Gynecologic oncology最新文献

{"title":"The effect of a multimodal prehabilitation programme on preoperative physical fitness and nutritional status of women with gynaecological cancer","authors":"J. Dhanis ,&nbsp;J.M.A. Pijnenborg ,&nbsp;C.J.H.M. van Laarhoven ,&nbsp;S. Verlaan ,&nbsp;B. van der Heuvel ,&nbsp;A. Smits","doi":"10.1016/j.ygyno.2025.10.012","DOIUrl":"10.1016/j.ygyno.2025.10.012","url":null,"abstract":"<div><h3>Background</h3><div>Surgical treatment for gynaecological malignancies is still associated with high postoperative morbidity. Multimodal prehabilitation may improve functional capacity and thereby reduce surgical-related morbidity. Therefore, this study aims to assess the effect of multimodal prehabilitation on physical fitness and nutritional status of gynaecological oncology patients.</div></div><div><h3>Methods</h3><div>Within the F4S-PREHAB trial, a stepped-wedge trial assessing the effect of multimodal prehabilitation comprising exercise, nutrition, psychological support and intoxication cessation, a subgroup analysis was performed in women with gynaecological cancer undergoing surgery between May 2022 and April 2024 at the Radboudumc, Nijmegen. Physical fitness was compared before and after participation using estimated peak oxygen uptake, muscle strength (indirect 1-Repetition Maximum (1-RM) leg press), handgrip strength and Five-times Chair-Stand-Test. In addition, nutritional status was assessed through risk of malnutrition assessments. Further outcomes include the effect on body composition and biomarkers (Haemoglobin, Leukocytes, C-Reactive Protein, Albumin).</div></div><div><h3>Results</h3><div>In total, 140 women underwent the prehabilitation programme. Significant improvements were observed in VO2peak with 8 % (<em>P</em> = 0.001), 1-RM leg press with 20 % (<em>p</em> &lt; 0.001) and Five-times Chair-Stand-Test with 0.5 s (<em>p</em> = 0.001). The number of patients at moderate to high risk of malnutrition significantly decreased after the programme, from 29 % to 19 % (p = 0.001). No changes in body composition and biomarkers were found.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that multimodal prehabilitation has the ability to improve physical fitness and nutritional status preoperatively in gynaecological oncology patients. Further studies are needed to define the role of prehabilitation in improving physical fitness and nutritional status, and its association with postoperative outcomes, allowing for more personalized and effective treatment.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"203 ","pages":"Pages 1-7"},"PeriodicalIF":4.1,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145335183","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 positive peritoneal cytology in FIGO 2009 stage IA grade 1 endometrioid endometrial cancer","authors":"Christian Dagher ,&nbsp;Pier Selenica ,&nbsp;Carsten F.J. Bakhuis ,&nbsp;Hunter Green ,&nbsp;Kaitlyn Gill ,&nbsp;Jacqueline Feinberg ,&nbsp;Sarah H. Kim ,&nbsp;David Kim ,&nbsp;Qin Zhou ,&nbsp;Alexia Iasonos ,&nbsp;Lora H. Ellenson ,&nbsp;Amir Momeni-Boroujeni ,&nbsp;Mario M. Leitao Jr. ,&nbsp;Nadeem R. Abu-Rustum ,&nbsp;Britta Weigelt ,&nbsp;Jennifer J. Mueller","doi":"10.1016/j.ygyno.2025.10.008","DOIUrl":"10.1016/j.ygyno.2025.10.008","url":null,"abstract":"<div><h3>Background</h3><div>We examined the prognostic value of positive peritoneal cytology (PPC) in International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IA grade 1 endometrioid endometrial cancer.</div></div><div><h3>Methods</h3><div>This single-institution retrospective cohort study included patients who underwent surgical staging with peritoneal cytology sampling and bilateral pathologic pelvic lymph node evaluation between 1/1/2008 and 8/1/2021. Exclusion criteria included suspicious/atypical cytology, lymphovascular space invasion, lymph node involvement (including isolated tumor cells), synchronous malignancies, no nodal evaluation, or receipt of adjuvant therapy. Patients were stratified by PPC or negative peritoneal cytology (NPC) status. Molecular classification and mutational profiling were available for some tumors.</div></div><div><h3>Results</h3><div>Of 1151 eligible patients, 50 (4 %) had PPC. Median age at surgery was 58 years and was similar between groups <em>(P =</em> 0.59). Depth of myometrial invasion, vaginal tears, age, prior secondary malignancies, and PPC were associated with progression-free survival (PFS) on univariable analysis. Five-year PFS rates were 95.2 % (NPC) and 88.8 % (PPC) (<em>P</em> = 0.02). PPC remained independently associated with worse PFS on multivariable analysis (adjusted HR: 2.63, 95 % CI: 1.19–5.80; <em>P</em> = 0.02), though recurrence was limited in number, with 31 events observed across the entire cohort. Molecular profiling of 216 tumors confirmed all four subtypes; subtype distribution did not correlate with outcomes. Tumors in the PPC group were enriched in <em>ARID1A</em> (82 % vs. 44 %, <em>P</em> = 0.001) mutations.</div></div><div><h3>Conclusion</h3><div>PPC appears to be independently associated with worse PFS in low-grade, early-stage endometrial cancer despite excellent overall outcomes and absence of adjuvant therapy. <em>ARID1A</em> mutations may promote peritoneal dissemination in these otherwise low-risk tumors.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"202 ","pages":"Pages 154-161"},"PeriodicalIF":4.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318190","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":"Gynecologic oncology fellowship trends: Supply outpacing demand, geographical maldistribution","authors":"Sharonne Holtzman ,&nbsp;Evan Myers ,&nbsp;Laura J. Havrilesky ,&nbsp;Diane Yamada ,&nbsp;Sarah Ackroyd ,&nbsp;Kristen Zeligs ,&nbsp;Monica Prasad-Hayes ,&nbsp;Konstatin Zakashansky ,&nbsp;Teresa Boitano ,&nbsp;Warner Huh ,&nbsp;Stephanie V. Blank","doi":"10.1016/j.ygyno.2025.09.003","DOIUrl":"10.1016/j.ygyno.2025.09.003","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the trends and geographic distribution of US GO fellowship programs over time and analyze GO specific procedures by regions.</div></div><div><h3>Methods</h3><div>Using the publicly available data from the NRMP, the number of GO fellowship programs and positions between 2004 and 2023 was obtained. The number of programs and positions in each geographic region was calculated. Total number of GO cases was calculated based on SEER data by region, with GO-specific cases categorized as early cervical cancer and advanced ovarian cases as surrogates. Growth rates were calculated for the study period and a simple linear regression analysis was performed to study the significant trends by years.</div></div><div><h3>Results</h3><div>The Northeast exhibited the highest position growth (B = 0.49, <em>p</em> &lt; 0.001), whereas program expansion was most rapid in the West (B = 0.42, <em>p</em> &lt; 0.001). From 2004 to 2021, early-stage cervical cancer cases per fellow declined significantly across all regions (p &lt; 0.001), with the Midwest decreasing the most by 68.2 % (from 85 to 27 cases). Similarly, advanced ovarian cancer cases per fellow decreased, with the Midwest experiencing a 70 % decline (from 202 to 60 cases) and the West demonstrating the greatest rate of decline at 8.86 fewer cases per fellow per year (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>There is a geographic imbalance in new programs and positions relative to the number of GO cases per fellow with surgical cases by fellow varying significantly by geographic region. These data raise the issue of an unmet need in considering the future of our profession.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"202 ","pages":"Pages 162-166"},"PeriodicalIF":4.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318162","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":"Development and optimization of an integrated exercise and nutrition program for ovarian cancer patients: Phase I of the BENITA multi-center study","authors":"Tabea Maurer ,&nbsp;Matthias H. Belau ,&nbsp;Birgit-Christiane Zyriax ,&nbsp;Götz Welsch ,&nbsp;Bettina Jagemann ,&nbsp;Jenny Chang-Claude ,&nbsp;Anne Daubmann ,&nbsp;Anika Buchholz ,&nbsp;Alexander Fierenz ,&nbsp;Karin Glismann ,&nbsp;Annika Moeller ,&nbsp;Jalid Sehouli ,&nbsp;Hannah Woopen ,&nbsp;Pauline Wimberger ,&nbsp;Philipp Harter ,&nbsp;Sabrina Kaiser ,&nbsp;Nicolai Maass ,&nbsp;Marion Kiechle ,&nbsp;Tobias Engler ,&nbsp;Barbara Schmalfeldt ,&nbsp;Holger Schulz","doi":"10.1016/j.ygyno.2025.10.005","DOIUrl":"10.1016/j.ygyno.2025.10.005","url":null,"abstract":"<div><h3>Background</h3><div>Ovarian cancer patients face treatment-related challenges such as malnutrition and muscle wasting associated with cancer cachexia. If left untreated, these complications can severely impact quality of life and autonomy. The BENITA study aims to develop and evaluate a tailored exercise and nutrition program during and after first-line chemotherapy. Phase I focused on program development and optimization; Phase II will test its effectiveness in a randomized controlled trial.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with patients, survivors, physicians, nutrition and physiotherapy experts, and a health insurance representative. Thematic analysis following Braun and Clarke was used to identify key insights for program design and implementation.</div></div><div><h3>Results</h3><div>Patients' motivation to engage in exercise and nutrition was driven by enjoyment and external encouragement. Barriers included chemotherapy-induced fatigue, physical weakness, and psychological strain. Uncertainty about safe training post-surgery was common. Regular support from healthcare professionals was seen as essential for confidence and adherence.</div></div><div><h3>Discussion</h3><div>Findings highlight the need for a personalized, flexible program tailored to ovarian cancer patients' needs. A blended digital approach combining self-guided elements with professional support could improve implementation, offering customized exercise routines, nutrition plans, and regular check-ins to facilitate patient-centered participation.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"202 ","pages":"Pages 167-173"},"PeriodicalIF":4.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318173","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":"Survival outcomes and treatment patterns in malignant ovarian sex cord-stromal tumors: A population-based analysis","authors":"Uisuk Kim ,&nbsp;Byeong-Chan Oh ,&nbsp;Jaekyung Bae ,&nbsp;Sokbom Kang","doi":"10.1016/j.ygyno.2025.10.007","DOIUrl":"10.1016/j.ygyno.2025.10.007","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate treatment patterns and survival outcomes by histologic subtype and stage in malignant ovarian sex cord-stromal tumors (SCSTs), focusing on the impact of adjuvant chemotherapy to inform histology-specific treatment strategies.</div></div><div><h3>Methods</h3><div>This retrospective cohort study identified adult patients newly diagnosed with malignant ovarian SCSTs using nationwide claims data from Korea (2012–2019). Patients were classified into granulosa-type and other subtypes. Treatment patterns, including upfront cytoreductive surgery and adjuvant chemotherapy, were described. Overall survival (OS) and time to first subsequent therapy or death (TFST) were estimated using Kaplan–Meier methods and compared across subgroups. In localized-stage patients undergoing upfront surgery, the association between adjuvant chemotherapy and survival outcomes was further evaluated. Sensitivity and landmark analyses assessed the robustness of findings.</div></div><div><h3>Results</h3><div>Among 314 patients (256 granulosa-type and 58 non-granulosa), localized disease was more common in both groups (granulosa-type: 68.4 %, non-granulosa: 67.2 %). Most patients received upfront cytoreductive surgery (granulosa-type: 88.7 %, non-granulosa: 89.7 %, overall: 88.9 %), while adjuvant chemotherapy was more commonly administered in non-granulosa tumors. In the localized-stage subgroup, adjuvant chemotherapy was associated with longer TFST in non-granulosa SCSTs (5-year TFST: 94.1 % vs. 61.9 %), whereas no significant benefit was observed in granulosa-type tumors. OS remained high (&gt;85 %) across all histologic subtypes and treatment.</div></div><div><h3>Conclusions</h3><div>This study supports upfront cytoreductive surgery as the primary treatment for ovarian SCSTs and suggests the role of adjuvant chemotherapy should be guided by histologic subtype. These findings support histology-driven treatment strategies and the need for prospective studies to optimize individualized management.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"202 ","pages":"Pages 146-153"},"PeriodicalIF":4.1,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312796","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":"Interstitial lung disease in targeted therapies: A Society of Gynecologic Oncology clinical practice statement","authors":"Charles A. Powell ,&nbsp;Ira S. Winer ,&nbsp;Christopher M. Tarney ,&nbsp;Stéphanie Gaillard ,&nbsp;Róisín E. O'Cearbhaill","doi":"10.1016/j.ygyno.2025.09.010","DOIUrl":"10.1016/j.ygyno.2025.09.010","url":null,"abstract":"<div><div>Interstitial lung disease (ILD) is a potentially serious and sometimes fatal complication of targeted therapies, including antibody-drug conjugates and immunotherapies, in gynecologic oncology. Risk factors include pre-existing lung disease, advanced age and prior thoracic radiation. Early detection, patient and clinician education, and prompt multidisciplinary collaboration are critical to mitigate ILD morbidity and mortality. This Society of Gynecologic Oncology clinical practice statement provides evidence-based recommendations for the diagnosis, grading and management of ILD associated with gynecologic cancer therapies, emphasizing the importance of baseline risk assessment, ongoing monitoring and standardized intervention protocols to optimize patient outcomes.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"202 ","pages":"Pages 137-145"},"PeriodicalIF":4.1,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307766","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":"Immunohistochemistry, next generation sequencing (NGS), and whole exome sequencing concordance in HER2 testing in uterine serous carcinoma: a retrospective analysis","authors":"Victoria M. Ettorre ,&nbsp;Stefania Bellone ,&nbsp;Natalia Buza ,&nbsp;Pei Hui ,&nbsp;Tobias Max Philipp Hartwich ,&nbsp;Cem Demirkiran ,&nbsp;Michelle Greenman ,&nbsp;Namrata Sethi ,&nbsp;Luca Palmieri ,&nbsp;Alessandro D. Santin","doi":"10.1016/j.ygyno.2025.09.017","DOIUrl":"10.1016/j.ygyno.2025.09.017","url":null,"abstract":"<div><h3>Background</h3><div>HER2-targeted treatments are an important therapeutic option for a subset of uterine serous carcinoma (USC) patients. We evaluated the concordance of routine immunohistochemistry (IHC) testing and fluorescence in situ hybridization (FISH) for HER2 expression versus next generation sequencing (NGS) by a commercial platform (Foundation Medicine), and comprehensive whole exome sequencing (WES).</div></div><div><h3>Methods</h3><div>Two groups of USC patients with IHC and FISH results for HER2 were compared for concordance with matched NGS data (152 USC patients) and WES (76 USC patients) performed at the Yale Center for Genome Analysis (YCGA). Clinical HER2 positivity was defined as 3+ IHC staining or 2+ IHC staining with reflex gene amplification utilizing fluorescent-in-situ-hybridization (FISH). NGS HER2 positivity was defined as ERBB2 amplifications identified in the NGS/WES report.</div></div><div><h3>Results</h3><div>In the IHC/NGS group, the overall correlation was 81 % (<em>p</em> &lt; 0.001), which improved to 85 % (p &lt; 0.001) when IHC/FISH and NGS were performed on the same pathology tissue block of a particular specimen. In the IHC/WES group, the overall correlation was similar at 82 % (<em>p</em> &lt; 0.001). NGS captured 1 additional patient missed by IHC/FISH, while WES captured 11 additional patients not identified by IHC/FISH.</div></div><div><h3>Conclusions</h3><div>The correlation of HER2 IHC/FISH with NGS and WES ranges between 80 and 85 %, with improvement in correlation when testing is performed on the same tissue block. WES may be superior to commercially available NGS platforms in the detection/identification of HER2 treatment-eligible patients. While highly correlated, these results confirm that IHC should not be abandoned in the evaluation of patients eligible for HER2-targeted therapy.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"202 ","pages":"Pages 131-136"},"PeriodicalIF":4.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299735","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":"SMARCA4 pathogenic variants: Gynecological cancer histories from a laboratory tested cohort","authors":"Brittany A. Borden ,&nbsp;Adela Rodriguez-Hernandez ,&nbsp;Magan Trottier ,&nbsp;Miki Horiguchi ,&nbsp;Jamie D. Weyandt ,&nbsp;Carolyn Horton ,&nbsp;Linda M. Polfus ,&nbsp;Brittany L. Bychkovsky ,&nbsp;Colin C. Young ,&nbsp;Judy E. Garber ,&nbsp;Jessica D. St. Laurent ,&nbsp;Huma Q. Rana","doi":"10.1016/j.ygyno.2025.10.001","DOIUrl":"10.1016/j.ygyno.2025.10.001","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the cancer histories of individuals with a <em>SMARCA4</em> germline pathogenic/likely pathogenic variant (gPV) obtained through clinical laboratory-based testing to aid in informing guidance surrounding surveillance and prevention for individuals with gPV.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzed individuals with a <em>SMARCA4</em> gPV identified by multigene panel testing for hereditary cancer at a single commercial clinical laboratory (2014–2024). Descriptive statistics were used to summarize individuals with a gPV in <em>SMARCA4</em>. Age at diagnosis of small cell carcinoma of the ovary hypercalcemic type (SCCOHT) and of unspecified ovarian cancer among individuals with a <em>SMARCA4</em> gPV was enumerated using cumulative distribution functions.</div></div><div><h3>Results</h3><div>Among genotyped individuals, 137 had a <em>SMARCA4</em> gPV. After applying exclusion criteria, 127 individuals were included in the analysis. Individuals with a <em>SMARCA4</em> gPV were predominately female (74.8 %), and 53.5 % (<em>n</em> = 68) had a history of cancer. Of the females with a cancer history, SCCOHT (17.9 %) and ovarian cancer not otherwise specified (7.4 %) were reported. SCCOHT accounted for 29.8 % of cancer diagnoses among females aged ≤50 years. All SCCOHT cases among individuals with <em>SMARCA4</em> gPVs were diagnosed by age 40.</div></div><div><h3>Conclusion</h3><div>Our data support the inclusion of <em>SMARCA4</em> in genetic testing for hereditary early-onset ovarian cancer, enumerate the ages of SCCOHT diagnosis, and highlight the need for prospective penetrance studies to improve counseling and management for patients and their families.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"202 ","pages":"Pages 125-130"},"PeriodicalIF":4.1,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292002","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":"Sentinel lymph node mapping in early-stage cervical cancer: Results from the SENTIX prospective multicenter study","authors":"Roman Kocian ,&nbsp;Christhardt Kohler ,&nbsp;Jaroslav Klat ,&nbsp;Jiri Jarkovsky ,&nbsp;Ignacio Zapardiel ,&nbsp;Giampaolo Di Martino ,&nbsp;Luc van Lonkhuijzen ,&nbsp;Michal Zikan ,&nbsp;Octavio Arencibia Sanchez ,&nbsp;Blanca Gil-Ibanez ,&nbsp;Francesco Raspagliesi ,&nbsp;Jiri Presl ,&nbsp;Lubos Minar ,&nbsp;Radim Marek ,&nbsp;Peter Kascak ,&nbsp;Pavel Havelka ,&nbsp;Martin Michal ,&nbsp;Toon Van Gorp ,&nbsp;Kristyna Nemejcova ,&nbsp;Pavel Dundr ,&nbsp;David Cibula","doi":"10.1016/j.ygyno.2025.09.018","DOIUrl":"10.1016/j.ygyno.2025.09.018","url":null,"abstract":"<div><h3>Objective</h3><div>To assess sentinel lymph node (SLN) bilateral detection rate, anatomical distribution, and tracer performance in early-stage cervical cancer patients undergoing primary surgery, based on data from the prospective multicenter SENTIX trial.</div></div><div><h3>Methods</h3><div>Patients with FIGO 2018 stage IA1 (LVSI+) to IB2 cervical cancer and no suspicious lymph nodes on preoperative imaging were enrolled in the SENTIX trial. SLN biopsy was performed using blue dye (BD), radiocolloid (RC), indocyanine green (ICG), or their combinations. Only patients with successful bilateral SLN detection and negative intraoperative frozen section proceeded to radical hysterectomy or fertility-sparing surgery. SLN locations and metastatic status were documented by anatomical region and centrally reviewed for consistency.</div></div><div><h3>Results</h3><div>Among 724 patients who underwent SLN biopsy, the overall bilateral detection rate was 92.3 %, with the highest rate (100 %) achieved using ICG and RC combination. If mapping-failure cases were considered, the bilateral detection rate would be 84.6 %. Most SLNs (91.6 %) were located at pelvic level I, predominantly in the external iliac and interiliac regions. SLNs above the interiliac bifurcation were infrequent (2.7 %), and isolated positive SLNs in pelvic level II were rare (1.3 %). No SLNs were identified in paraaortic regions. Bilateral detection was unaffected by BMI, histology, or prior conization. Although detection was slightly lower in tumors &gt;2 cm, bilateral rates exceeded 90 %.</div></div><div><h3>Conclusions</h3><div>SLN mapping demonstrated high bilateral detection across tracers and patient subgroups. Nearly all SLNs were confined to pelvic level I, underscoring anatomical predictability. These results demonstrate reproducible SLN mapping in tumors ≤4 cm and may help inform individualized surgical planning.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"202 ","pages":"Pages 118-124"},"PeriodicalIF":4.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267711","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":"Multidisciplinary ambulatory management of malignant bowel obstruction (MAMBO) program in patients with advanced gynecological cancers: A prospective study","authors":"V. Garg ,&nbsp;E. Armstrong ,&nbsp;A. Celeste ,&nbsp;C. Wang ,&nbsp;A. Shukla ,&nbsp;A. Tesfu ,&nbsp;O. Odujoko ,&nbsp;A. Madariaga ,&nbsp;Y.C. Lee ,&nbsp;L. Wang ,&nbsp;H. Alqaisi ,&nbsp;P. Soberanis ,&nbsp;B. Grant ,&nbsp;D. Braik ,&nbsp;T. Chawla ,&nbsp;E. Shlomovitz ,&nbsp;A. Veneziani ,&nbsp;N. Dhani ,&nbsp;R. Grant ,&nbsp;N. Jivraj ,&nbsp;S. Lheureux","doi":"10.1016/j.ygyno.2025.09.012","DOIUrl":"10.1016/j.ygyno.2025.09.012","url":null,"abstract":"<div><h3>Objectives</h3><div>This prospective study aimed to assess the feasibility of a risk-stratified, multidisciplinary ambulatory approach for managing malignant bowel obstruction (MBO) in patients with advanced gynecological cancer.</div></div><div><h3>Methods</h3><div>A clinical risk-based MBO triage system was implemented by incorporating bowel function assessments, management regimes, and educational tools. An interdisciplinary team (IDT) guided treatment decisions. At risk patients received proactive management through nursing phone calls for up to 4 weeks, while patients with MBO continued proactive management for up to 8 weeks based on symptom resolution. The primary endpoint was the ratio of days alive and out of the hospital to days in the hospital within 60 days post-MBO diagnosis.</div></div><div><h3>Results</h3><div>92 patients (median age 62 years [range 31–83]) were enrolled. At enrollment, 49 % (<em>n</em> = 45) had MBO, and 51 % (<em>n</em> = 47) were at risk of MBO development. 7 % (<em>n</em> = 3) at-risk patients progressed to MBO in 4 weeks, while 93 % had symptom resolution with proactive outpatient management.</div><div>Overall, 62 % (<em>n</em> = 57) of patients developed MBO during study period. Among these, 93 % (<em>n</em> = 53) needed inpatient care, with a median stay of 12.5 days (range 0–57) in the first 60 days. Median OS after MBO was 5.7 months (95 % CI, 3.6–8.4). The median of hospital-to-home ratio was 0.3 (range 0–19) within 60 days. MBO resolved in 42 % (<em>n</em> = 24) of the patients. Microbiome analysis showed lower Shannon diversity and species richness for MBO patients compared to those at risk.</div></div><div><h3>Conclusion</h3><div>This study confirms the feasibility of ambulatory management for MBO patients, using a risk-based MBO triage system guided by IDT.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"202 ","pages":"Pages 110-117"},"PeriodicalIF":4.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267710","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}