Ritu Salani

The Ohio State University, Columbus, Ohio, United States

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Publications (26)96.38 Total impact

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    ABSTRACT: The purpose of this study was to examine the experiences, attitudes, and preferences of uterine cancer survivors with regard to weight and lifestyle counseling. Members of the US Uterine Cancer Action Network of the Foundation for Women's Cancer were invited to complete a 45-item, Web-based survey. Standard descriptive statistical methods and χ tests were used to analyze responses. One hundred eighty (28.3%) uterine cancer survivors completed the survey. Median age was 58 years, 85% were white, and median survivorship period was 4.4 years. Most had stage I-II disease (69%) and were overweight or obese (65%). Eighty-nine percent of respondents received care by a gynecologic oncologist. Increased respondent body mass index was associated with decreased exercise frequency (P = 0.016). Only 50% of respondents underwent any weight/lifestyle counseling, with those living in the West and Southwest reporting the highest rates (70.8% and 69.2%, P = 0.011). Most who received counseling felt that discussions were motivating, performed in a sensitive manner, and did not undermine the patient-physician relationship. Specific recommendations were rarely offered; there were no reported referrals to weight loss programs or bariatric specialists, and few (6%) reported referrals to nutritionists. Respondents (85%) preferred their gynecologic oncologist address weight using direct, face-to-face counseling with specific recommendations regarding interventions and referral to specialists. Finally, self-reported overweight respondents experienced greater success with weight loss compared to those reporting obesity or morbid obesity (30.8% vs 15.8% vs 12.5%, P = 0.011). Uterine cancer survivors reported high obesity, low activity rates, and a desire for substantive weight loss counseling from their gynecologic oncologists. Respondents suggested that current counseling practices are inadequate and incongruent with their needs. Further research to define optimal timing, interventional strategies, and specific recommendations for successful lifestyle changes in this population is warranted.
    International Journal of Gynecological Cancer 05/2015; Publish Ahead of Print(7). DOI:10.1097/IGC.0000000000000475 · 1.95 Impact Factor

  • Gynecologic Oncology 04/2015; 137. DOI:10.1016/j.ygyno.2015.01.208 · 3.77 Impact Factor
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    ABSTRACT: To determine long-term survival and associated prognostic factors after intraperitoneal (IP) chemotherapy in patients with advanced ovarian cancer. Data from Gynecologic Oncology Group protocols 114 and 172 were retrospectively analyzed. Cox proportional hazards regression models were used for statistical analyses. In 876 patients, median follow-up was 10.7 years. Median survival with IP therapy was 61.8 months (95% CI, 55.5 to 69.5), compared with 51.4 months (95% CI, 46.0 to 58.2) for intravenous therapy. IP therapy was associated with a 23% decreased risk of death (adjusted hazard ratio [AHR], 0.77; 95% CI, 0.65 to 0.90; P = .002). IP therapy improved survival of those with gross residual (≤ 1 cm) disease (AHR, 0.75; 95% CI, 0.62 to 0.92; P = .006). Risk of death decreased by 12% for each cycle of IP chemotherapy completed (AHR, 0.88; 95% CI, 0.83 to 0.94; P < .001). Factors associated with poorer survival included: clear/mucinous versus serous histology (AHR, 2.79; 95% CI, 1.83 to 4.24; P < .001), gross residual versus no visible disease (AHR, 1.89; 95% CI, 1.48 to 2.43; P < .001), and fewer versus more cycles of IP chemotherapy (AHR, 0.88; 95% CI, 0.83 to 0.94; P < .001). Younger patients were more likely to complete the IP regimen, with a 5% decrease in probability of completion with each year of age (odds ratio, 0.95; 95% CI, 0.93 to 0.96; P < .001). The advantage of IP over intravenous chemotherapy extends beyond 10 years. IP therapy enhanced survival of those with gross residual disease. Survival improved with increasing number of IP cycles. © 2015 by American Society of Clinical Oncology.
    Journal of Clinical Oncology 03/2015; 33(13). DOI:10.1200/JCO.2014.55.9898 · 18.43 Impact Factor
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    Ritu Salani · Valerie Waddell · Jonathan Schaffir ·

    Women s Health 07/2014; 10(4):349-51. DOI:10.2217/whe.14.36
  • G.A.L. McCann · B. Smith · G. Phillips · R. Salani ·

    Gynecologic Oncology 06/2014; 133:67-68. DOI:10.1016/j.ygyno.2014.03.183 · 3.77 Impact Factor
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    ABSTRACT: A relatively rare occurrence, pregnancy-associated cancer affects ∼1 in 1,000 pregnancies. Optimizing treatment of the cancer and minimizing harm to the fetus are often dependent on the extent of disease, treatment options required and impact on the pregnancy, as well as the gestational age of pregnancy. When malignancy is diagnosed, the obstetrician/gynecologist plays a key role in the diagnosis, initial evaluation, and coordination of patient care. Furthermore, the obstetrician/gynecologist may be asked to assist in fertility planning for young women with a new diagnosis of cancer and may be responsible for addressing questions about family planning needs and the safety of future pregnancy. Therefore, the purpose of this article is to provide the obstetrician/gynecologist with a relevant overview of the current literature regarding concurrent pregnancy and cancer diagnoses, management options, including maternal and neonatal outcomes as well as the future needs of young women diagnosed with cancer who desire fertility preservation.
    American journal of obstetrics and gynecology 12/2013; 211(1). DOI:10.1016/j.ajog.2013.12.002 · 4.70 Impact Factor
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    ABSTRACT: Lymphedema remains a poorly understood entity that can occur after lymphadenectomy. Herein, we will review the pathogenesis of lymphedema, diagnostic modalities and the natural history of extremity involvement. We will review the incidence of upper extremity lymphedema in patients treated for breast malignancies and lower extremity lymphedema in those treated for gynecologic malignancy. Finally, we will review traditional treatment modalities for lymphedema, as well as introduce new surgical treatment modalities that are under active investigation.
    World Journal of Surgical Oncology 09/2013; 11(1):237. DOI:10.1186/1477-7819-11-237 · 1.41 Impact Factor

  • Gynecologic Oncology 07/2013; 130(1):e78. DOI:10.1016/j.ygyno.2013.04.244 · 3.77 Impact Factor
  • D. Tewari · J. Java · R. Salani · D. Armstrong · M. Markman · T. Herzog · B. Monk · J. Chan ·

    Gynecologic Oncology 07/2013; 130(1):e4. DOI:10.1016/j.ygyno.2013.04.065 · 3.77 Impact Factor
  • Ritu Salani ·
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    ABSTRACT: Objective: There are over one million survivors from gynecologic malignancies currently living in the United States and this population is expected to increase by 33% over the next decade. Identifying the needs of these cancer survivors is often understudied and overlooked. Methods: A literature review using MEDLINE was searched for research articles published in English from 1967 to 2013 focusing on survivorship care in women with gynecologic malignancies. Results: For women with gynecologic malignancies, the survivorship period requires management of several aspects of care. Improved coordination of care between providers that may be addressed with the use of survivorship care plans and should include surveillance recommendations. Providers should conduct a focused evaluation of late and long-term effects of cancer that may continue to effect patients during and after treatment. Opportunities to improve lifestyle behaviors and continue general health maintenance should also be maximized. Conclusions: The survivorship period incorporates the following: prevention of new cancer diagnoses, surveillance for recurrence, assessment and management of side effects from cancer and cancer treatment, and the coordination of care between patients and healthcare providers. Focusing on these components may improve quality of life as it allows for a seamless transition for cancer survivors and their caregivers.
    Gynecologic Oncology 05/2013; 130(2). DOI:10.1016/j.ygyno.2013.05.022 · 3.77 Impact Factor
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    ABSTRACT: Objective: The objective of this study was to evaluate peri-operative and survival outcomes of ovarian cancer patients undergoing percutaneous upper gastrointestinal decompression for malignant bowel obstruction (MBO). Methods: Retrospective chart review was used to identify patients with ovarian, peritoneal, or fallopian tube cancer who underwent palliative decompressive treatment for MBO from 1/2002 to 12/2010. Kaplan-Meier methods were used to estimate the median survival (MS) and multivariate analysis used to determine if any variables were associated with the hazard of death. Results: Fifty-three patients met inclusion criteria. Median length of diagnosis prior to intervention was 21 months. Fifteen (28.3%) patients experienced complications and 9 required revision. Forty-nine (92.5%) experienced relief of symptoms after placement, and 91% tolerated some form of oral intake. Following placement, 19 (36%) patients received additional chemotherapy and 21(41%) patients received total parental nutrition (TPN). Thirty-five patients were discharged home/outpatient facility, 16 to hospice care, and 2 died prior to discharge. MS for all patients was 46 days. Patients who received chemotherapy had a MS of 169 days compared to 33 days (p<0.001). We failed to find an association between survival and TPN or performance status. Conclusions: Malignant bowel obstruction is a common complication of ovarian cancer. Management is palliative; risks and benefits of any therapy must be considered. Percutaneous decompressive therapy provides relief from associated symptoms, and allows patients to be discharged home. Median survival in this group is limited, and decisions regarding aggressive therapy should be individualized.
    Gynecologic Oncology 01/2013; 129(1). DOI:10.1016/j.ygyno.2013.01.021 · 3.77 Impact Factor
  • L Krill · R Salani · R Bristow · M Gerardi · O Ibeanu ·

    Gynecologic Oncology 10/2012; 127(1 Suppl):S24. DOI:10.1016/j.ygyno.2012.07.067 · 3.77 Impact Factor
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    ABSTRACT: To describe the effects of intracavitary brachytherapy (IVB) on sexual function and quality of life of women with early-stage endometrial cancer. Women with International Federation of Gynecology and Obstetrics stage I to stage II endometrial cancer treated surgically with or without IVB were identified and mailed questionnaires. Quality of life and sexual function were measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and the cervical cancer disease-specific module. Pertinent data from prior surgery and radiation treatments were abstracted retrospectively. Linear transformation of the survey subscale scores was conducted per European Organization for Research and Treatment of Cancer guidelines. Sixteen women in the IVB arm and 53 in the surgery-alone group completed the survey. Of the sexually active patients, 33% of the IVB patients and 42% of the surgery-alone patients felt their vagina was dry during sexual activity (P = 0.804) and 17% versus 20% felt their vagina was short (P = 0.884). Seventeen percent of patients in the IVB group felt their vagina was tight compared to 29% in the surgery-alone group (P = 0.891) and 0% versus 14% of patients reported pain during intercourse (P = 0.808). There was no statistically significant difference in sexual/vaginal functioning, sexual worry, or sexual enjoyment between the 2 groups. Although both groups report vaginal changes that may affect sexual function, the patients treated with IVB reported similar outcomes on a sexual function questionnaire compared to patients treated with surgery alone.
    International Journal of Gynecological Cancer 03/2012; 22(4):703-8. DOI:10.1097/IGC.0b013e3182481611 · 1.95 Impact Factor

  • Gynecologic Oncology 03/2012; 125:S65. DOI:10.1016/j.ygyno.2011.12.156 · 3.77 Impact Factor
  • R. Salani · E. Hade · M. Husain · M. Katz ·

    Gynecologic Oncology 03/2012; 125:S167. DOI:10.1016/j.ygyno.2011.12.410 · 3.77 Impact Factor
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    ABSTRACT: To determine the maximum tolerated dose (MTD) and acute dose-limiting toxicities (DLT) of intravenous topotecan administered with weekly cisplatin during pelvic radiation therapy in patients with locally advanced cervical cancer. Patients were treated at one of two dose levels receiving intravenous topotecan at 0.5mg/m(2) and cisplatin at either 30 or 40 mg/m(2) given weekly for 6 weeks concurrently with pelvic radiation and intracavitary brachytherapy. The primary endpoint for the escalation study was acute dose-limiting toxicities occurring within 30 days of completing radiation therapy. Eleven patients were enrolled. Dose-limiting toxicity consisting of Grade 3 nausea and vomiting lasting >24h in one patient and grade 3 febrile neutropenia in another patient occurred at the first dose level of weekly topotecan 0.5mg/m(2) and cisplatin 40 mg/m(2). This necessitated de-escalation to weekly cisplatin 30 mg/m(2) in combination with topotecan 0.5mg/m(2) and pelvic radiation. This dose level was tolerable in 6 evaluable patients with only one DLT consisting of grade 4 thrombocytopenia, grade 3 abdominal pain and grade 3 elevated gamma glutamyl transpeptidase (GGT). In women with locally advanced cervical cancer, intravenous topotecan 0.5mg/m(2) and cisplatin 30 mg/m(2) given weekly for 6 weeks with concurrent pelvic radiation and intracavitary brachytherapy were tolerable. Further expansion of the feasibility cohort of this study was suspended based on the results of a phase 3 trial comparing the efficacy of platinum combinations in advanced and recurrent cervical cancer.
    Gynecologic Oncology 12/2011; 125(1):158-62. DOI:10.1016/j.ygyno.2011.12.431 · 3.77 Impact Factor
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    ABSTRACT: Hematologic, gastrointestinal, and neurologic complications are common side effects of the platinum and taxane-based chemotherapy used in the primary treatment of epithelial ovarian cancer (EOC). These side effects and the impact of the resultant chemotherapy dose modification on disease free interval have not been extensively studied. The goal of this study was to determine the effect of chemotherapy delays and dose reductions on progression free survival (PFS) and overall survival (OS). A review of patients with primary epithelial ovarian, peritoneal, and fallopian tube carcinoma treated between 1/2000 and 12/2007 was performed. Inclusion criteria were advanced stage disease and first line chemotherapy with a platinum and taxane regimen. Cox proportional hazard models were used to determine the effect of chemotherapy reductions and delays on PFS and OS. One hundred and fifty seven patients met the inclusion criteria. Patients were divided into four groups: no delays or reductions (48%), delay only (27%), reduction only (8%), and both delay and reduction (18%). The mean number of delays/reductions per patient was 1.1 (range=0-5) and therapy was delayed a mean of 8 days. The most common reasons for delays/reductions were neutropenia (n=51), thrombocytopenia (n=45), and neuropathy (n=18). There were no differences detected in PFS or OS between groups. There were no differences detected in survival between patients who required dose adjustments and treatment delays and those who did not. The lack of association between survival and chemotherapy alterations suggests that in specific circumstances patients with advanced ovarian cancer should have individualized treatment plans.
    Gynecologic Oncology 11/2011; 124(2):221-4. DOI:10.1016/j.ygyno.2011.10.003 · 3.77 Impact Factor
  • A. Suarez · R. Salani · D. Cohn · E. Eisenhauer ·

    Gynecologic Oncology 03/2011; 120(1). DOI:10.1016/j.ygyno.2010.12.283 · 3.77 Impact Factor
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    ABSTRACT: Purpose: The doublet gemcitabine and carboplatin is effective for the treatment of recurrent ovarian cancer, while multi-agent chemotherapy with bevacizumab may add additional benefit. This phase II study tested the efficacy and safety of a biweekly gemcitabine, carboplatin, and bevacizumab combination in patients with platinum-sensitive recurrent ovarian, peritoneal, or tubal cancer (ROC). Patients and methods: Eligible patients received concurrent gemcitabine 1000 mg/m(2), carboplatin area under the curve 3, and bevacizumab 10 mg/kg administered intravenously on days 1 and 15 every 28 days for six cycles or up to 24 cycles if clinical benefit occurred. The primary end points were progression-free survival (PFS) by RECIST, and safety; the secondary end points were objective response rates and overall survival. Results: Overall, 45 patients were enrolled. The median PFS was 13.3 months (95% CI, 11.3 to 15.3). The objective response rate was 69%. Grade 4 hematologic toxicities included neutropenia (27%) and thrombocytopenia (2%). Grades 3 and 4 non-hematologic toxicities included fatigue (18%), pain (9%), and nausea/vomiting (4%). There were 2 episodes of cerebrovascular accidents, 2 noted DVTs, and no episodes of bowel perforation. Median OS was 36.1 months (95% CI, 26.7 to 45.5). Conclusion: Biweekly gemcitabine, carboplatin, and bevacizumab were an effective regimen in recurrent ovarian cancer, with comparable toxicity to recently reported day 1 gemcitabine, carboplatin, bevacizumab, and day 8 gemcitabine. Response rate and PFS are improved from reported outcomes of the gemcitabine carboplatin doublet. The degree to which biweekly dosing may present a more rationale schedule for this triplet should be evaluated further.
    Gynecologic Oncology 03/2011; 120(2). DOI:10.1016/j.ygyno.2010.12.076 · 3.77 Impact Factor
  • P. Gary · R. Salani · E. Eisenhauer · J. Fowler · L. Copeland · D. Cohn ·

    Gynecologic Oncology 03/2011; 120(1). DOI:10.1016/j.ygyno.2010.12.080 · 3.77 Impact Factor

Publication Stats

195 Citations
96.38 Total Impact Points


  • 2009-2015
    • The Ohio State University
      • Department of Obstetrics and Gynecology
      Columbus, Ohio, United States
  • 2008
    • Johns Hopkins Medicine
      • Department of Gynecology & Obstetrics
      Baltimore, Maryland, United States