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  1. Article ; Online: The effect of subsequent pregnancy and childbirth on stress urinary incontinence recurrence after midurethral sling procedure: a response.

    Nahshon, Chen / Abramov, Yoram / Zilberlicht, Ariel

    American journal of obstetrics and gynecology

    2024  

    Language English
    Publishing date 2024-03-23
    Publishing country United States
    Document type Letter
    ZDB-ID 80016-8
    ISSN 1097-6868 ; 0002-9378
    ISSN (online) 1097-6868
    ISSN 0002-9378
    DOI 10.1016/j.ajog.2024.03.023
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  2. Article ; Online: Attitude of BRCA1/2 mutation carriers towards surgical risk reduction for breast, ovarian and uterine cancer: still much to be done.

    Nahshon, Chen / Segev, Yakir / Schmidt, Meirav / Lavie, Ofer

    International journal of gynecological cancer : official journal of the International Gynecological Cancer Society

    2023  

    Abstract: Objective: To study and quantify the attitude of BRCA1/2 mutation carriers towards surgical risk reduction procedures.: Methods: This cross-sectional national study was conducted by distribution of an anonymous questionnaire on social media platforms ...

    Abstract Objective: To study and quantify the attitude of BRCA1/2 mutation carriers towards surgical risk reduction procedures.
    Methods: This cross-sectional national study was conducted by distribution of an anonymous questionnaire on social media platforms and to BRCA1/2 carriers' medical clinic.
    Results: 530 BRCA1/2 mutation carriers answered the survey. Risk reduction bilateral salpingo-oophorectomy was discussed with 447/489 (91%) of patients and performed in 260/489 (53%). Hormonal replacement therapy was discussed in 280/474 (59%) of patients. Addition of hysterectomy to risk reduction bilateral salpingo-oophorectomy was discussed in 129/481 (27%) of patients and performed in 44/443(10%). Age over 35 years at time of mutation detection was found to be significant in raising risk reduction bilateral salpingo-oophorectomy and hysterectomy performance rates. Risk reduction mastectomy was discussed in 390/471 (83%) of patients and performed in 156/471 (33%). In a multivariate analysis, BRCA1 mutation carriers (OR=1.66 (95% CI 1.07 to 2.57), p=0.024) and a personal cancer history leading to the mutation detection (OR=4.75 (95% CI 1.82 to 12.4), p=0.001) were found to be significant in increasing the likelihood of opting for risk reduction mastectomy. Additionally, highest risk reduction mastectomy performance rates were observed in the group of patients with a first-degree family history of breast cancer under the age of 50 years (OR=1.58 (95% CI 1.07 to 2.32), p=0.01).
    Conclusions: This study highlights the high performance rates of risk reduction bilateral salpingo-oophorectomy, while hysterectomy was added in 10%, and that despite high awareness and acceptance rates for risk reduction mastectomy, only 33% had the procedure. The data presented provides insights for the clinician counseling BRCA1/2 mutation carriers, with regards to adherence to recommendations, understanding their concerns towards treatment and management alternatives; and finally, to construct a personalized management medical plan.
    Language English
    Publishing date 2023-11-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 1070385-8
    ISSN 1525-1438 ; 1048-891X
    ISSN (online) 1525-1438
    ISSN 1048-891X
    DOI 10.1136/ijgc-2023-004801
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  3. Article ; Online: Attitude of BRCA1/2 mutation carriers towards fertility preservation, family planning and preimplantation genetic testing for primary prevention of breast and ovarian cancer in the next generation.

    Nahshon, Chen / Lavie, Ofer / Oron, Galia

    Journal of assisted reproduction and genetics

    2023  Volume 40, Issue 12, Page(s) 2835–2842

    Abstract: Purpose: To study the attitude of BRCA1/2 mutation carriers regarding family planning, fertility preservation, and preimplantation genetic testing (PGT).: Methods: A national cross-sectional study was conducted by the distribution of an anonymous ... ...

    Abstract Purpose: To study the attitude of BRCA1/2 mutation carriers regarding family planning, fertility preservation, and preimplantation genetic testing (PGT).
    Methods: A national cross-sectional study was conducted by the distribution of an anonymous questionnaire, from August 2022 to January 2023. The main outcomes measures were discussion, acceptance, and performance rates of fertility preservation and PGT.
    Results: The questionnaire was completed by 530 BRCA1/2 mutation carriers. The mean (SD) age at mutation detection was 36.4 (9.6) years. At the time of mutation detection, 40% did not have children. Following mutation detection, 37% of responders changed their family planning, mostly choosing to have children earlier or to have less children than planned. Twenty-eight percent of BRCA carriers discussed the option of fertility preservation with a physician, 72% agreed that fertility preservation is an acceptable option for BRCA1/2 mutation carriers and finally 11% underwent oocyte/embryo vitrification before RRBSO. 44% of BRCA carriers discussed the option of PGT, 58% agreed that PGT is justified in BRCA1/2 mutation carriers and finally 8% underwent PGT to select non-carrier embryos. In a multivariate analysis, age under 35 years and the a priori need for fertility treatments were both found significant factors increasing the likelihood of performing fertility preservation and PGT.
    Conclusion: This study emphasizes that despite a substantial proportion of women admitting that mutation detection affected their family planning and high acceptance rates, performance of fertility preservation and PGT remained exceedingly low. Increasing the knowledge and awareness of these issues is important and should be included in multidisciplinary counselling.
    MeSH term(s) Pregnancy ; Child ; Female ; Humans ; Adult ; Fertility Preservation ; Family Planning Services ; BRCA1 Protein/genetics ; Cross-Sectional Studies ; Preimplantation Diagnosis ; Mutation/genetics ; BRCA2 Protein/genetics ; Genetic Testing ; Ovarian Neoplasms/diagnosis ; Ovarian Neoplasms/genetics ; Ovarian Neoplasms/prevention & control ; Primary Prevention
    Chemical Substances BRCA1 protein, human ; BRCA1 Protein ; BRCA2 protein, human ; BRCA2 Protein
    Language English
    Publishing date 2023-09-26
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1112577-9
    ISSN 1573-7330 ; 1058-0468
    ISSN (online) 1573-7330
    ISSN 1058-0468
    DOI 10.1007/s10815-023-02954-1
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  4. Article ; Online: RE: Endometrial Cancer Risk in Women With Germline BRCA1 or BRCA2 Mutations: Multicenter Cohort Study.

    Nahshon, Chen / Lavie, Ofer

    Journal of the National Cancer Institute

    2021  Volume 114, Issue 2, Page(s) 320–321

    MeSH term(s) BRCA1 Protein/genetics ; BRCA2 Protein/genetics ; Cohort Studies ; Endometrial Neoplasms/epidemiology ; Endometrial Neoplasms/genetics ; Female ; Germ Cells ; Humans ; Mutation
    Chemical Substances BRCA1 Protein ; BRCA1 protein, human ; BRCA2 Protein ; BRCA2 protein, human
    Language English
    Publishing date 2021-08-23
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2992-0
    ISSN 1460-2105 ; 0027-8874 ; 0198-0157
    ISSN (online) 1460-2105
    ISSN 0027-8874 ; 0198-0157
    DOI 10.1093/jnci/djab154
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  5. Article ; Online: Effect of known pathological risk factors on the incidence of metastatic lymph nodes and survival in early-stage vulvar cancer: SEER analysis.

    Nahshon, Chen / Leitao, Mario M / Lavie, Ofer / Segev, Yakir

    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

    2023  Volume 164, Issue 1, Page(s) 339–344

    Abstract: Objective: The current study was performed to evaluate the incidence of positive lymph nodes (LNs) in relation to known pathological risk factors, specifically among patients with apparent low-grade, small tumors.: Methods: We used the Surveillance, ... ...

    Abstract Objective: The current study was performed to evaluate the incidence of positive lymph nodes (LNs) in relation to known pathological risk factors, specifically among patients with apparent low-grade, small tumors.
    Methods: We used the Surveillance, Epidemiology, and End Results (SEER) database to retrospectively identify patients with vulvar squamous cell carcinoma (SCC) diagnosed between January 1, 2000, and December 31, 2019, with known tumor size and regional LN examined. A comparison between patients who had positive and negative LNs was conducted to identify risk factors for LN metastases in relation to survival. Subgroup analysis was conducted in patients with diagnosed grade 1 vulvar SCC and tumor size up to 2 cm according to the status of LNs.
    Results: Multivariate analysis found that both grade of disease and tumor size were significant factors in predicting LN status. Among patients with low-grade small tumors up to 2 cm, the odds ratio for positive LNs was 2.5 for those with tumor size larger than 1 cm. In a multivariate survival analysis, older age, larger tumor size, and positive LNs were independently associated with decreased survival.
    Conclusions: The current study confirms that among small tumors, those larger than 1 cm have a significantly increased risk for positive nodes compared with those smaller than 1 cm, and, among this specific group, patients with positive nodes have decreased survival. Future studies are needed to answer the question of whether, in the era of the sentinel node procedure, it is safe to omit LN evaluation altogether.
    MeSH term(s) Female ; Humans ; Retrospective Studies ; Vulvar Neoplasms/epidemiology ; Vulvar Neoplasms/pathology ; Prognosis ; Incidence ; Lymphatic Metastasis/pathology ; Lymph Nodes/pathology ; Carcinoma, Squamous Cell/pathology ; Risk Factors ; Lymph Node Excision/methods ; Neoplasm Staging
    Language English
    Publishing date 2023-09-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80149-5
    ISSN 1879-3479 ; 0020-7292
    ISSN (online) 1879-3479
    ISSN 0020-7292
    DOI 10.1002/ijgo.15093
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  6. Article ; Online: Sentinel lymph node sampling versus full lymphadenectomy in endometrial cancer: a SEER database analysis.

    Nahshon, Chen / Kadan, Yfat / Lavie, Ofer / Ostrovsky, Ludmila / Segev, Yakir

    International journal of gynecological cancer : official journal of the International Gynecological Cancer Society

    2023  Volume 33, Issue 10, Page(s) 1557–1563

    Abstract: Objective: To assess the long term outcomes and prognosis of sentinel lymph node sampling compared with full lymph node dissection in endometrial cancer patients.: Methods: We used the Surveillance, Epidemiology, and End Results (SEER) database for ... ...

    Abstract Objective: To assess the long term outcomes and prognosis of sentinel lymph node sampling compared with full lymph node dissection in endometrial cancer patients.
    Methods: We used the Surveillance, Epidemiology, and End Results (SEER) database for information on women diagnosed with endometrial cancer from 2010 to 2019. We conducted a comparison including overall survival between patients who had undergone sentinel lymph node sampling only and patients who had undergone formal lymph node dissection. Propensity score matching was performed according to the patient's age, type of endometrial cancer, grade and stage of disease, and adjuvant therapy. Subgroup analyses were performed according to type and grade of endometrial cancer.
    Results: 41411 endometrial cancer patients were identified through the database. After matching, 6019 patients each were included in the sentinel lymph node and lymph node dissection groups. Median (interquartile range (IQR)) follow-up time was 16 (7-31) months in both groups. One year survival rates were longer in the sentinel lymph node group compared with the lymph node dissection group (hazard ratio (HR) 1.61 (95% confidence interval (CI) 1.17 to 2.21); p=0.004). Subgroups analysis according to grade of disease showed that 1 year survival rates were longer in the sentinel lymph node group in patients with endometrioid-type grade 1-2 endometrial cancer (HR 1.70 (95% CI 1.31 to 2.56); p=0.01), while no difference in survival was found between the sentinel lymph node and lymph node dissection groups in the subgroup of patients with high grade endometrial cancer (HR 1.40 (95%CI 0.94 to 2.24); p=0.17). In patients with low grade endometrial cancer included in the sentinel lymph node group, only 7% had lymph nodes positive for malignancy compared with 17% in the high grade group.
    Conclusion: Survival rates were not compromised in endometrial cancer patients undergoing sentinel lymph node sampling versus full lymph node dissection for all grades of disease.
    MeSH term(s) Humans ; Female ; Sentinel Lymph Node/surgery ; Sentinel Lymph Node/pathology ; Sentinel Lymph Node Biopsy/methods ; Lymph Node Excision/methods ; Lymph Nodes/surgery ; Lymph Nodes/pathology ; Endometrial Neoplasms/surgery ; Endometrial Neoplasms/pathology ; Carcinoma, Endometrioid/pathology ; Lymphadenopathy/pathology ; Neoplasm Staging
    Language English
    Publishing date 2023-10-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 1070385-8
    ISSN 1525-1438 ; 1048-891X
    ISSN (online) 1525-1438
    ISSN 1048-891X
    DOI 10.1136/ijgc-2023-004474
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  7. Article ; Online: Author's Reply: Hazardous Postoperative Outcomes of Unexpected COVID-19 Infected Patients: A Call for Global Consideration of Sampling All Asymptomatic Patients Before Surgical Treatment.

    Nahshon, Chen / Lavie, Ofer

    World journal of surgery

    2020  Volume 44, Issue 9, Page(s) 3194–3195

    Keywords covid19
    Language English
    Publishing date 2020-07-01
    Publishing country United States
    Document type Letter
    ZDB-ID 224043-9
    ISSN 1432-2323 ; 0364-2313
    ISSN (online) 1432-2323
    ISSN 0364-2313
    DOI 10.1007/s00268-020-05672-2
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  8. Article ; Online: Incidence and characteristics of ovarian cancer following endometrial cancer in the emerging era of conservative management of endometrial cancer-Implications for counseling-A SEER analysis.

    Nahshon, Chen / Segev, Yakir / Schmidt, Meirav / Ostrovsky, Ludmila / Assaf, Wissam / Gerszman, Eden / Lavie, Ofer

    The journal of obstetrics and gynaecology research

    2023  Volume 49, Issue 9, Page(s) 2379–2386

    Abstract: Objective: To assess the ovarian cancer (OC) risk following endometrial cancer (EC) in patients who underwent ovarian preservation as part of the EC staging.: Study design: With permission of the Surveillance, Epidemiology and End Results (SEER) ... ...

    Abstract Objective: To assess the ovarian cancer (OC) risk following endometrial cancer (EC) in patients who underwent ovarian preservation as part of the EC staging.
    Study design: With permission of the Surveillance, Epidemiology and End Results (SEER) program of the United States National Cancer Institute, clinicopathological information of women diagnosed with EC and following OC were analyzed. Incidence of OC and survival according to the surgical approach were studied. Primary analysis was conducted in women up to and including the age of 49 years.
    Results: A total of 116 patients up to the age of 49 years were diagnosed with EC and following OC. In this group of patients, no differences in incidence (IRR 0.9, CI 0.56-1.49, p = 0.66) or survival rates (p = 0.71) were found comparing ovarian preservation and bilateral salpingo-oophorectomy (BSO) performance. In an overall analysis of women diagnosed with EC and following OC at any age, incidence of OC did not differ between groups (IRR 1.07, CI 0.83-1.39, p = 0.59) yet when including patients older than 49 years old survival rates were shorter in ovarian preservation patients compared to patients with BSO performed as part of their EC treatment.
    Conclusion: Ovarian preservation in EC patients under the age of 49 years may be considered safe, with no impact on OC incidence or survival, benefiting longer natural hormonal status.
    MeSH term(s) Humans ; Female ; United States/epidemiology ; Infant ; Conservative Treatment ; Incidence ; Ovarian Neoplasms/epidemiology ; Ovarian Neoplasms/surgery ; Endometrial Neoplasms/epidemiology ; Endometrial Neoplasms/surgery ; Counseling
    Language English
    Publishing date 2023-06-26
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 1327307-3
    ISSN 1447-0756 ; 1341-8076
    ISSN (online) 1447-0756
    ISSN 1341-8076
    DOI 10.1111/jog.15729
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  9. Article ; Online: Risk factors for pelvic organ prolapse recurrence following colpocleisis: A meta-analysis.

    Nahshon, Chen / Karmakar, Debjyoti / Abramov, Yoram / Kugelman, Nir / Lavie, Ofer / Zilberlicht, Ariel

    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

    2023  Volume 164, Issue 3, Page(s) 848–856

    Abstract: Background: Studies aimed to assess risk factors for pelvic organ prolapse (POP) recurrence following colpocleisis with nonconclusive results.: Objective: To investigate risk factors for POP recurrence following colpocleisis.: Search strategy: ... ...

    Abstract Background: Studies aimed to assess risk factors for pelvic organ prolapse (POP) recurrence following colpocleisis with nonconclusive results.
    Objective: To investigate risk factors for POP recurrence following colpocleisis.
    Search strategy: MEDLINE, PUBMED, Embase, Web of Science, and Cochrane databases were systematically searched.
    Selection criteria: Experimental and non-experimental studies investigating POP recurrence following colpocleisis.
    Data collection and analysis: We assessed the association between preoperative and postoperative physical examination findings, demographics and medical history, and the risk of recurrence following colpocleisis.
    Main results: A total of 954 studies were identified, of which five studies comprising 2978 patients were eligible for analysis. Both preoperative and postoperative genital hiatus length were significantly longer in the recurrence group (mean difference [MD] 0.48, 95% confidence interval [CI] 0.01-0.94, P = 0.04, I
    Conclusion: Wider preoperative and postoperative genital hiatus as well as longer post-operative TVL and previous POP surgery were associated with a higher risk for recurrence following colpocleisis, highlighting the importance of appropriate patient selection and surgical technique in minimizing this risk.
    MeSH term(s) Pregnancy ; Humans ; Female ; Colpotomy/methods ; Vagina/surgery ; Pelvic Organ Prolapse/surgery ; Pelvic Organ Prolapse/complications ; Hysterectomy ; Risk Factors ; Treatment Outcome ; Gynecologic Surgical Procedures/adverse effects ; Gynecologic Surgical Procedures/methods ; Recurrence
    Language English
    Publishing date 2023-07-24
    Publishing country United States
    Document type Systematic Review ; Meta-Analysis ; Journal Article ; Review
    ZDB-ID 80149-5
    ISSN 1879-3479 ; 0020-7292
    ISSN (online) 1879-3479
    ISSN 0020-7292
    DOI 10.1002/ijgo.14999
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  10. Article ; Online: Breast Cancer Patients Are at Increased Risk of Developing Uterine Serous Cancer: Implications for Counseling - A SEER Analysis.

    Nahshon, Chen / Segev, Yakir / Schmidt, Meirav / Shulman, Katerina / Lavie, Ofer

    Oncology research and treatment

    2022  Volume 45, Issue 12, Page(s) 728–735

    Abstract: Introduction: Several studies have investigated whether patients with prior breast cancer (BC) are at an increased risk for endometrial cancer (EC)/uterine serous cancer (USC). We aimed to study this relationship and analyze the effect of prior BC on ... ...

    Abstract Introduction: Several studies have investigated whether patients with prior breast cancer (BC) are at an increased risk for endometrial cancer (EC)/uterine serous cancer (USC). We aimed to study this relationship and analyze the effect of prior BC on the incidence and prognosis of USC patients.
    Methods: With permission of the Surveillance, Epidemiology, and End Results (SEER) program of the US National Cancer Institute, clinicopathological information of women diagnosed with BC and following USC were analyzed. The recorded data included age at diagnosis, stage of disease, cause of death, interval time between BC and USC diagnosis, and overall survival.
    Results: The SEER database included 10,021 patients with USC during the years 1975-2015. 698 (6.96%) of these patients had been previously diagnosed with BC. The incidence of USC in patients with BC history was 57 times higher than in women without BC history (p value <0.001). The incidence of USC did not differ between estrogen receptor (ER)-positive and ER-negative BC patients (p value 0.94). The mean survival of USC patients with previous BC history was 8 years (96 months, 95% CI: 85.7-106.2), shorter than in USC patients with no BC history, presenting a mean survival of 10.6 years (127 months, 95% CI: 124.0-130.8) (p value = 0.002).
    Conclusion: Our results highlight the relationship between BC and USC, suggesting an increased risk for USC among BC patients. This clinical association should be introduced to BC patients, and physicians should be alert to any EC presenting symptom in BC survivors.
    MeSH term(s) Humans ; Female ; Breast Neoplasms/epidemiology
    Language English
    Publishing date 2022-06-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2760274-6
    ISSN 2296-5262 ; 2296-5270
    ISSN (online) 2296-5262
    ISSN 2296-5270
    DOI 10.1159/000525522
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