Gynecologic oncology最新文献

{"title":"Maintenance olaparib monotherapy in patients with platinum-sensitive relapsed ovarian cancer without a germline BRCA1 and/or BRCA2 mutation: Final overall survival results from the OPINION trial","authors":"Andrés Poveda ,&nbsp;Stéphanie Lheureux ,&nbsp;Nicoletta Colombo ,&nbsp;David Cibula ,&nbsp;Mari Elstrand ,&nbsp;Johanne Weberpals ,&nbsp;Maria Bjurberg ,&nbsp;Ana Oaknin ,&nbsp;Magdalena Sikorska ,&nbsp;Antonio González-Martín ,&nbsp;Radoslaw Madry ,&nbsp;María Jesus Rubio Pérez ,&nbsp;Jonathan Ledermann ,&nbsp;Ignacio Romero ,&nbsp;Ozan Özgören ,&nbsp;Alan Barnicle ,&nbsp;Helen Marshall ,&nbsp;Zahid Bashir ,&nbsp;Erik Škof","doi":"10.1016/j.ygyno.2025.04.580","DOIUrl":"10.1016/j.ygyno.2025.04.580","url":null,"abstract":"<div><h3>Objective</h3><div>Maintenance olaparib demonstrated clinical activity for progression-free survival in patients without a germline <em>BRCA1</em> and/or <em>BRCA2</em> mutation (non-gBRCAm) who had platinum-sensitive relapsed ovarian cancer in the phase IIIb, open-label, single-arm, non-comparator, international OPINION trial (<span><span>NCT03402841</span><svg><path></path></svg></span>). We report final overall survival (OS; secondary endpoint), prespecified secondary endpoint updates and <em>ad hoc</em> OS analysis by homologous recombination deficiency (HRD) and somatic BRCAm (sBRCAm) status.</div></div><div><h3>Methods</h3><div>Patients with non-gBRCAm platinum-sensitive relapsed ovarian cancer, ≥2 prior lines of platinum-based chemotherapy, and in response following their last platinum-based chemotherapy received 300 mg olaparib tablets twice daily until disease progression or unacceptable toxicity.</div></div><div><h3>Results</h3><div>279 patients were enrolled and treated. With a median follow-up in patients censored for OS of 33.1 months (data cut-off September 17, 2021), median OS was 32.7 months (95 % CI 29.5–35.3); the 24-month OS rate was 65.8 %. In <em>ad hoc</em> subgroup analyses, OS rates tended to be higher in patients with HRD-positive tumors; 24-month OS rates were 81.5 %, 74.2 %, 72.0 % and 55.8 % in the sBRCAm, HRD-positive including sBRCAm, HRD-positive excluding sBRCAm, and HRD-negative subgroups, respectively. Grade ≥ 3 treatment-emergent adverse events were reported in 82 patients (29.4 %), most commonly anemia (13.6 %). Overall, two cases of myelodysplastic syndrome were reported (no new cases since the primary analysis).</div></div><div><h3>Conclusion</h3><div>These data provide additional evidence of olaparib as maintenance therapy in patients with non-gBRCAm platinum-sensitive relapsed ovarian cancer, with longer OS observed in those with HRD-positive tumors. The safety profile was consistent with the primary analysis and known safety profile of olaparib, with no new safety findings.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 74-82"},"PeriodicalIF":4.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878627","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":"Impact of adding the immune checkpoint inhibitor atezolizumab to first-line chemotherapy on progression-free survival in poor-prognosis ovarian cancer: A retrospective analysis from the IMagyn050 trial","authors":"Benoit You ,&nbsp;Charles Anderson ,&nbsp;Sabrina Chiara Cecere ,&nbsp;Aurore Carrot ,&nbsp;Tashanna Myers ,&nbsp;Florian Heitz ,&nbsp;Sudarshan Sharma ,&nbsp;Fatih Selçukbiricik ,&nbsp;Carol Aghajanian ,&nbsp;Josefin Fernebro ,&nbsp;Stephanie Blank ,&nbsp;Maria Elena Laudani ,&nbsp;Premal H. Thaker ,&nbsp;Mayu Yunokawa ,&nbsp;Lyndsay Willmott ,&nbsp;Alla Lisyanskaya ,&nbsp;Roberto Hegg ,&nbsp;Yvette He ,&nbsp;Charles Landen ,&nbsp;Yvonne G. Lin ,&nbsp;Kathleen N. Moore","doi":"10.1016/j.ygyno.2025.04.577","DOIUrl":"10.1016/j.ygyno.2025.04.577","url":null,"abstract":"<div><h3>Purpose</h3><div>Adding the anti-PD-L1 antibody atezolizumab to frontline chemotherapy-bevacizumab regimen did not improve progression-free survival (PFS) in ovarian cancer (OC) patients in IMagyn050 trial. This post-hoc analysis assessed the efficacy of atezolizumab in a subgroup of patients with particularly poor prognosis, as defined by the GCIG meta-analysis—characterized by a poor chemosensitivity and a suboptimal surgical resection.</div></div><div><h3>Methodology</h3><div>This analysis included 1199 evaluable participants with ≥3 available CA-125 concentrations, as required for KELIM score. The prognostic factors were identified through univariable and multivariable analyses. If both the KELIM score (unfavorable &lt;1.0, vs favorable ≥1.0) and surgical outcome (suboptimal, vs optimal resection) demonstrated independent prognostic value, they were to be combined into prognostic subgroups. The PFS benefit of atezolizumab versus placebo was then evaluated within each of these defined subgroups.</div></div><div><h3>Results</h3><div>Both the KELIM score and surgical outcome were independent prognostic factors. Combining these two parameters generated three distinct prognostic subgroups. In the poor prognosis subgroup (<em>n</em> = 269), defined by both an unfavorable KELIM score (&lt;1.0) and suboptimal cytoreduction, the addition of atezolizumab was associated with a significantly longer median PFS compared to placebo (14.3 vs 11.3 months; HR 0.75, 95 % CI 0.59–0.95). This benefit was observed in both neoadjuvant and adjuvant settings. No significant PFS benefit was observed in the other prognostic subgroups.</div></div><div><h3>Conclusion</h3><div>The poor prognostic OC patient subgroup, may have an extension of PFS from treatment intensification with atezolizumab added to frontline chemotherapy-bevacizumab regimen. This hypothesis-generating outcome warrants further understanding on the added role of ICI in the frontline setting.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 66-73"},"PeriodicalIF":4.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869896","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":"Mesonephric-like adenocarcinoma of the female genital tract: Pathologic diagnosis, clinical outcomes, and novel therapeutics","authors":"Kari L. Ring ,&nbsp;Anne M. Mills ,&nbsp;Brooke E. Howitt ,&nbsp;Rachel N. Grisham ,&nbsp;Elizabeth D. Euscher ,&nbsp;Hyun-Soo Kim ,&nbsp;Ann H. Klopp ,&nbsp;David L. Kolin ,&nbsp;W. Glenn McCluggage ,&nbsp;Jelena Mirkovic ,&nbsp;Kay J. Park ,&nbsp;Eliane Aoun ,&nbsp;Chika Awujo ,&nbsp;Ji Son ,&nbsp;Samuel C. Mok ,&nbsp;Sammy Ferri-Borgogno ,&nbsp;David S. Hong ,&nbsp;Lien Hoang ,&nbsp;Amir A. Jazaeri ,&nbsp;Jeffrey A. How ,&nbsp;Karen H. Lu","doi":"10.1016/j.ygyno.2025.04.583","DOIUrl":"10.1016/j.ygyno.2025.04.583","url":null,"abstract":"<div><div>In 2016, McCluggage and colleagues first defined mesonephric-like adenocarcinoma (MLA) of the uterus and extra-uterine sites. Following this initial description, the World Health Organization officially recognized MLA as a type of uterine and ovarian carcinoma and subsequent studies have further refined the morphologic definition, immunohistochemical profile, molecular underpinnings, and clinical behavior in this rare entity. A consortium of pathologists, gynecologic oncologists, medical oncologists, radiation oncologists, as well as basic science collaborators with expertise in MLA was convened to develop consensus regarding the pathologic diagnosis, and to identify unanswered questions and priority areas for research. Here, we review the current understanding of MLA from a pathologic, molecular, and clinical standpoint.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 57-65"},"PeriodicalIF":4.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869910","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 phase I clinical trial of radiation therapy, durvalumab and tremelimumab in recurrent gynecologic cancer","authors":"Kelly J. Fitzgerald,&nbsp;Panagiotis Konstantinopoulos,&nbsp;Ursula Matulonis,&nbsp;Joyce Liu,&nbsp;Neil Horowitz,&nbsp;Elizabeth Lee,&nbsp;David L. Kolin,&nbsp;Larissa Lee,&nbsp;Martin King","doi":"10.1016/j.ygyno.2025.04.006","DOIUrl":"10.1016/j.ygyno.2025.04.006","url":null,"abstract":"<div><h3>Objective</h3><div>Dual immune checkpoint blockade (ICB) may synergize with palliative radiotherapy (RT) to improve responses in patients with recurrent/metastatic gynecologic cancer. We conducted an open label prospective phase I trial to assess the safety and tolerability of ICB plus RT.</div></div><div><h3>Methods</h3><div>Patients with recurrent/metastatic endometrial, ovarian, cervical, vaginal or vulvar cancer were eligible. The safety lead-in cohort A was treated with programmed death ligand (PD-L1) inhibitor durvalumab 1500 mg IV q4 weeks and palliative RT of 25 Gy in 5 fractions to a single abdominopelvic lesion. Cohort B also received 4 cycles of cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitor tremelimumab 75 mg IV. The primary endpoint was the rate of dose-limiting toxicities (DLTs) in patients on protocol 8 weeks after RT. Secondary endpoints included the overall response rate (ORR) in non-irradiated lesions.</div></div><div><h3>Results</h3><div>16 patients were enrolled, with 12 able to be assessed for the primary endpoint. Zero DLTs occurred in cohort A and 1 in cohort B. One patient in cohort B with platinum resistant ovarian cancer with two metastatic sites (a pelvic mass irradiated prior to trial enrollment and a peritoneal nodule irradiated on protocol) had a dramatic reduction in disease burden and remains off all therapy &gt;3 years. The ORR of non-irradiated lesions was 0 %.</div></div><div><h3>Conclusions</h3><div>Combining durvalumab, tremelimumab and RT to a single lesion had limited DLTs but no response in non-irradiated lesions in unselected patients with recurrent gynecologic malignancies. One patient with oligometastatic disease experienced prolonged durable benefit. Clinical trial information: <span><span>NCT03277482</span><svg><path></path></svg></span></div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 51-56"},"PeriodicalIF":4.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860736","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":"Reduced symptoms of late radiation tissue injury of the vagina after treatment with hyperbaric oxygen therapy: A retrospective analysis of 19 patients","authors":"M.M. Möring ,&nbsp;A.C. Valkenburg ,&nbsp;N. Schuur-van’t Hof ,&nbsp;H.J. van Beekhuizen ,&nbsp;C.A. Lansdorp","doi":"10.1016/j.ygyno.2025.04.003","DOIUrl":"10.1016/j.ygyno.2025.04.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Hyperbaric oxygen therapy (HBOT) is a well-established treatment for late radiation tissue injury (LRTI) of the pelvis, such as radiation-cystitis and -proctitis, but not for LRTI of the vagina. This study aims to describe the outcomes of patients with vaginal symptoms after HBOT.</div></div><div><h3>Methods</h3><div>The records of all patients with LRTI of the vagina, referred for HBOT from a tertiary hospital, between 2010 and 2020 were retrospectively analyzed. Patients with a non-vaginal primary complaint, fistulas, or incomplete HBOT treatment (&lt;20 sessions) were excluded. Outcomes included patient- and physician-reported symptoms (such as dyspareunia, dryness, bleeding, and anatomical changes) and quality-of-life questionnaires. Outcomes were assessed at baseline, after HBOT, 3 months after HBOT, and during yearly follow-up. Responders were defined as patients with ≥1 vaginal symptoms improving after treatment.</div></div><div><h3>Results</h3><div>19 Patients (median age 42) received an average of 40 sessions of HBOT (80 min of 100 % oxygen at 2.5 ATA). 15/19 patients (79 %) were responders at the end of treatment (median of 3 symptoms improving). The symptoms most responsive to HBOT were ulceration (89 %), dyspareunia (82 %), pain (71 %), and changes in anatomy like stenosis or fibrosis (80 %). Response was maintained during 3 month follow-up in 14/15 patients. No major adverse events of HBOT were reported.</div></div><div><h3>Conclusion</h3><div>A majority of patients had a lasting improvement of vaginal complaints after HBOT in this study. Based on this study and the generic effects of HBOT in LRTI, HBOT should be considered as a treatment option for patients with ongoing complaints of the vagina due to LRTI.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 27-33"},"PeriodicalIF":4.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856090","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":"Pattern of recurrence of the molecular subgroups in stage I high-grade endometrial cancer","authors":"Alicia León-Castillo ,&nbsp;Nanda Horeweg ,&nbsp;Elke E.M. Peters ,&nbsp;Natalja ter Haar ,&nbsp;Vincent T.H.B.M. Smit ,&nbsp;Cor D. de Kroon ,&nbsp;Marie Boennelycke ,&nbsp;Estrid Hogdall ,&nbsp;Claus Hogdall ,&nbsp;Remi R.A. Nout ,&nbsp;Carien L. Creutzberg ,&nbsp;Tjalling Bosse ,&nbsp;Gitte Ortoft","doi":"10.1016/j.ygyno.2025.04.576","DOIUrl":"10.1016/j.ygyno.2025.04.576","url":null,"abstract":"<div><h3>Objective</h3><div>Patterns of recurrence may impact the possibilities for salvage treatment and prognosis of patients with endometrial carcinoma (EC). We evaluated the recurrence rate and distribution pattern of the molecular EC subgroups in patients with stage I high-grade disease without adjuvant treatment and those staged by lymphadenectomy.</div></div><div><h3>Method</h3><div>412 high-grade EC from the Danish Gynecological Cancer Database were molecularly profiled and classified into <em>POLE</em> mutant (<em>POLE</em>mut), mismatch repair deficient (MMRd), p53-abnormal (p53abn) or no specific molecular profile (NSMP) EC. Patients with stage II-IV (FIGO 2009) or residual disease after surgery were excluded. Crude and actuarial recurrence rates were calculated.</div></div><div><h3>Results</h3><div>Stage I high-grade <em>POLE</em>mut and MMRd EC rarely recurred (5-year overall recurrence rate 7 % (95 % CI 3–16) and 6 % (95 % CI 2–22), respectively), also when not receiving adjuvant treatment. Stage I high-grade NSMP and p53abn EC had high recurrence rates (5-year overall recurrence rate 29 % (95 % CI 16–48) and 35 % (95 % CI 27–45), respectively), mostly presenting with abdominal (NSMP EC <em>n</em> = 1 (3.0 %); p53abn EC <em>n</em> = 28 (22.4 %)) or distant recurrences (NSMP EC <em>n</em> = 8 (24.2 %); p53abn EC <em>n</em> = 21 (16.8 %)).</div></div><div><h3>Conclusion</h3><div>Stage I high-grade EC present more frequently with abdominal and distant recurrences rather than isolated loco-regional recurrences, independently of molecular subgroup. Stage I high-grade <em>POLE</em>mut EC and MMRd EC have a favorable prognosis with few recurrences, even with no adjuvant treatment. Stage I high-grade NSMP and p53abn EC have a high recurrence rate, frequently with abdominal or distant recurrences, underscoring the need to investigate more effective adjuvant systemic treatments for these patients.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 43-50"},"PeriodicalIF":4.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860604","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":"Disparities in hysterectomy-corrected endometrial cancer incidence trends by histologic subtype among racial/ethnic groups in California, 2012–2019","authors":"Jingjing Xie ,&nbsp;Frances B. Maguire ,&nbsp;Brenda M. Hofer ,&nbsp;Julianne J.P. Cooley ,&nbsp;Hui A. Chen ,&nbsp;Arti Parikh-Patel ,&nbsp;Theresa H.M. Keegan","doi":"10.1016/j.ygyno.2025.04.581","DOIUrl":"10.1016/j.ygyno.2025.04.581","url":null,"abstract":"<div><h3>Background</h3><div>Hysterectomy-corrected endometrial cancer incidence among racial/ethnic minority groups by histologic subtype and age group has not been well studied. To examine recent trends in hysterectomy-corrected endometrial cancer rates among California women by histologic subtype, race/ethnicity, and age group.</div></div><div><h3>Methods</h3><div>We estimated hysterectomy prevalence from the Behavioral Risk Factor Surveillance System. Hysterectomy-corrected age-standardized endometrial cancer incidence rates (per 100,000 women) by endometrioid and non-endometrioid subtypes, age at diagnosis, and race and ethnicity from 2012 to 2019 were calculated using California Cancer Registry data. Incidence rates and annual percentage changes (APC) were estimated.</div></div><div><h3>Results</h3><div>Among endometrioid subtypes, American Indian women had the highest incidence (62.9 per 100,000). Incidence rates also significantly increased among Asians/Pacific Islanders (1.69 %), with an increase of 7.14 % and 7.39 % for women aged 45–54 and 55–64, respectively, though these did not reach statistical significance. In addition, Hispanics had an increased incidence rate (3.02 %) from 2012 to 2019, with a particularly sharp rise (18.42 %) observed in Hispanics aged 25–34 years between 2016 and 2019. For non-endometrioid subtypes, non-Hispanic Blacks had the highest incidence (29.4 per 100,000), with the ≥65 age group showing an upward trend (9.39 % increase from 2012 to 2016) before significantly declining by 8.16 % from 2017 to 2019. American Indians had the second-highest incidence (14.1 per 100,000), but no significant trend was observed, likely due to the small sample size of this population.</div></div><div><h3>Conclusions</h3><div>Our findings show that race/ethnicity is associated with endometrial cancer incidence and underscore the importance of jointly examining racial/ethnic disparities with age and histologic subtype.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 34-42"},"PeriodicalIF":4.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860745","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":"STK11 adnexal tumor: A newly recognized entity that expands the spectrum of neoplasms associated with Peutz-Jeghers syndrome","authors":"Jennifer A. Bennett ,&nbsp;Esther Oliva ,&nbsp;Robert H. Young","doi":"10.1016/j.ygyno.2025.04.001","DOIUrl":"10.1016/j.ygyno.2025.04.001","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 25-26"},"PeriodicalIF":4.5,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856089","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":"Temporal trends of sentinel lymph node biopsy without lymphadenectomy at cervical cancer surgery","authors":"Emmeline L. Friedman ,&nbsp;X. Mona Guo ,&nbsp;Katelyn B. Furey ,&nbsp;Alice J. Lee ,&nbsp;Shinya Matsuzaki ,&nbsp;Mamoru Kakuda ,&nbsp;Mariya Kobayashi ,&nbsp;Michiko Kodama ,&nbsp;Hiroyuki Kanao ,&nbsp;Maximilian Klar ,&nbsp;Lynda D. Roman ,&nbsp;Jason D. Wright ,&nbsp;Koji Matsuo","doi":"10.1016/j.ygyno.2025.04.519","DOIUrl":"10.1016/j.ygyno.2025.04.519","url":null,"abstract":"<div><h3>Objective</h3><div>To assess temporal trends of sentinel lymph node biopsy alone without additional lymphadenectomy at surgery for cervical cancer in the United States.</div></div><div><h3>Methods</h3><div>This retrospective cohort study queried the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Study population was 13,498 patients with American Joint Commission on Cancer T1 classification cervical cancer who underwent anti-cancer surgery either with hysterectomy, trachelectomy, or cervical excision and additional surgical nodal evaluation from 2004 to 2021. Temporal trends were assessed with linear segment regression model. In exploratory analysis, survival was assessed with multivariable Cox proportional hazard regression model.</div></div><div><h3>Results</h3><div>Utilization rate of sentinel lymph node biopsy with or without lymphadenectomy increased from 0.2% to 15.1% in 2004–2018 (<em>P-trend</em>&lt;0.001), followed by stabilization after 2018 (15.1% to 17.3%, <em>P-trend</em>=0.752). Utilization rate of sentinel lymph node biopsy alone without additional lymphadenectomy exceeded the rate of concurrent sentinel lymph node biopsy together with lymphadenectomy in 2018 (8.8% versus 6.3%). Following this surgery-shift in 2018, sentinel lymph node biopsy alone without additional lymphadenectomy continued to increase from 8.8% to 11.3% between 2018 and 2021 (<em>P-trend</em>&lt;0.001). In 2021, nearly two thirds of sentinel lymph node evaluation were performed by sentinel lymph node biopsy alone without additional lymphadenectomy (65.2%). Sentinel lymph node biopsy alone and sentinel lymph node biopsy with additional lymphadenectomy had comparable cervical cancer-specific survival (5-year rates 96.5% versus 95.7%, <em>P</em>=0.828) and overall survival (95.3 % versus 94.6 %, <em>P</em> =0.893).</div></div><div><h3>Conclusion</h3><div>This population-based assessment suggests that the majority of sentinel lymph node assessments for cervical cancer after the late-2010s were performed without additional lymphadenectomy.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"196 ","pages":"Pages 182-191"},"PeriodicalIF":4.5,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848671","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":"Safety and feasibility of same day discharge for robotic hysterectomy and staging for endometrial cancer","authors":"Leah Grcevich ,&nbsp;Olena Chuzhyk ,&nbsp;Andrea Giannini ,&nbsp;Michaela E. McGree ,&nbsp;Angela J. Fought ,&nbsp;Ilaria Capasso ,&nbsp;Gabriella Schivardi ,&nbsp;Giuseppe Cucinella ,&nbsp;Gretchen Glaser ,&nbsp;Carrie Langstraat ,&nbsp;Kristina Butler","doi":"10.1016/j.ygyno.2025.04.517","DOIUrl":"10.1016/j.ygyno.2025.04.517","url":null,"abstract":"<div><h3>Objectives</h3><div>Same day discharge (SDD) is well established for benign minimally invasive hysterectomy, but its adoption for endometrial cancer has been met with some concerns. This multicenter study investigates outcomes for endometrial cancer patients discharged on the same day following robotic hysterectomy and lymphadenectomy.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed endometrial cancer patients treated with robotic hysterectomy and lymphadenectomy from January 2019 to December 2021. We collected clinical, pathologic, and surgical data, and reviewed medical records for unscheduled contacts, acute visits, or readmissions within 30 days postoperatively. Logistic regression models were used to assess associations with non-SDD.</div></div><div><h3>Results</h3><div>Of 690 patients, 208 (30.1 %) required overnight observation. Indications for observation included nausea/vomiting (14.9 %), persistent sedation (9.1 %), hypoxia (7.7 %), and urinary retention (7.2 %). In 123 patients (59.1 %), the admission reason was undocumented. Univariate analysis revealed that factors associated with overnight observation included age (OR 1.19 per 10 years, <em>P</em> = 0.04), BMI (OR 1.10 per 5 kg/m², P = 0.04), ASA score ≥ 3 (OR 1.53, <em>P</em> = 0.01), operative time (OR 1.52 per 60 min, <em>P</em> &lt; 0.01), and other comorbidities. Unscheduled contacts were most frequently due to uncontrolled pain (12 SDD patients, 14 non-SDD) and urinary tract infection (15 SDD, 13 non-SDD). Twelve SDD patients (2.5 %) and four non-SDD patients (1.9 %) were readmitted within 30 days.</div></div><div><h3>Conclusions</h3><div>For patients undergoing robotic hysterectomy and lymphadenectomy for endometrial cancer, no significant differences in unscheduled contact, 30-day readmission, or reoperation were observed between SDD and non-SDD cohorts. Factors associated with non-SDD included chronic kidney disease, anticoagulation, conversion to laparotomy, and procedure timing.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 19-24"},"PeriodicalIF":4.5,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848277","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}