Gynecologic oncology最新文献

{"title":"Validating the predicted impact of HPV vaccination on HPV prevalence, cervical lesions, and cervical cancer: A systematic review of population level data and modelling studies","authors":"Daniël de Bondt ,&nbsp;Emi Naslazi ,&nbsp;Erik Jansen ,&nbsp;Rachel Kupets ,&nbsp;Bronwen McCurdy ,&nbsp;Christine Stogios ,&nbsp;Inge de Kok ,&nbsp;Jan Hontelez","doi":"10.1016/j.ygyno.2025.03.008","DOIUrl":"10.1016/j.ygyno.2025.03.008","url":null,"abstract":"<div><h3>Background</h3><div>We compared model predictions with independently published primary data from population-based studies on the impact of HPV vaccination on HPV prevalence, cervical cancer and its precursors.</div></div><div><h3>Methods</h3><div>We searched Cochrane Library, EMBASE, MEDLINE, Web of Science for studies concerning high-income countries published between 2005 to June 2, 2023. Relative risk (RR) for HPV-related outcomes comparing the pre-vaccination and post-vaccination periods were collected from observational and modelling studies. The relationship between vaccination coverage and observed relative reductions was determined using meta-regressions, and we compared model prediction to observations.</div></div><div><h3>Findings</h3><div>We identified a total of 5649 potential articles, of which one systematic review, 14 observational studies and 32 modelling studies met our inclusion criteria. A clear relation was found between the RR of HPV diseases related outcomes in the pre- versus post-vaccination era and the vaccination coverage, with 23 out of 28 data points and 19 out of 20 data points showing significant reductions in HPV prevalence and CIN2+ prevalence respectively. Around 67 % (n/<em>N</em> = 12/18) of model predictions were more optimistic on HPV prevalence reductions compared to the 95 % CI of the meta-regression derived from observational studies. For CIN2+ lesions, 48 % (n/<em>N</em> = 31/64) of model predictions for CIN2+ outcomes fell within the 95 % CI.</div></div><div><h3>Interpretation</h3><div>Model predictions and observational data agree that HPV vaccination can have a substantial impact on HPV related outcomes on a population level. Despite large heterogeneity in observational data and modelling studies, it is particularly encouraging that model predictions on the impact of HPV vaccination on CIN2+ model lesions align with observational studies.</div></div><div><h3>Funding</h3><div>Ontario Health (formerly known as Cancer Care Ontario).</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"195 ","pages":"Pages 134-143"},"PeriodicalIF":4.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incorporation of triapine (T) to cisplatin chemoradiation (CRT) for locally advanced cervical and vaginal cancer: Results from NRG-GY006, a phase III randomized trial","authors":"Charles A. Leath III ,&nbsp;Wei Deng ,&nbsp;Loren K. Mell ,&nbsp;Debra L. Richardson ,&nbsp;Joan L. Walker ,&nbsp;Laura L. Holman ,&nbsp;Jayanthi S. Lea ,&nbsp;Sudha R. Amarnath ,&nbsp;Luis Javier Santos-Reyes ,&nbsp;Rebecca C. Arend ,&nbsp;Jyoti Mayadev ,&nbsp;Naresh Jegadeesh ,&nbsp;Paul DiSilvestro ,&nbsp;Hye Sook Chon ,&nbsp;Sharad A. Ghamande ,&nbsp;Lei Gao ,&nbsp;Kevin Albuquerque ,&nbsp;Junzo P. Chino ,&nbsp;Eric Donnelly ,&nbsp;Jonathan M. Feddock ,&nbsp;Bradley J. Monk","doi":"10.1016/j.ygyno.2025.03.007","DOIUrl":"10.1016/j.ygyno.2025.03.007","url":null,"abstract":"<div><h3>Background</h3><div>Cisplatin-based chemoradiation (CRT) plus brachytherapy for locally advanced cervical cancer (LACC) is standard. Intrinsic overexpression of ribonucleotide reductase (RNR) may enhance DNA damage repair from CRT. We report on outcomes of adding RNR inhibitor, triapine (T), to CRT.</div></div><div><h3>Methods</h3><div>NRG-GY006 is an open-label randomized phase III trial. FIGO 2009 LACC (stages IB2, II, IIIB or IVA) without para-aortic nodal involvement or stages II-IV vaginal cancer were eligible. Random assignment to CRT or in combination with thrice-weekly T (CRT + T) occurred. Radiation consisted of either 3D conformal (3DCRT) or image-guided intensity modulated RT (IG-IMRT) followed by intracavitary brachytherapy. Primary endpoint was overall survival (OS). Progression-free survival (PFS) was secondary. Exploratory endpoints included complete metabolic response rate on post treatment PET/CT imaging and comparative toxicity and outcomes for 3DCRT vs. IG-IMRT.</div></div><div><h3>Findings</h3><div>Four-hundred-fifty patients were randomized including 448 eligible (224 in CRT and 224 in CRT + T). Median age was 47 (range 23–85). The majority had cervical cancer (93.3 %) with squamous histology (82 %). 52 % had FIGO stage II disease. Racial/ethnic distribution included non-Hispanic white (53.8 %), black (15.2 %) and Hispanic/Latina (22.5 %). At randomization, IG-IMRT was planned in 74.3 % and HDR brachytherapy in 98.2 %. No differences in Grade 3–5 toxicities were observed: CRT: 52 % and CRT + T: 49 %, with two G5 toxicities (cardiac arrest and acidosis) in the CRT + T arm. The median patient follow-up was 28 months (IQR 15–45). HR for death was 1.018 (95 % CI 0.634–1.635) while HR for progression was 1.021 (95 % CI 0.694–1.501).</div></div><div><h3>Interpretation</h3><div>Triapine added to CRT did not improve OS.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"195 ","pages":"Pages 122-133"},"PeriodicalIF":4.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive outcomes after premenopausal risk-reducing Salpingo-oophorectomy: The role of hormone therapy.","authors":"Mei Zhao, Lianwei Xu","doi":"10.1016/j.ygyno.2025.03.014","DOIUrl":"https://doi.org/10.1016/j.ygyno.2025.03.014","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial/ethnic, socioeconomic, and healthcare access disparities in achieving textbook oncologic outcome in advanced ovarian cancer","authors":"Giuseppe Caruso ,&nbsp;Amanika Kumar ,&nbsp;Carrie L. Langstraat ,&nbsp;Michaela E. McGree ,&nbsp;Angela J. Fought ,&nbsp;Shariska Harrington ,&nbsp;Dimitrios Nasioudis ,&nbsp;Giovanni D. Aletti ,&nbsp;Nicoletta Colombo ,&nbsp;Robert L. Giuntoli ,&nbsp;William Cliby","doi":"10.1016/j.ygyno.2025.03.016","DOIUrl":"10.1016/j.ygyno.2025.03.016","url":null,"abstract":"<div><h3>Objective</h3><div>Textbook Oncologic Outcome (TOO) is a composite measure that strongly predicts survival after surgery for advanced epithelial ovarian cancer (AEOC), regardless of approach: primary (PDS) or interval debulking surgery (IDS). We aimed to identify risk factors associated with failure to achieve TOO and to receive standard treatment (surgery and chemotherapy) for AEOC.</div></div><div><h3>Methods</h3><div>Patients diagnosed with AEOC between 2008 and 2019 were identified using the National Cancer Database. TOO was defined as achieving complete cytoreduction, hospital stay &lt;10 days, no 30-day readmission, adjuvant chemotherapy initiation &lt;42 days, and 90-day survival. Logistic regression models were used to identify factors associated with TOO and receipt of standard treatment.</div></div><div><h3>Results</h3><div>Among 58,635 AEOC patients, 49% received standard treatment. Of the 21,657 patients who underwent surgery, 51.4% received PDS and 48.6% IDS. For PDS multivariable analysis, factors associated with lower likelihood to achieve TOO included age &gt;75 years (vs &lt;60; OR 0.47, 95% CI 0.38–0.58), Black race (vs White; OR 0.73, 95% CI 0.59–0.90), government insurance (vs private; OR 0.82, 95% CI 0.73–0.92), high surgical complexity (vs low; OR 0.62, 95% CI 0.56–0.68), and median surgical volume ≤5 cases/year (vs ≥20; OR 0.75, 95% CI 0.63–0.89). For IDS, similar associations were observed for government insurance (OR 0.87, 95% CI, 0.80–0.96), high surgical complexity (OR 0.61, 95% CI 0.55–0.66), and median surgical volume ≤5 cases/year (OR 0.60, 95% CI 0.52–0.70).</div></div><div><h3>Conclusions</h3><div>Several factors are associated with lower likelihood of achieving TOO after treatment for AEOC. Some of these factors (age, race, payor type) reflect disparities in care; others (facility volume, surgical complexity) highlight the need for referral to high-volume centers for initial treatment planning.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"195 ","pages":"Pages 106-114"},"PeriodicalIF":4.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution and concordance of HER2 scores in endometrial and ovarian cancer","authors":"Julia Salinaro ,&nbsp;Kamaljeet Singh ,&nbsp;Natalie Sands ,&nbsp;Victoria Gill ,&nbsp;Shriya Perati ,&nbsp;Nicole James ,&nbsp;Shreenidhi Sharma ,&nbsp;Apsra Nasir ,&nbsp;Paul DiSilvestro ,&nbsp;Katherine Miller ,&nbsp;Matthew Oliver ,&nbsp;Cara Mathews","doi":"10.1016/j.ygyno.2025.03.012","DOIUrl":"10.1016/j.ygyno.2025.03.012","url":null,"abstract":"<div><h3>Objectives</h3><div>Although multiple HER2 scoring criteria exist, the optimal strategy to identify patients with gynecologic malignancies who may benefit from HER2-directed therapies remains unknown. The objectives of this study were to assess the distribution and concordance of HER2 scores in endometrial and ovarian cancer.</div></div><div><h3>Methods</h3><div>One hundred five tumor specimens from 94 patients with endometrial or epithelial ovarian cancer (EOC) who underwent Caris tumor profiling from 11/2022 to 01/2025 were identified from a retrospective database. Each sample was assigned a HER2 immunohistochemistry (IHC) score of 0, 1+, 2+, or 3+ using breast, endometrial, and gastric criteria. <em>ERBB2</em> amplification and HER2 IHC scores were abstracted from Caris reports. Patient characteristics and HER2 score distributions were analyzed using descriptive statistics and Fisher's exact test. Matrix correlation coefficients were used to assess HER2 score concordance.</div></div><div><h3>Results</h3><div>A total of 105 samples underwent internal triplicate HER2 scoring – 63 EOC and 42 endometrial. A higher percentage of patients with endometrial cancer were HER2-high compared to those with EOC (45.2–50 % vs 20.6 %, <em>p</em> &lt; 0.05). Internal triplicate HER2 score concordance was strong (<em>r</em> ≥ 0.96, <em>p</em> &lt; 0.001) but weaker when compared to Caris scores (<em>r</em> = 0.66). Of the 23 discordant HER2 results, 13 would have changed therapy eligibility (56.5 %). Only 12 patients (12.7 %) had intermediate or high <em>ERBB2</em> amplification.</div></div><div><h3>Conclusions</h3><div>A clinically significant percentage of patients had HER2-high tumors regardless of tumor type. HER2 score concordance was strong within each sample but weaker when compared to Caris scores. Incorporating multi-site testing and/or validation of external IHC into any gynecologic HER2 scoring algorithm should be considered.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"195 ","pages":"Pages 115-121"},"PeriodicalIF":4.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity and lower extremity lymphedema among endometrial cancer survivors: A population-based cross-sectional study","authors":"Anette Engh ,&nbsp;Corina Silvia Rueegg ,&nbsp;Pernille K. Bjerre Trent ,&nbsp;Linn Ø. Opheim ,&nbsp;Ida Engeskaug ,&nbsp;Nina Jebens Nordskar ,&nbsp;Arnhild Bakken ,&nbsp;Jostein Steene-Johannessen ,&nbsp;Ane Gerda Z. Eriksson ,&nbsp;Lene Thorsen","doi":"10.1016/j.ygyno.2025.03.009","DOIUrl":"10.1016/j.ygyno.2025.03.009","url":null,"abstract":"<div><h3>Objective</h3><div>The aims of this cross-sectional study were to describe the prevalence of self-reported lower extremity lymphedema (LEL) by different physical activity (PA) levels and to examine if higher levels of PA are associated with lower odds of self-reported LEL among endometrial cancer survivors.</div></div><div><h3>Methods</h3><div>Women treated for assumed early-stage endometrial cancer between 2006 and 2021 were invited to complete the Lower Extremity Lymphedema Screening Questionnaire (LELSQ) and the Physical Activity Frequency, Intensity, and Duration (PAFID) questionnaire. Responses of PAFID were converted into metabolic equivalent of task minutes per week (MET-min/week), and participants were categorized into different PA levels: meeting (≥500 MET-min/week) versus <em>not</em> meeting PA guidelines; low active (&lt;500 MET-min/week), active (500–1000 MET-min/week), and high active (&gt;1000 MET-min/week); and PA quartiles.</div></div><div><h3>Results</h3><div>Among 1077 included, the prevalence of LEL was 48 %, 32 %, and 32 % among the low active, active, and high active survivors, respectively. Compared to the low active, the active survivors had 40 % lower odds of LEL (OR 0.60, 95 % CI 0.44–0.81), but no further reduction was observed among the high active survivors (OR 0.71, 95 % CI 0.47–1.06). According to PA quartiles, higher PA levels were associated with lower odds of LEL, but not in a linear dose-response way.</div></div><div><h3>Conclusion</h3><div>Findings suggest that regular PA according to the current PA guidelines is associated with decreased the odds of self-reported LEL among endometrial cancer survivors; however, causality of association needs to be verified in a longitudinal setting.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"195 ","pages":"Pages 82-88"},"PeriodicalIF":4.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The genomic landscape of distant metastatic endometrial cancer","authors":"William A. Zammarrelli III ,&nbsp;Subhiksha Nandakumar ,&nbsp;Elizabeth Kertowidjojo ,&nbsp;Bastien Nguyen ,&nbsp;Lea A. Moukarzel ,&nbsp;Arnaud Da Cruz Paula ,&nbsp;Eric V. Rios-Doria ,&nbsp;Shaleigh A. Smith ,&nbsp;Amir Momeni-Boroujeni ,&nbsp;Vicky Makker ,&nbsp;Carol Aghajanian ,&nbsp;Walid K. Chatila ,&nbsp;Jennifer J. Mueller ,&nbsp;Nadeem R. Abu-Rustum ,&nbsp;Nikolaus Schultz ,&nbsp;Lora H. Ellenson ,&nbsp;Britta Weigelt","doi":"10.1016/j.ygyno.2025.03.006","DOIUrl":"10.1016/j.ygyno.2025.03.006","url":null,"abstract":"<div><h3>Objective</h3><div>The molecular underpinnings of primary treatment-naïve endometrial carcinoma (EC) are well described. Here we sought to characterize the genomic landscape of distant metastatic EC.</div></div><div><h3>Methods</h3><div>Distant metastatic ECs from a total of 1888 cases subjected to a clinical panel sequencing between 4/2015 and 6/2020 were identified, and their genomic profiles, affected pathways and actionable alterations were compared to those of 711 primary ECs. Wilcoxon and Fisher's exact tests were used for continuous and categorical variables, respectively, and <em>p</em>-values adjusted for multiple hypothesis-testing.</div></div><div><h3>Results</h3><div>Distant EC metastases (<em>n</em> = 137) of the lung (<em>n</em> = 66, 48 %), liver (<em>n</em> = 21, 15 %), soft tissue (<em>n</em> = 15, 11 %), distant lymph nodes (n = 15, 11 %), gastrointestinal tract (<em>n</em> = 10, 7 %), central nervous system (<em>n</em> = 5, 4 %), bone (<em>n</em> = 4, 3 %), and renal system (n = 1, 1 %) were included. Distant EC metastases were most commonly of copy number (CN)-high/<em>TP53</em> abnormal (42 %) or CN-low/no specific molecular profile (NSMP) (39 %) molecular subtype; 18 % were microsatellite instability (MSI)-high/mismatch repair (MMR)-deficient and 1 % were of <em>POLE</em> molecular subtype. Distant EC metastases were significantly more chromosomally unstable compared to primary ECs across molecular subtypes (<em>p</em> &lt; 0.0001). <em>CTNNB1</em> mutations were more prevalent in distant CN-low/NSMP and MSI-high/MMR-deficient metastases compared to primary ECs (q &lt; 0.1). Clinically actionable alterations were significantly less common in metastatic ECs (27 % vs 37 % primary; <em>p</em> = 0.025). PI3K, p53 and epigenetic pathways were the most altered pathways among all anatomic sites.</div></div><div><h3>Conclusions</h3><div>Distant metastatic ECs are more frequently chromosomally unstable but less commonly exhibit hypermutator phenotypes. Exploitation of genetic differences of metastatic EC is warranted for targeted treatment strategy development.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"195 ","pages":"Pages 89-97"},"PeriodicalIF":4.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of assessing ctDNA in patients with endometrial carcinoma - an international multicenter study","authors":"Kristina Lindemann ,&nbsp;Franziska Siegenthaler ,&nbsp;Karin T. Lande ,&nbsp;Carlos Casas-Arozamena ,&nbsp;Daniel Nebdal ,&nbsp;Tilman T. Rau ,&nbsp;Erling A. Hoivik ,&nbsp;Michael D. Mueller ,&nbsp;Rose Meng Gold ,&nbsp;Sara Imboden ,&nbsp;Ben Davidson ,&nbsp;Camilla Krakstad ,&nbsp;Therese Sørlie","doi":"10.1016/j.ygyno.2025.03.002","DOIUrl":"10.1016/j.ygyno.2025.03.002","url":null,"abstract":"<div><h3>Objective</h3><div>At present, no reliable blood-based biomarkers have been established for patients with endometrial cancer. Liquid biopsies, which can detect circulating tumor DNA (ctDNA), provide a non-invasive way to assess prognosis, monitor tumor evolution and treatment response. We aimed to examine the feasibility and performance of ctDNA as a prognostic tool in a multi-center cohort of EC patients with matched tumor samples.</div></div><div><h3>Methods</h3><div>Blood plasma samples were collected preoperatively from 83 patients at three European cancer centers. Circulating cell-free DNA (cfDNA) was isolated and analyzed using the Oncomine™ Pan-Cancer cell-free assay. Tumor tissue from 56 of the 83 patients was subjected to whole-exome sequencing, and clinical data were collected for oncological outcome assessment.</div></div><div><h3>Results</h3><div>The mean input of cfDNA was 8.17 ng (range 1.47–29.12 ng). Sixteen (19.3 %) patients were considered ctDNA positive with mutations in one or more genes. Most alterations detected in plasma were concordant with mutations found in the matched tumor for the paired cases. The preoperative presence of ctDNA was associated with a significantly higher rate of recurrence (37.5 % vs 11.9 %, <em>P</em> = 0.024). Although eight of the 14 (57 %) patients with recurrence were negative for ctDNA at diagnosis, positive ctDNA status remained an independent predictor of recurrence also when controlling for other known histopathologic risk factors (HR 5.49, 95 % CI 1.5–20, <em>P</em> = 0.010).</div></div><div><h3>Conclusions</h3><div>Our results demonstrated the feasibility of using an off-the-shelf gene panel to detect ctDNA in patients with endometrial cancer. ctDNA positivity was significantly associated with worse oncological outcomes.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"195 ","pages":"Pages 98-105"},"PeriodicalIF":4.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of physical function and quality of life before and after nonradical surgical therapy for stage IA1 and IA2-IB1 cervical cancer (GOG-0278)","authors":"Jeanne Carter ,&nbsp;Helen Q. Huang ,&nbsp;Bradley J. Monk ,&nbsp;Yong-Beom Kim ,&nbsp;Moon-Hong Kim ,&nbsp;Ashley Stuckey ,&nbsp;Danielle L. Vicus ,&nbsp;Laura L. Holman ,&nbsp;Aimee C. Fleury ,&nbsp;J. Matthew Pearson ,&nbsp;Nitika Thawani ,&nbsp;Mark Shahin ,&nbsp;Jayanthi Lea ,&nbsp;Sharon E. Robertson ,&nbsp;David Warshal ,&nbsp;Floor J. Backes ,&nbsp;Colleen Feltmate ,&nbsp;Ivy Wilkinson-Ryan ,&nbsp;Allan Covens","doi":"10.1016/j.ygyno.2025.02.023","DOIUrl":"10.1016/j.ygyno.2025.02.023","url":null,"abstract":"<div><h3>Objective</h3><div>To examine patient outcomes before and after cone biopsy (CB) or simple hysterectomy (SH) and pelvic lymph node dissection (PLND) for bladder, bowel, and sexual function, quality of life (QOL), cancer worry, reproductive concerns, and lymphedema.</div></div><div><h3>Methods</h3><div>We stratified women with stage IA1 (lymphovascular space invasion–positive) and IA2-IB1 (≤2 cm) cervical carcinoma by fertility preservation (CB) or none (SH) with PLND. All patients completed study questionnaires at baseline (preoperatively) and postoperatively at 4–6 weeks and 6-, 12-, 18-, and 24-months, consisting of: Functional Assessment Cancer Therapy - Cervical Cancer (FACT-Cx); Female Sexual Functioning Index (FSFI), and 2 Patient-Reported Outcomes Measurement Information System (PROMIS) items; Gynecologic Cancer Lymphedema Questionnaire (GCLQ); Impact of Events Scale (IES); and Reproductive Concerns Scale (RCS).</div></div><div><h3>Results</h3><div>We enrolled 224 patients from 10/12 to 10/21, with 72 choosing CB and 152 SH. A total of 169 patients (54 CB; 115 SH) were eligible for QOL analysis and completed baseline assessment with at least one follow-up assessment. Postoperatively in both groups, bladder and bowel function slightly decreased but recovered over time, sexual function declined at 6 weeks but improved over time, QOL increased, and cancer worry decreased. As per the GCLQ, 12 patients reported a diagnosis of lymphedema with a GCLQ score change ≥4 (6 CB; 6 SH).</div></div><div><h3>Conclusions</h3><div>Nonradical surgery for early-stage cervical cancer is associated with excellent QOL and small decreases in physical function (bladder, bowel, sexual) that quickly improve postoperatively to baseline or above. Lymphedema rates were low but present in both groups.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"195 ","pages":"Pages 50-58"},"PeriodicalIF":4.5,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized phase II/III study of paclitaxel/carboplatin/metformin versus paclitaxel/carboplatin/placebo as initial therapy for measurable stage III or IVA, stage IVB, or recurrent endometrial cancer: An NRG oncology/GOG study","authors":"Victoria L. Bae-Jump ,&nbsp;Michael W. Sill ,&nbsp;Paola A. Gehrig ,&nbsp;Jason D. Merker ,&nbsp;David L. Corcoran ,&nbsp;Adam D. Pfefferle ,&nbsp;Michele C. Hayward ,&nbsp;Joan L. Walker ,&nbsp;Andrea R. Hagemann ,&nbsp;Steven E. Waggoner ,&nbsp;Roisin E. O'Cearbhaill ,&nbsp;Megan E. McDonald ,&nbsp;Mitchell I. Edelson ,&nbsp;Paul A. DiSilvestro ,&nbsp;Amy L. McNally ,&nbsp;Aimee Fleury ,&nbsp;Ramey D. Littell ,&nbsp;Frederick R. Ueland ,&nbsp;Heather A. Lankes ,&nbsp;Carol Aghajanian","doi":"10.1016/j.ygyno.2025.03.003","DOIUrl":"10.1016/j.ygyno.2025.03.003","url":null,"abstract":"<div><h3>Introduction</h3><div>We evaluated the efficacy of the addition of the anti-diabetic drug metformin to standard-of-care paclitaxel and carboplatin (PC) in patients with advanced and recurrent endometrial cancer (EC).</div></div><div><h3>Methods</h3><div>In this phase II/III trial, EC patients with chemotherapy-naïve stage III/IVA (with measurable disease) and stage IVB or recurrent (with or without measurable disease) disease were randomly assigned to PC/metformin (850 mg BID) <em>versus</em> PC/placebo. Metformin or placebo was continued as maintenance therapy after completion of PC until disease progression. The primary endpoint of phase II was progression-free survival (PFS). The primary endpoint of phase III was overall survival (OS). Secondary endpoints were objective response, duration of response, and toxicity.</div></div><div><h3>Results</h3><div>From 3/17/2014 to 12/22/2017, 448 patients were randomized to phase II/III studies, and the data were frozen for interim analysis. The phase II study deemed metformin worthy of further investigation in the phase III study. The interim phase III analysis stopped accrual for futility on 2/1/2018. The addition of metformin to PC had a slightly higher hazard of death compared to the PC regimen (HR = 1.088; 90% CI 0.803 to 1.475), which was sufficient to close the study early. The PFS had (HR = 0.814; 90% CI 0.635 to 1.043). At a median follow-up of 10 months and 121 deaths, median OS was not determined and 28 months, on PC/placebo and PC/metformin, respectively.</div></div><div><h3>Conclusion</h3><div>The hazard ratios for PFS and OS endpoints was not sufficiently decreased with the addition of metformin to PC to justify continuing the trial.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"195 ","pages":"Pages 66-74"},"PeriodicalIF":4.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}