.217.Peer-Reviewed Original ResearchEndometrioid endometrial cancerEarly-stage endometrioid endometrial cancerExternal beam radiation therapyAdjuvant radiation therapyLymphovascular space invasionOverall survivalGrade 3Radiation therapyStage IMultivariate analysisWorse RFSWorse OSEndometrial cancerUnivariate analysisMulti-institutional retrospective cohort studyFIGO 2009 stage IRecurrence-free survival ratesCox proportional hazards modelPost-surgical stagingRetrospective cohort studyKaplan-Meier methodDeep myometrial invasionFIGO grade 1Proportional hazards modelBeam radiation therapyPO38 Clinical Outcomes Following Brachytherapy for Endometrial Cancer Patients with Narrow Vaginal Anatomy
Adefres B, Tien C, Damast S. PO38 Clinical Outcomes Following Brachytherapy for Endometrial Cancer Patients with Narrow Vaginal Anatomy. Brachytherapy 2023, 22: s84-s85. DOI: 10.1016/j.brachy.2023.06.139.Peer-Reviewed Original ResearchVaginal cuff brachytherapyVaginal recurrenceEndometrial cancerEC patientsVaginal surfaceClinical outcomesVaginal anatomyGrade 2Single-channel vaginal cylinderStage IVb endometrial cancerAdjuvant vaginal cuff brachytherapyConsecutive EC patientsEndometrial cancer patientsExcellent local controlKaplan-Meier methodExternal beam radiotherapyInsertional painBaseline painVaginal stenosisCTCAE v4.0Patient demographicsStage IIIAUrinary toxicityMedian ageMedian BMI
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 ResearchConceptsMultiparametric 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 ResearchConceptsStage 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 Research
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
Uterine Neoplasms, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology.
Koh WJ, Abu-Rustum NR, Bean S, Bradley K, Campos SM, Cho KR, Chon HS, Chu C, Cohn D, Crispens MA, Damast S, Dorigo O, Eifel PJ, Fisher CM, Frederick P, Gaffney DK, George S, Han E, Higgins S, Huh WK, Lurain JR, Mariani A, Mutch D, Nagel C, Nekhlyudov L, Fader AN, Remmenga SW, Reynolds RK, Tillmanns T, Ueda S, Wyse E, Yashar CM, McMillian NR, Scavone JL. Uterine Neoplasms, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology. Journal Of The National Comprehensive Cancer Network 2018, 16: 170-199. PMID: 29439178, DOI: 10.6004/jnccn.2018.0006.Peer-Reviewed Original ResearchConceptsEndometrial carcinomaUterine neoplasmsNCCN Clinical Practice GuidelinesEarly-stage endometrial carcinomaCommon gynecologic malignancyClinical practice guidelinesEndometrial carcinoma casesMalignant epithelial tumorsNCCN guidelinesGynecologic malignanciesEndometrial cancerUterine sarcomaCarcinoma casesPractice guidelinesEpithelial tumorsCarcinomaNeoplasmsUterusTwo-thirdsDiagnosisInner liningTreatmentGuidelinesEndometriumSarcoma
2017
Adjuvant 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 cancerImpact 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 effectsPatients
2016
Who 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 Predictive
2014
Adjuvant Carboplatin, Paclitaxel, and Vaginal Cuff Brachytherapy for Stage III Endometrial Cancer: Analysis of Outcomes and Patterns of Recurrence Based on Pathologic Characteristics
Young MR, Higgins SA, Ratner E, Yu JB, Mani S, Silasi DA, Azodi M, Rutherford T, Schwartz PE, Damast S. Adjuvant Carboplatin, Paclitaxel, and Vaginal Cuff Brachytherapy for Stage III Endometrial Cancer: Analysis of Outcomes and Patterns of Recurrence Based on Pathologic Characteristics. International Journal Of Gynecological Cancer 2014, 25: 431. PMID: 25621409, PMCID: PMC5603450, DOI: 10.1097/igc.0000000000000376.Peer-Reviewed Original ResearchMeSH KeywordsAdenocarcinomaAgedAntineoplastic Combined Chemotherapy ProtocolsBrachytherapyCarboplatinChemoradiotherapy, AdjuvantDisease-Free SurvivalEndometrial NeoplasmsFemaleHumansHysterectomyLymph NodesLymphatic MetastasisMiddle AgedNeoplasm Recurrence, LocalNeoplasm StagingPaclitaxelRetrospective StudiesSurvival RateTreatment FailureConceptsDisease-free survivalVaginal cuff brachytherapyStage III endometrial adenocarcinomaStage III endometrial cancerNode-negative diseaseOverall survivalAdjuvant chemotherapyEndometrial cancerEndometrial adenocarcinomaType IComprehensive surgical stagingLow-risk histologyNode-positive diseaseOutcomes of patientsHigh-risk histologyNode-positive ratePatterns of recurrenceAnalysis of outcomesType II diseaseAdjuvant carboplatinVaginal failuresSurgical stagingAdjuvant therapyNode negativeNode positiveComparative Patient-Centered Outcomes (Health State and Adverse Sexual Symptoms) Between Adjuvant Brachytherapy Versus No Adjuvant Brachytherapy in Early Stage Endometrial Cancer
Damast S, Alektiar K, Eaton A, Gerber NK, Goldfarb S, Patil S, Jia R, Leitao M, Carter J, Basch E. Comparative Patient-Centered Outcomes (Health State and Adverse Sexual Symptoms) Between Adjuvant Brachytherapy Versus No Adjuvant Brachytherapy in Early Stage Endometrial Cancer. Annals Of Surgical Oncology 2014, 21: 2740-2754. PMID: 24619493, DOI: 10.1245/s10434-014-3562-4.Peer-Reviewed Original ResearchConceptsFemale Sexual Function IndexPoor health statesSexual functioningEndometrial cancerSexual functionEarly-stage endometrial cancerHealth statesStage I endometrial cancerBaseline sexual activityStage endometrial cancerEndometrial cancer survivorsSexual Function IndexSignificant risk factorsSurgery groupUnderwent surgeryEQ5D scoresFSFI scoreSurgery typeAdjuvant brachytherapyCancer survivorsMore frequent useRisk factorsFunction IndexSexual dysfunctionMultivariable regression
2012
Comparative patient-centered outcomes (health state and adverse sexual symptoms) between adjuvant brachytherapy versus no adjuvant brachytherapy in early-stage endometrial cancer.
Damast S, Alektiar K, Goldfarb S, Gerber N, Eaton A, Patil S, Mosenkis J, Sit L, Rogak L, Leitao M, Carter J, Basch E. Comparative patient-centered outcomes (health state and adverse sexual symptoms) between adjuvant brachytherapy versus no adjuvant brachytherapy in early-stage endometrial cancer. Journal Of Clinical Oncology 2012, 30: 9104-9104. DOI: 10.1200/jco.2012.30.15_suppl.9104.Peer-Reviewed Original ResearchFemale Sexual Function IndexSimple hysterectomyPoor sexual functioningFSFI scoreEndometrial cancerSexual functioningAdjuvant brachytherapyExact testEarly-stage endometrial cancerHealth statesStage I endometrial cancerBaseline sexual activityMedian FSFI scorePatient-centered outcomesSexual Function IndexWorse sexual functioningFisher's exact testWaiver of consentTreatment-related itemsCross-sectional analysisPoor health statesCurrent sexual functioningHormonal therapyPrimary endpointAlone group