Gynecologic oncology最新文献

{"title":"The use of transrectal ultrasound to improve gynecologic interstitial applicator implantation","authors":"Katelyn Ragland ,&nbsp;Joel Pogue ,&nbsp;Eric Simiele ,&nbsp;Samantha Simiele ,&nbsp;Michael Soike ,&nbsp;Rebecca C. Arend ,&nbsp;J. Michael Straughn Jr. ,&nbsp;Michael D. Toboni ,&nbsp;Warner K. Huh ,&nbsp;Charles A. Leath ,&nbsp;Haller J. Smith ,&nbsp;Teresa K.L. Boitano ,&nbsp;Samuel Marcrom","doi":"10.1016/j.ygyno.2025.07.013","DOIUrl":"10.1016/j.ygyno.2025.07.013","url":null,"abstract":"<div><h3>Objective</h3><div>Brachytherapy is essential for treating locally advanced cervical cancer and vaginal recurrences post-hysterectomy. While MRI and CT have permitted volumetric planning, precise interstitial applicator placement remains crucial for optimal dosimetry. We evaluated the impact of transrectal ultrasound (TRUS) on interstitial gynecologic brachytherapy needle utilization and dosimetry.</div></div><div><h3>Methods</h3><div>A retrospective single institute study was conducted of patients requiring interstitial brachytherapy between 2020 and 2023. Cases were categorized based on TRUS use. Endpoints included number of needles placed, removed, unloaded channels, and dosimetry to the high risk clinical target volume (CTV_HR) and organs at risk.</div></div><div><h3>Results</h3><div>A total of 142 implants were performed on 139 patients; 58 % did not utilize a tandem, representing post-hysterectomy recurrences or primary vaginal cancers. Mean CTV_HR volume was 59 cc. TRUS was used in 73 % of cases and was associated with 4–5 fewer needles per implant, independent of CTV_HR volume. With TRUS, needle removal at simulation decreased from 41 % to 3 % (<em>p</em> &lt; 0.001), and plans with unloaded needle channels decreased from 76 % to 25 % (p &lt; 0.001). Despite fewer needles, CTV_HR coverage among definitive cervical cancers remained comparable (D90 &gt; 85 Gy EQD2 in 79 % with TRUS and 78 % without). The ABS rectal constraint of D2cc &lt; 75 Gy was met more often with TRUS (92 % vs. 56 %, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>TRUS improves interstitial needle placement efficiency and rectal dosimetry without compromising target coverage. Its accessibility supports broader integration into gynecologic brachytherapy workflows as a practical optimization tool for achieving disease control and minimizing toxicity.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"200 ","pages":"Pages 88-95"},"PeriodicalIF":4.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679651","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":"Perioperative outcomes after interval cytoreductive surgery and primary cytoreductive surgery for advanced epithelial ovarian cancer in Australia: A National Gynae-Oncology Registry (NGOR) study","authors":"Monica McGauran ,&nbsp;Simon Hyde ,&nbsp;Sharnel Perera ,&nbsp;Mike Lloyd ,&nbsp;Mahendra Naidoo ,&nbsp;Sherine Sandhu ,&nbsp;Tahlia Knights ,&nbsp;Aleesha Whitely ,&nbsp;Natasha Pritchard ,&nbsp;John Zalcberg ,&nbsp;Robert Rome","doi":"10.1016/j.ygyno.2025.07.015","DOIUrl":"10.1016/j.ygyno.2025.07.015","url":null,"abstract":"<div><h3>Objective</h3><div>The National Gynae-Oncology Registry (NGOR) is an Australian Clinical Quality Registry (CQR). This study reports data on surgical outcomes in patients who underwent cytoreductive surgery for Stage III-IV epithelial Ovarian/Tubal/Peritoneal (OTP) cancer between 2017 and 2022. This study aims to understand rates of perioperative adverse events, complete and optimal cytoreduction, and factors that contribute to this in addition to comparing overall survival (OS) in those who undergo primary cytoreduction (PCS) versus interval cytoreduction (ICS). In doing so, this study aims to evaluate current Australian practice.</div></div><div><h3>Method</h3><div>All women with Stage III-IV epithelial OTP cancer who underwent cytoreductive surgery between 2017 and 2022 registered with the NGOR were included (<em>N</em> = 1084). Outcomes included: rates of postoperative complications (Clavien Dindo Grade III+), PCS and ICS, complete and optimal cytoreduction, OS, intraoperative complications, and the effects of rurality, performance status, age and socioeconomic status on these outcomes.</div></div><div><h3>Results</h3><div>PCS was undertaken in 470 (43 %) patients and ICS in 614 (57 %) patients. Postoperative complications were more common in those who underwent PCS versus ICS (<em>p</em> = 0.025 and <em>p</em> = 0.009 respectively). Optimal cytoreduction (macroscopic residual disease &lt;1 cm) was more commonly achieved at ICS (<em>p</em> = 0.047). No difference was observed between groups for complete cytoreduction. Median OS was 4.1 years [IQR 3.9–4.4] with those undergoing PCS surviving longer than those who undergo ICS after propensity matching (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>ICS was associated with less perioperative morbidity, and increased rates of optimal cytoreduction when compared with PCS in patients with Stage III-IV epithelial OTP cancer. PCS was, however, associated with improved overall survival in this registry cohort. This is consistent with international literature and this study uses national CQR data to report on current Australian practice.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"200 ","pages":"Pages 72-79"},"PeriodicalIF":4.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679650","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 lymph node dissection and adjuvant chemotherapy on survival of patients with early-stage ovarian cancer: Update of a national cohort study","authors":"Pim Laven ,&nbsp;Hans H.B. Wenzel ,&nbsp;Maaike A. van der Aa ,&nbsp;Sandrina Lambrechts ,&nbsp;Roy F.P.M. Kruitwagen","doi":"10.1016/j.ygyno.2025.07.010","DOIUrl":"10.1016/j.ygyno.2025.07.010","url":null,"abstract":"<div><h3>Aim</h3><div>To determine the impact of lymph node dissection and adjuvant chemotherapy on survival in patients with early-stage epithelial ovarian cancer (EOC) in an updated national cohort study.</div></div><div><h3>Methods</h3><div>All patients with International Federation of Gynaecology and Obstetrics (FIGO) 2014 stage I-IIA or IIIA1 EOC, diagnosed in the Netherlands between 2000 and 2020 (8 additional years) were included. Data concerning patient, tumour and treatment characteristics and survival were extracted from the Netherlands Cancer Registry.</div></div><div><h3>Results</h3><div>Of 5407 patients included, 2911 (53.8 %) had lymph nodes removed. Ten-year relative survival (RS) of patients with (compared to without) lymph node dissection was significantly better, also after correcting for age, stage, tumour grade and histology (83.3 % and 73.3 %, respectively; relative excess risk [RER] 0.56; 95 % confidence interval [CI]: 0.48–0.66). After adjusting for confounders, patients with 10+ lymph nodes removed had a significantly higher ten-year RS if they received adjuvant chemotherapy compared to those who did not (RER 0.64; 95 % CI 0.41–1.00, <em>p</em> = 0.048). This was also true for a subgroup of patients with high-risk features (stage IC and IIA and/or tumour grade 3 and/or clear cell histology) (RER 0.59; 95 % CI 0.37–0.95, <em>p</em> = 0.028).</div></div><div><h3>Conclusion</h3><div>For early-stage EOC patients, removing 10 or more lymph nodes and providing adjuvant chemotherapy is associated with improved RS after 10 years of follow-up. The contribution of adjuvant chemotherapy to improved RS is clinically relevant and in contrast to our previous findings reporting survival rates after only five years of follow-up.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"200 ","pages":"Pages 51-57"},"PeriodicalIF":4.5,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670493","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":"Persistent opioid use among gynecologic oncology patients after surgery","authors":"Michaela Pesce,&nbsp;Katelyn Tondo-Steele ,&nbsp;Cynthia Stroup,&nbsp;Alli Straubhar ,&nbsp;Yang Liu,&nbsp;Shitanshu Uppal,&nbsp;Aimee Rolston","doi":"10.1016/j.ygyno.2025.07.014","DOIUrl":"10.1016/j.ygyno.2025.07.014","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to identify rates of persistent opioid use at 30 and 90 days postoperatively among patients undergoing surgery for a known or suspected gynecologic malignancy, and to identify patient characteristics that predict persistent opioid use.</div></div><div><h3>Methods</h3><div>A questionnaire was administered to patients 30 days postoperatively to assess patterns of opioid use; responses were validated by chart review. Propensity score matching was used to compare patients with and without opioid use at 30 days to identify whether a history of anxiety, depression, chronic pain, substance use, or any 30-day postoperative complications conferred a higher risk of persistent opioid use.</div></div><div><h3>Results</h3><div>Of 752 patients who received the questionnaire, 596 (79.3 %) responded. Of the 431 opioid-naïve patients included in the analysis, 12 (2.8 %) were using opioids at 30 days and 2 (0.5 %) were using opioids at 90 days postoperatively. Patients with persistent opioid use at 30 days had no difference in history of anxiety, depression, chronic pain, or substance use than patients without persistent opioid use. Patients with postoperative complications were more likely to be using opioids at 30 days (33.3 %) than those without complications (8.3 %, <em>p</em> = .055).</div></div><div><h3>Conclusions</h3><div>The rate of persistent postoperative opioid use in gynecologic oncology patients is low when compared to previously identified rates among similar populations. No association was found between anxiety, depression, chronic pain, or history of substance use and persistent opioid use at 30 days postoperatively. This study may help providers identify optimal prescribing strategies in gynecologic oncology.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"200 ","pages":"Pages 68-71"},"PeriodicalIF":4.5,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679649","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":"The risk for residual AIS/CIN3+ after the first conservative surgical procedure for cervical adenocarcinoma in situ – A Dutch retrospective cohort study","authors":"M. Schaafsma ,&nbsp;T.N. Schuurman ,&nbsp;R.L.M. Bekkers ,&nbsp;F. Rosier-van Dunné ,&nbsp;H.R. Verhoeve ,&nbsp;P.L.M. Zusterzeel ,&nbsp;M.C.G. Bleeker ,&nbsp;C.H. Mom ,&nbsp;A.G. Siebers ,&nbsp;J. Berkhof ,&nbsp;N.E. van Trommel","doi":"10.1016/j.ygyno.2025.07.012","DOIUrl":"10.1016/j.ygyno.2025.07.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Conservative treatment options for cervical adenocarcinoma in situ (AIS) include a large loop excision of the transformation zone (LLETZ) and cold-knife conisation (CKC). Since each subsequent intervention might have adverse effects, this study aimed to 1) describe the risk of residual AIS, cervical intraepithelial neoplasia (CIN) grade 3, and cervical cancer (combined AIS/CIN3+) after the first surgical procedure and 2) develop a prediction model for residual AIS/CIN3+.</div></div><div><h3>Methods</h3><div>AIS/CIN3+ incidence was assessed in Dutch patients with AIS who underwent a LLETZ or CKC between 1990 and 2021. The discriminative performance (area-under-the-curve, AUC) for AIS/CIN3+ was compared between a prediction model including four prognostic variables (margin status, age, type of surgical procedure, history of CIN) and a prediction model based on surgical margins only.</div></div><div><h3>Results</h3><div>4115 patients were eligible, including 2363 patients (57.4 %) treated by LLETZ and 1752 patients (42.6 %) treated by CKC. Of the 3585 patients with known follow-up, 549 patients (15.3 %) were diagnosed with residual AIS/CIN3+, of which 409 of 2152 patients after LLETZ (19 %) and 140 of 1433 patients after CKC (9.3 %) (<em>p</em> &lt; 0.001). The discriminative performance of the prediction model including four prognostic variables was higher (AUC = 0.80, 95 %CI0.78–0.82) than predictions based on surgical margins only (AUC = 0.74, 95 %CI:0.71–0.76). By applying the prediction model, the number of retreatments after unclear margins could decrease by 15.2 %.</div></div><div><h3>Conclusion</h3><div>The prediction model developed in this study enables better quantitative assessment of the risk for residual AIS/CIN3+ after the first conservative surgical procedure for AIS compared to surgical margins only. This model could be used to guide decisions on re-excision in patients with AIS.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"200 ","pages":"Pages 44-50"},"PeriodicalIF":4.5,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679647","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":"Textbook oncologic outcome in endometrial cancer surgery: A quality measure to improve survival and address disparities","authors":"Giuseppe Caruso ,&nbsp;Chiara Ainio ,&nbsp;Diletta Fumagalli ,&nbsp;Evelyn A. Reynolds ,&nbsp;Dimitrios Nasioudis ,&nbsp;Michaela E. Mc Gree ,&nbsp;Angela J. Fought ,&nbsp;Robert L. Giuntoli ,&nbsp;Andrea Mariani ,&nbsp;William A. Cliby","doi":"10.1016/j.ygyno.2025.07.009","DOIUrl":"10.1016/j.ygyno.2025.07.009","url":null,"abstract":"<div><h3>Objective</h3><div>Textbook Oncologic Outcome (TOO) is a composite quality measure in surgical oncology associated with improved overall survival (OS). This study evaluated the prognostic impact of TOO and identified factors associated with achieving TOO in endometrial cancer (EC).</div></div><div><h3>Methods</h3><div>Patients undergoing surgery for presumed early-stage EC between 2018 and 2020 were identified in the National Cancer Database. TOO was defined as achieving all six of the following metrics: minimally invasive hysterectomy, required lymph node assessment, hospital stay ≤1 day, no unplanned 30-day hospital readmission, appropriate adjuvant therapy, and no 90-day mortality. Kaplan-Meier and Cox regression analyses were used to evaluate 5-year OS by TOO status. Logistic regression was used to identify factors associated with TOO.</div></div><div><h3>Results</h3><div>Among 66,416 patients, 81.0 % achieved TOO (TOO+). TOO+ patients had significantly improved 5-year OS (90.3 % vs 76.4 %; adjusted hazard ratio 0.46, 95 % CI 0.43–0.49). Factors associated with lower likelihood to achieve TOO included age &gt; 75 years (vs &lt;60; adjusted odds ratio [aOR] 0.58, 95 % CI 0.54–0.62), Black race (vs White, aOR 0.74, 95 % CI 0.69–0.79), government insurance (vs private; aOR 0.68, 95 % CI 0.65–0.72), and non-endometrioid histology (aOR 0.62, 95 % CI, 0.58–0.67). Higher hospital volume was associated with a higher likelihood of achieving TOO (median ≥84 vs ≤32 cases/year; aOR 1.54, 95 % CI 1.45–1.64).</div></div><div><h3>Conclusion</h3><div>TOO in EC surgery is strongly associated with overall survival and may serve as a benchmark goal for assessing quality of care. Disparities related to race, insurance status, and hospital volume highlight the need to expand access to high-quality care nationally.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"200 ","pages":"Pages 33-43"},"PeriodicalIF":4.5,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670492","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":"Corrigendum to \"FOXM1 promotes tumor cell invasion and correlates with poor prognosis in early-stage cervical cancer\" [Gynecologic Oncology 127 (2012) 601-610].","authors":"Shan-Yang He, Hong-Wei Shen, Lin Xu, Xiao-Hui Zhao, Li Yuan, Gang Niu, Ze-Shan You, Shu-Zhong Yao","doi":"10.1016/j.ygyno.2025.06.021","DOIUrl":"https://doi.org/10.1016/j.ygyno.2025.06.021","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667559","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":"The RAS-MEK-ERK pathway in low-grade serous ovarian cancer","authors":"Elizabeth H. Stover ,&nbsp;Elizabeth K. Lee ,&nbsp;Geoffrey I. Shapiro ,&nbsp;Joan S. Brugge ,&nbsp;Ursula A. Matulonis ,&nbsp;Joyce F. Liu","doi":"10.1016/j.ygyno.2025.06.022","DOIUrl":"10.1016/j.ygyno.2025.06.022","url":null,"abstract":"<div><div>Low-grade serous ovarian cancer (LGSC) is an uncommon subtype of epithelial ovarian cancer, often arising in association with serous borderline tumors (SBT). Compared to high-grade serous ovarian cancers, LGSCs often occur in younger patients and are relatively insensitive to platinum-based chemotherapy, though some patients with LGSC can benefit from hormonal therapies. Genomic studies have demonstrated that SBT and LGSC frequently harbor mutations in members of the RAS-MEK-ERK pathway, which can be targeted therapeutically. LGSC harbor mutations in <em>KRAS</em> (up to 54 %, primarily non-G12C mutations), <em>NRAS</em>, and <em>BRAF</em>. Treatment of recurrent LGSC with the MEK inhibitor trametinib demonstrated improved clinical outcomes relative to other treatment options (chemotherapy, hormonal therapy) in a phase 3 trial. Other MEK inhibitors have also shown efficacy in LGSC, with some studies demonstrating higher response rates in patients whose tumors harbor <em>KRAS</em> mutations. However, some trials of MEK inhibitors showed more limited benefit (e.g. binimetinib), and RAS pathway mutations do not always correlate with increased efficacy, highlighting the need for further clinical and translational research in RAS-MEK-ERK pathway targeted therapeutics. Current clinical trials are evaluating MEK inhibitor combinations such as MEK inhibitors plus inhibitors of poly (ADP-ribose) polymerase (PARP), AKT, PI3K, CDK4/6, or BCL2/BCL-XL. Novel approaches to targeting the RAS-MEK-ERK pathway include the RAF/MEK clamp avutometinib, which has been evaluated in combination with the FAK inhibitor defactinib, and this combination received United States Food and Drug Administration (FDA) accelerated approval in 2025. Multiple newly developed inhibitors of KRAS, including KRAS G12C or G12D inhibitors, as well as pan-RAS inhibitors, including RAS (ON) inhibitors such as RMC-6236, are being evaluated in solid tumors. These emerging strategies for inhibiting RAS-MEK-ERK pathway activity may offer new treatment options for patients with LGSC.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"200 ","pages":"Pages 22-32"},"PeriodicalIF":4.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655322","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":"The detrimental impact of diverting ileostomy on renal function after tumor debulking surgery for advanced ovarian cancer","authors":"Yuki Koike ,&nbsp;Arisa Fujiwara ,&nbsp;Toshiyuki Seki ,&nbsp;Yuki Kochi ,&nbsp;Yuichi Shoburu ,&nbsp;Suguru Odajima ,&nbsp;Ryosuke Saito ,&nbsp;Yuichiro Tsukada ,&nbsp;Kazuo Kitagawa ,&nbsp;Motoaki Saito ,&nbsp;Hiroshi Tanabe ,&nbsp;Masaaki Ito ,&nbsp;Ken Eto ,&nbsp;Kyosuke Yamada ,&nbsp;Hirokuni Takano ,&nbsp;Aikou Okamoto","doi":"10.1016/j.ygyno.2025.07.004","DOIUrl":"10.1016/j.ygyno.2025.07.004","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the impact of ileostomy on both short- and long-term renal function in patients with advanced ovarian cancer.</div></div><div><h3>Methods</h3><div>This retrospective, multi-institutional study included patients diagnosed with stage II-IV ovarian cancer who underwent primary or interval debulking surgery with rectal resection at five institutions in Japan between April 2013 and March 2022. We assessed renal function during and up to 12 months following postoperative adjuvant chemotherapy (AC), using estimated glomerular filtration rate (eGFR) values and the incidence of chronic kidney disease (CKD) in patients with or without ileostomy.</div></div><div><h3>Results</h3><div>A total of 215 patients were included in the study, of whom 87 patients (40.5 %) underwent ileostomy. When comparing patients with and without ileostomy, those with ileostomy had a lower eGFR from the first cycle of chemotherapy up to 12 months after AC (<em>p</em> &lt; 0.0001). Additionally, patients who underwent ileostomy were more likely to develop CKD 12 months after AC (p &lt; 0.0001). Logistic regression analysis identified age (<em>p</em> = 0.039), baseline renal dysfunction (<em>p</em> = 0.013), and ileostomy (<em>p</em> &lt; 0.001) as independent risk factors for CKD at 12 months after AC. Furthermore, stoma closure did not result in an improvement in eGFR. In patients who underwent ileostomy, high stoma output (&gt;1500 mL/day) was independently associated with CKD development at 12 months after AC.</div></div><div><h3>Conclusions</h3><div>In patients with ovarian cancer, ileostomy can impair renal function following AC, and this effect persists even after stoma closure.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"200 ","pages":"Pages 14-21"},"PeriodicalIF":4.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655321","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":"Risk for non-sentinel metastases in the contralateral groin in patients with a unilateral positive sentinel lymph node in primary vulvar cancer- a subgroup analysis of the AGO-VOP.2 QS Vulva Study","authors":"Anna Jaeger ,&nbsp;Monika Hampl ,&nbsp;Katharina Prieske ,&nbsp;Christine Eulenburg ,&nbsp;Juliane Reichenbach ,&nbsp;Rüdiger Klapdor ,&nbsp;Sabine Heublein ,&nbsp;Fabienne Schochter ,&nbsp;Paul Gaß ,&nbsp;Annika Rohner ,&nbsp;Ulrich Canzler ,&nbsp;Sven Becker ,&nbsp;Mareike Bommert ,&nbsp;Dirk Bauerschlag ,&nbsp;Agnieszka Denecke ,&nbsp;Lars Hanker ,&nbsp;Ingo Runnebaum ,&nbsp;Dirk M. Forner ,&nbsp;Maximilian Klar ,&nbsp;Roxana Schwab ,&nbsp;Linn Woelber","doi":"10.1016/j.ygyno.2025.07.003","DOIUrl":"10.1016/j.ygyno.2025.07.003","url":null,"abstract":"<div><div>The need for contralateral full groin dissection after bilateral sentinel node biopsy (SNB) with only unilateral detection of a macrometastasis is still a matter of debate. GROINSS-VI/II subanalysis has shown an absolute risk &lt;3 % for contralateral groin recurrence or contralateral non-sentinel metastases, however, the individual risk varied widely dependent on the primary tumor characteristics.</div></div><div><h3>Methods</h3><div>The AGO VOP.2 QS vulva study is a retrospective, multicenter study. Data from 306 patients diagnosed with primary groin node positive VSCC (vulvar squamous cell carcinoma) between 2017 and 2019 at 33 gynecologic cancer centers in Germany were collected. In the current subgroup analysis, only patients with bilateral SNB and unilateral positive SNL were included.</div></div><div><h3>Results</h3><div>Of 306 documented groin node positive patients, 137 received bilateral SNB. Of these, 98 had a unilaterally positive SNL. The consecutive contralateral groin procedure was at the surgeons' discretion. 58/98 (59.2 %) received a bilateral inguinofemoral lymphadenectomy (if-LAE). 30/98 (30.6 %) underwent ipsilateral if-LAE only and 10/98 (10.2 %) had no further surgical treatment of the groins. 3/98 (3.1 %) patients either showed contralateral non-SN metastasis after bilateral if-LAE (<em>n</em> = 2) or developed isolated contralateral groin recurrence after unilateral if-LAE dissection (<em>n</em> = 1).</div></div><div><h3>Conclusion</h3><div>In this large multicenter retrospective study the risk of contralateral groin recurrence was low (3,1 %). Therefore, morbidity should be carefully balanced against oncologic safety and omission of contralateral LAE should be considered.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"200 ","pages":"Pages 8-13"},"PeriodicalIF":4.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633365","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}