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ObjectiveThe goals of this study were to describe opioid and benzodiazepine prescribing practices in the gynecologic oncology patient population and determine risks for opioid misuse in these patients.MethodsRetrospective study of opioid and benzodiazepine prescriptions for patients treated for cervical, ovarian (including fallopian tube/primary peritoneal), and uterine cancers within a single healthcare system from January 2016 to August 2018.ResultsA total of 7643 prescriptions for opioids and/or benzodiazepines were dispensed to 3252 patients over 5754 prescribing encounters for cervical (n=2602, 34.1%), ovarian (n=2468, 32.3%), and uterine (n=2572, 33.7%) cancer. Prescriptions were most often written in an outpatient setting (51.0%) compared with inpatient discharge (25.8%). Cervical cancer patients were more likely to have received a prescription in an emergency department or from a pain/palliative care specialist (p=0.0001). Cervical cancer patients were least likely to have prescriptions associated with surgery (6.1%) compared with ovarian cancer (15.1%) or uterine cancer (22.9%) patients. The morphine milligram equivalents prescribed were higher for patients with cervical cancer (62.6) compared with patients with ovarian and uterine cancer (46.0 and 45.7, respectively) (p=0.0001). Risk factors for opioid misuse were present in 25% of patients studied; cervical cancer patients were more likely to have at least one risk factor present during a prescribing encounter (p=0.0001). Cervical cancer was associated with a higher number of risk factors (p<0.001).ConclusionsOpioid and benzodiazepine prescribing patterns differ for cervical, ovarian, and uterine cancer patients. Gynecologic oncology patients are overall at low risk for opioid misuse; however, patients with cervical cancer are more likely to have risk factors present for opioid misuse.

cytoreduction. 43 patients received IDS with HIPEC and 80 patients had IDS without HIPEC. The median follow-up period was 34.4 months. Results No differences in baseline characteristics in patients were found between the 2 groups. The IDS with HIPEC group had fewer median cycles of chemotherapy (P = 0.002) than IDS group. The IDS with HIPEC group had higher rate of high surgical complexity score (P = 0.032) and higher rate of complete resection (P = 0.041) compared to IDS group. The times to start adjuvant chemotherapy were longer in IDS with HIPEC group compared to IDS group (P < 0.001). Postoperative grade 3 or 4 complications were similar in the two groups (P = 0.237). Kaplan-Meier analysis showed that HIPEC with IDS group had better progression-free survival (PFS) (P = 0.010), while there was no difference in overall survival between two groups (P = 0.142). In the multivariate analysis, HIPEC was significantly associated with better PFS (HR, 0.60; 95% CI, 0.39 -0.93). Conclusions The addition of HIPEC to IDS resulted in longer PFS than IDS without HIPEC not affecting safety profile. Further research is needed to evaluate the true place of HIPEC in the era of targeted treatments.