Gynecologic oncology最新文献

{"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}

{"title":"TP53 somatic evolution in the normal endometrium of Black and White individuals","authors":"Eric Rios-Doria ,&nbsp;Elizabeth U. Parker ,&nbsp;Brendan F. Kohrn ,&nbsp;Mindy Pike ,&nbsp;Coohleen Coombes ,&nbsp;Elena Latorre-Esteves ,&nbsp;Daniel J. Reiter ,&nbsp;Jeanne Fredrickson ,&nbsp;Ronit Katz ,&nbsp;Elizabeth M. Swisher ,&nbsp;Kemi M. Doll ,&nbsp;Rosa Ana Risques","doi":"10.1016/j.ygyno.2025.04.002","DOIUrl":"10.1016/j.ygyno.2025.04.002","url":null,"abstract":"<div><h3>Background</h3><div><em>TP53</em> mutations are the main drivers of aggressive, high-risk endometrial carcinomas commonly diagnosed in Black individuals. However, <em>TP53</em> mutations have also been identified in benign, non-cancerous tissues. We sought to understand the <em>TP53</em> mutational landscape in benign endometrium throughout the lifespan of Black and White individuals, accounting for structural socioeconomic context.</div></div><div><h3>Methods</h3><div>Ultra-sensitive <em>TP53</em> mutation detection was performed with high-depth duplex sequencing (∼13,000×) in DNA extracted from histologically normal endometrium collected at autopsy (69 % of cases) or surgery (31 % of cases) from 83 individuals ages 0 to 81 (31 Black and 52 White, median age 35 years) without endometrial cancer. Histologically normal endometrium was also collected from 10 White individuals with endometrial cancer.</div></div><div><h3>Results</h3><div>We identified 266 coding <em>TP53</em> mutations in the normal endometrium of individuals without endometrial cancer, 57 % of which were pathogenic. The number, pathogenicity, and size of <em>TP53</em> mutant clones in normal endometrium increased with age. Multivariable models showed no significant association between race or socioeconomic metrics and <em>TP53</em> mutation frequency in normal endometrium. An exploratory analysis on the histologically normal endometrium of White individuals with endometrial cancer identified the tumor mutations at low levels in the normal biopsy of 5 out of 6 cases.</div></div><div><h3>Conclusions</h3><div>Our study revealed prevalent <em>TP53</em> somatic evolution in benign endometrium across human lifespan and no racial differences in this cohort of predominantly younger individuals. Future studies should consider the analysis of larger cohorts with older individuals to detect potential effects of racial disparities on <em>TP53</em> somatic evolution later in life.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 1-10"},"PeriodicalIF":4.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848270","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 facility-level adoption of minimally invasive interval debulking surgery for advanced ovarian cancer","authors":"Roni Nitecki Wilke ,&nbsp;Chi-Fang Wu ,&nbsp;Alexa Kanbergs ,&nbsp;Alexandra S. Bercow ,&nbsp;Nuria Agusti ,&nbsp;David Viveros-Carreño ,&nbsp;Abigail S. Zamorano ,&nbsp;Jose Alejandro Rauh-Hain ,&nbsp;Alexander Melamed","doi":"10.1016/j.ygyno.2025.04.518","DOIUrl":"10.1016/j.ygyno.2025.04.518","url":null,"abstract":"<div><h3>Objective</h3><div>Facility-level disparities in the adoption of minimally invasive (MIS) interval debulking surgery (IDS) among Commission-on-Cancer–accredited programs in the United States were examined.</div></div><div><h3>Methods</h3><div>Patients with stage IIIC or IV epithelial ovarian cancer (2010−2021) who received neoadjuvant chemotherapy and IDS were identified in the National Cancer Database. Analytical periods were categorized as the preadoption (2010 to 2014) and postadoption (2015 to 2021) periods. We defined “Adopter” facilities as those that significantly increased their use of MIS for IDS after 2015 and “non-adopter” facilities as those that restricted the use of this approach after 2015. Hospital-level variation in the use of IDS via MIS was estimated and then adopter programs were matched with non-adopter programs. We examined the associations between characteristics of interest—Black-serving (top 5 %), serving a high proportion of uninsured patients (top 5 %), high-volume (top quartile), and academic—and the tendency to perform IDS using logistic regressions.</div></div><div><h3>Results</h3><div>We identified 5464 patients treated in 141 adopter facilities and 4820 patients treated in 141 non-adopter facilities. Adopter facilities were less likely than non-adopter facilities to be Black-serving (odds ratio [OR], 0.66; 95 % CI, 0.55–0.79; <em>P</em> &lt; 0.001) and to have a high proportion of uninsured patients (OR, 0.73; 95 % CI, 0.61–0.87, <em>P</em> &lt; 0.001) and more likely to be high-volume centers (OR, 1.48; 95 % CI, 1.35–1.60; <em>P</em> &lt; 0.001) and academic institutions (OR, 1.89; 95 % CI, 1.74–2.04, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>As MIS IDS is adopted in the United States, minoritized patients may have unequal access depending on where they receive care.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"197 ","pages":"Pages 11-18"},"PeriodicalIF":4.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848276","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":"Trends in sentinel lymph node evaluation for vulvar melanoma in the United States from 2012 to 2018","authors":"Stephanie Alimena ,&nbsp;Hadley Reid ,&nbsp;Alexandra Bercow ,&nbsp;Colleen Feltmate ,&nbsp;Jessica St Laurent ,&nbsp;Taymaa May ,&nbsp;Ross Berkowitz ,&nbsp;Neil Horowitz ,&nbsp;Michelle Davis","doi":"10.1016/j.ygyno.2025.04.007","DOIUrl":"10.1016/j.ygyno.2025.04.007","url":null,"abstract":"<div><h3>Objective</h3><div>To describe trends in type of lymph node assessment for vulvar melanoma over time and factors associated with sentinel lymph node biopsy (SLNB).</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study of patients in the National Cancer Database (NCDB) with vulvar melanoma from 2012 to 2018. Type of lymph node evaluation, demographic and clinical characteristics, and characteristics of the treating institution were abstracted. Chi square and multivariate logistic regression were used to evaluate predictors of SLNB compared to inguinofemoral lymph node dissection (IFLD) and no lymph node evaluation.</div></div><div><h3>Results</h3><div>A total of 1828 patients with vulvar melanoma were identified. Of those, 925 (50.6 %) underwent lymph node evaluation, 357 (38.6 %) with SLNB alone, 97 (10.5 %) with SLNB and IFLD, and 471 (50.9 %) with IFLD alone. Year of diagnosis, age, T stage, insurance status, facility type, and facility volume were significant predictors of use of SLNB in univariate analyses. Age, year of diagnosis, T stage and facility type remained significant in multivariate analysis. SLNB was most often performed for T1 and T2 lesions (31.3 % and 36.2 %, respectively), while only 19.6 % of T3, 1.3 % of T4, and 25.8 % of those with unknown T stage underwent SLNB. Survival outcomes were similar regardless of mode of lymph node assessment, but worse in those who received no assessment.</div></div><div><h3>Conclusions</h3><div>Current practice in the United States for lymph node evaluation in vulvar melanoma differs from the recommended guidelines for cutaneous melanomas by T stage. Updated guidelines for vulvar melanoma aligned with those for cutaneous melanoma are needed.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"196 ","pages":"Pages 175-181"},"PeriodicalIF":4.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829294","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":"Integration of a lifestyle modification intervention for women with overweight and obesity in a gynecologic oncology practice","authors":"David H. Morris ,&nbsp;Alison Kosmacki ,&nbsp;Leah Tolby ,&nbsp;Christine Marx ,&nbsp;Jessica Vanderlan ,&nbsp;David G. Mutch ,&nbsp;Graham Colditz ,&nbsp;Andrea R. Hagemann","doi":"10.1016/j.ygyno.2025.04.516","DOIUrl":"10.1016/j.ygyno.2025.04.516","url":null,"abstract":"<div><h3>Objective(s)</h3><div>We aimed to assess the feasibility and effectiveness of a remotely delivered, group-based lifestyle modification intervention (LMI) for women with gynecologic cancer and overweight or obesity in a real-world clinic.</div></div><div><h3>Methods</h3><div>A six-month LMI was implemented in an outpatient gynecologic oncologic clinic for women with a body mass index (BMI) &gt;25 kg/m². Participants were given a weight loss goal of ≥5 % initial body weight. Retrospective data were collected from patients enrolled in the intervention from September 2019 through February 2023. Feasibility of the LMI was assessed by the rate of enrollment and retention in the intervention. De-identified zip code data were collected to assess geographic proximity of participants to the clinic. Repeated measure analysis of variance (ANOVA) was performed to evaluate change in weight across the intervention.</div></div><div><h3>Results</h3><div>164 patients were referred to the LMI with 82 patients being enrolled during the study timeframe. The sample consisted primarily of white (68.3 %) women between the ages of 30 to 73 years old (median age of 57) with an initial median BMI of 41.41 kg/m². 74 % of enrolled patients completed the entire LMI. The LMI resulted in a mean loss of 4.19 kgs (<em>p</em> &lt; .001), with 40.30 % of patients losing ≥5 % initial body weight.</div></div><div><h3>Conclusions</h3><div>Remotely delivered, group based LMI for gynecologic cancer patients with overweight or obesity is feasible in clinical practice and can transcend rural-urban inequalities. Patients in the LMI achieved statistically and clinically significant weight loss, comparable to that observed in more rigorous clinical trial.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"196 ","pages":"Pages 168-174"},"PeriodicalIF":4.5,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824072","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":"Preoperative tumour size assessment in patients with early-stage cervical cancer: Final results of the SENTIX study","authors":"Martina Borčinová ,&nbsp;Christhardt Köhler ,&nbsp;Kristýna Němejcová ,&nbsp;Ignacio Zapardiel ,&nbsp;Jaroslav Klát ,&nbsp;Filip Frühauf ,&nbsp;Vladimír Kalist ,&nbsp;Wiktor Szatkowski ,&nbsp;Dariusz Wydra ,&nbsp;Roman Kocián ,&nbsp;Rene Laky ,&nbsp;Róbert Tóth ,&nbsp;Marcin Misiek ,&nbsp;Mikuláš Redecha ,&nbsp;Isabel Martin ,&nbsp;Frederic Kridelka ,&nbsp;Andrea Burgetová ,&nbsp;F. Javier Santiago Garcia ,&nbsp;Toon Van Gorp ,&nbsp;Grzegorz Szewczyk ,&nbsp;David Cibula","doi":"10.1016/j.ygyno.2025.04.005","DOIUrl":"10.1016/j.ygyno.2025.04.005","url":null,"abstract":"<div><h3>Background</h3><div>Preoperative tumour size is a key prognostic marker in tailoring surgical treatment in early-stage cervical cancer. This post-hoc analysis assessed the accuracy of preoperative tumour size evaluation via imaging, utilizing data from the prospective, international, multicentre SENTIX study that evaluated safety of sentinel lymph node (SLN) biopsy without pelvic lymph node dissection in patients with early-stage cervical cancer.</div></div><div><h3>Methods</h3><div>Between 05/2016–09/2020, forty-seven sites across 18 countries enrolled cervical cancer patients (FIGO2018 stages 1A1/lymphovascular-space-invasion-positive to 1B2). Preoperative staging included pelvic MRI or ultrasound as mandatory imaging modalities. All patients underwent primary surgical treatment. Pathological assessment of surgical specimens served as reference standard for evaluating the accuracy of preoperative assessments.</div></div><div><h3>Results</h3><div>Among the 680 included patients, although the mean tumour size discrepancy between preoperative/pathological assessments was only 1.24 ± 8.891 mm, postoperative pT stage was upgraded in 187 (27.5 %) and downgraded in 74 (10.9 %) patients. Discrepancy of ≥10 mm was observed among 155 (22.8 %) patients across all stages, with underestimation in 105 (15.4 %), overestimation in 50 (7.4 %), and a positive correlation (<em>P</em> &lt; 0.0001) between the pathological tumour size and the discrepancy in size assessment. If a maximum 2 cm tumour size threshold were applied to guide the decision between simple and radical hysterectomy, underestimation would result in inadequate surgical management for 9.0 % of patients, whereas overestimation would lead to unnecessarily radical procedures in 5.1 % of cases.</div></div><div><h3>Conclusions</h3><div>The study highlights, that even with the use of modern imaging in preoperative staging, inaccuracies in tumour size assessment remain a common cause of up−/down-staging after surgery resulting in potential inappropriate planning of surgery, and thus in procedure that is either excessively or insufficiently radical.</div><div>Trial registration: ClinicalTrials.gov: NCT02494063.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"196 ","pages":"Pages 160-167"},"PeriodicalIF":4.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143815935","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":"Genetic predictors of unexpected recurrence in low-risk endometrial cancer: A comprehensive genomic analysis reveals FGFR2 as a risk factor and a rare fatal POLE-mutated recurrence","authors":"Tuukka Mettälä ,&nbsp;Titta Joutsiniemi ,&nbsp;Jutta Huvila ,&nbsp;Sakari Hietanen","doi":"10.1016/j.ygyno.2025.03.038","DOIUrl":"10.1016/j.ygyno.2025.03.038","url":null,"abstract":"<div><h3>Objective</h3><div>Endometrial cancer is the most common gynecological malignancy in high-income countries. While early-stage endometrial cancer generally has a favorable prognosis, a small proportion of low-risk patients experience unexpected recurrence. This study aimed to identify molecular factors contributing to recurrence in stage 1 A grade 1–2 low-risk endometrioid endometrial cancer.</div></div><div><h3>Methods</h3><div>We performed next-generation sequencing (NGS) on tumor samples from 19 patients who experienced recurrence despite favorable clinicopathological features and compared them with six control patients without recurrence. Results were also compared to a matched cohort of low-risk endometrial cancers from The Cancer Genome Atlas (TCGA) database.</div></div><div><h3>Results</h3><div>Mutations in PTEN, PIK3CA, ARID1A, and FGFR2 were the most frequent in the recurrence group. FGFR2 mutations were exclusive to the recurrence group (9/19, 47.4 %) and absent in the non-recurrent group (0/6), a difference approaching statistical significance (<em>p</em> = 0.0571). FGFR2 mutations were also significantly more prevalent in the recurrence cohort compared to the TCGA low-risk cohort (<em>p</em> = 0.0039). Prominent FGFR2 missense mutations included S252W, K659E, and N549K, which may drive oncogenesis and tumor progression. Among the recurrence group, a rare POLE-mutated tumor recurred unexpectedly and proved fatal, highlighting the potential for poor outcomes even in typically favorable molecular subtypes.</div></div><div><h3>Conclusion</h3><div>FGFR2 mutations may play a role in tumor recurrence in a subset of low-risk endometrial cancers, underscoring the importance of molecular profiling in identifying patients at risk. FGFR2 represents a potential therapeutic target, warranting further validation in larger cohorts to establish its clinical utility.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"196 ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799134","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}