Gynecologic oncology最新文献

{"title":"Impact of a community-centered intervention on knowledge, confidence, and attitudes toward clinical trials: A pilot survey study","authors":"Oriana Krivenko ,&nbsp;Nicole Diaz ,&nbsp;Kimberly Richardson ,&nbsp;Daniel Antonio ,&nbsp;Dario Roque","doi":"10.1016/j.ygyno.2026.02.015","DOIUrl":"10.1016/j.ygyno.2026.02.015","url":null,"abstract":"<div><h3>Background</h3><div>Cancer clinical trials are essential to advancing the management of gynecologic cancers; however, women of color remain underrepresented despite experiencing disproportionately poor outcomes. Barriers to enrollment include skepticism, limited awareness, inadequate referral processes, and failure to offer trial participation. Community-based partnerships may help address these gaps.</div></div><div><h3>Methods</h3><div>We partnered with two Chicago-based community-based organizations serving African American and Hispanic women to co-develop a culturally tailored educational curriculum focused on gynecologic oncology clinical trials. Community leaders contributed to curriculum design to ensure cultural relevance. Anonymous pre- and post-session surveys assessed clinical trial knowledge, communication and decision self-efficacy, access and navigation, and trust-related attitudes using 10 Likert-scale items grouped into four thematic domains. Because responses were unlinked, pre- and post-groups were analyzed as independent samples using Mann–Whitney <em>U</em> tests with false discovery rate correction. Effect sizes were calculated using rank-biserial correlations.</div></div><div><h3>Results</h3><div>Seventy-eight participants were included (51 African American, 27 Hispanic). Across the full cohort, the intervention was associated with significant improvements in clinical trial knowledge, communication and decision self-efficacy, and access and navigation (<em>r</em> = 0.28–0.32, all <em>p</em> &lt; 0.001), with smaller, non-significant effects observed for trust-related attitudes. Among African American participants, eight of ten survey items demonstrated statistically significant post-intervention improvements, with small-to-moderate effect sizes (<em>r</em> = 0.28–0.47). Among Hispanic participants, effect sizes were consistently positive (<em>r</em> = 0.06–0.31), particularly for knowledge and access domains, but did not reach statistical significance due to limited power.</div></div><div><h3>Conclusion</h3><div>A community-engaged educational intervention was associated with improved clinical trial knowledge and self-efficacy among minoritized women, supporting further evaluation of community-partnered strategies to promote equitable clinical trial engagement.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"207 ","pages":"Pages 53-59"},"PeriodicalIF":4.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147685694","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":"Eco-responsible and rational interval debulking surgery for high-grade ovarian carcinomas: An observational, ambispective cohort study","authors":"Sarah Hodent ,&nbsp;Naoual Bakrin ,&nbsp;Pascal Rousset ,&nbsp;Vahan Kepenekian ,&nbsp;Witold Gertych ,&nbsp;Pierre Descargues ,&nbsp;Laurent Villeneuve ,&nbsp;Mojgan Devouassoux-Shisheboran ,&nbsp;Marion Favretto ,&nbsp;Benoit You ,&nbsp;Pierre-Adrien Bolze ,&nbsp;Lucie Gaillot-Durand ,&nbsp;Jonathan Lopez ,&nbsp;Olivier Glehen ,&nbsp;Alexis Trecourt","doi":"10.1016/j.ygyno.2026.01.771","DOIUrl":"10.1016/j.ygyno.2026.01.771","url":null,"abstract":"<div><h3>Background</h3><div>Since the workload generated by interval debulking surgeries (IDS) for advanced high-grade tubo-ovarian carcinomas is high in the surgical pathology department (SPD), we aimed to assess the impacts of implementing an eco-responsible protocol to manage specimens from IDS.</div></div><div><h3>Methods</h3><div>The protocol (ECO-IDS) defined the specimens to send to the SPD and the sampling strategy during gross examination. Twenty patients were prospectively included (post-ECO-IDS group). A retrospective cohort of 20 patients, who did not benefit from the protocol, was built (pre-ECO-IDS group). Criteria compared were: the number of jars sent/paraffin blocks prepared, pathology procedures' carbon footprint, financial cost of specimen processing, time for pathology report validation, and chemotherapy response score (CRS). Next-generation sequencing (NGS) was performed to ensure the feasibility of molecular techniques on the post-ECO-IDS samples.</div></div><div><h3>Results</h3><div>The median number of jars sent per patient was 4 (post-ECO-IDS group) <em>versus</em> 14 (pre-ECO-IDS group; <em>p</em> &lt; 0.0001). The median number of paraffin blocks prepared per patient was 12.5 (post-ECO-IDS group) <em>versus</em> 38 (pre-ECO-IDS group; <em>p</em> &lt; 0.0001). The median carbon footprint per patient was 8.6 KgCO₂eq (post-ECO-IDS group) <em>versus</em> 24.1 KgCO₂eq (pre-ECO-IDS group; p &lt; 0.0001). The median financial cost was €25.5 (post-ECO-IDS group) <em>versus</em> €57.9 (pre-ECO-IDS group; p &lt; 0.0001). The mean time for pathology report validation was 7.5 days (post-ECO-IDS group) <em>versus</em> 10 days (pre-ECO-IDS group; <em>p</em> = 0.0131). There was no difference in CRS between both groups. NGS identified <em>TP53</em> variants in 19/20 (95%) tumors.</div></div><div><h3>Conclusion</h3><div>Our protocol reduced environmental impacts, financial costs, and time to pathology report validation, without compromising the quality/safety of histopathology results.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 32-38"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131638","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":"Extending eligibility criteria for sentinel lymph node biopsy in vulvar cancer: An update on the GroSNaPET study","authors":"Simona Maria Fragomeni ,&nbsp;Angela Collarino ,&nbsp;Alex Federico ,&nbsp;Giusi Pisano ,&nbsp;Sara Ammar ,&nbsp;Luca Zagaria ,&nbsp;Pia Clara Pafundi ,&nbsp;Giacomo Corrado ,&nbsp;Stefano Gentileschi ,&nbsp;Anna Caretto ,&nbsp;Vittoria Rufini ,&nbsp;Anna Fagotti ,&nbsp;Giorgia Garganese","doi":"10.1016/j.ygyno.2026.01.011","DOIUrl":"10.1016/j.ygyno.2026.01.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Sentinel node biopsy (SNB) is the standard approach for nodal staging in clinically node-negative (cN0) patients with unifocal vulvar cancer ≤4 cm. Patients outside these criteria undergo lymphadenectomy, although many prove node-negative. The prospective GroSNaPET study evaluated SNB followed by lymphadenectomy in these patients. This report presents updated outcomes, long-term follow-up, and complication data.</div></div><div><h3>Materials and methods</h3><div>This single-center prospective study included cN0 patients ineligible for standard SNB due to ≥1 of the following: tumor &gt;4 cm, multifocality, prior excision or (chemo)radiotherapy, unilateral nodal involvement, or relapse. All patients underwent SNB followed by complete lymphadenectomy. Histopathology was the reference standard. Complications were graded by Clavien–Dindo system. Diagnostic accuracy and survival outcomes were assessed with standard methods.</div></div><div><h3>Results</h3><div>Seventy-two patients (114 groins) were enrolled. The preoperative lymphoscintigraphic SNB identification rate was 94.7%. Among 265 sentinel nodes removed, 19 (7.2%) showed metastases, involving 16/108 groins (14.8%). Overall, 17/108 groins resulted metastatic. The proportion of false negatives over the entire study population was 0.9% (1/108), with a false negative rate of 5.9% (1/17). The negative predictive value was 98.9% and the diagnostic accuracy was 99.1%. Postoperative complications occurred in 70.8% cases, mainly lymphedema (19.7%) and lymphoceles (12%); 17% were Clavien–Dindo grade ≥ III. Median follow-up was 54.5 months; 22 recurrences (30.6%, including 3 inguinal) and 15 deaths (20.8%) were recorded. 5-year Disease Free Survival and Overall Survival were 65.6% and 82.7%.</div></div><div><h3>Conclusions</h3><div>SNB is accurate and safe beyond standard criteria. This study provides a robust comparison for GroSNaPET 2, which omits lymphadenectomy when SN is negative.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 15-22"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076707","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":"BRCA1 and BRCA2 carriers: Perceptions of endometrial cancer risk","authors":"Mark E. Sherman ,&nbsp;Laura Pacheco-Spann ,&nbsp;Susan Friedman ,&nbsp;Diane Rose ,&nbsp;William D. Foulkes ,&nbsp;Christopher C. DeStephano ,&nbsp;Kristina A. Butler ,&nbsp;Kathryn J. Ruddy ,&nbsp;Zhihui Fang ,&nbsp;Lauren E. Haydu","doi":"10.1016/j.ygyno.2026.01.235","DOIUrl":"10.1016/j.ygyno.2026.01.235","url":null,"abstract":"<div><h3>Objective</h3><div>To survey knowledge, preferred information sources, and risk tolerance for EC among <em>BRCA1</em> and <em>BRCA2</em> pathogenic variant (PV) carriers.</div></div><div><h3>Methods</h3><div>Electronic survey of 332 anonymous women. Descriptive statistics presented.</div></div><div><h3>Results</h3><div>Participants included non-Hispanic White (89.3%) United States residents (91.7%), with mean age of 45 years; 50.6% were <em>BRCA 1</em> and 45.7% were <em>BRCA 2</em> carriers; 56.7% had undergone risk-reducing surgery, including hysterectomy in 44.3%. Most cited reasons for hysterectomy were physician recommendation and EC risk. Among women with intact uteri, 42.2% or participants indicated that they would undergo hysterectomy if EC risk was ≥15%. When queried about specific EC risk factors, responses of “don't know” (if risk is increased or decreased) were given for 30.9%–75.5%, and specifically for <em>BRCA1</em>: 55.2% and for <em>BRCA2</em>: 72.6%. Participants expressed preferences for sources of information about EC risk (decreasing order) as gynecologic oncologists; medical oncologists; genetic counselors and gynecologists. Respondents indicated that providers recommended hysterectomy for 36.0%, against hysterectomy for 15.7% or gave conflicting information for 16.6%.</div></div><div><h3>Conclusions</h3><div>Many carriers have limited knowledge of EC risk and do not receive consistent counseling about hysterectomy.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 23-31"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076706","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":"Hitting the mark—or missing it? The promise and peril of biomarkers in endometrial cancer","authors":"Ramez N. Eskander ,&nbsp;Domenica Lorusso","doi":"10.1016/j.ygyno.2026.02.034","DOIUrl":"10.1016/j.ygyno.2026.02.034","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages A1-A2"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147485763","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":"TOC","authors":"","doi":"10.1016/S0090-8258(26)00839-5","DOIUrl":"10.1016/S0090-8258(26)00839-5","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages iv-v"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147539201","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":"Remarkable preclinical activity of trastuzumab-deruxtecan (T-DXd) in FISH-negative, HER2 IHC 1+ and 2+ expressing primary endometrial cancer cell lines and xenografts","authors":"Luca Palmieri ,&nbsp;Stefania Bellone ,&nbsp;Cem Demirkiran ,&nbsp;Tobias M.P. Hartwich ,&nbsp;Namrata Sethi ,&nbsp;Victoria M. Ettorre ,&nbsp;Sarah Ottum ,&nbsp;Michelle Greenman ,&nbsp;Natalia Buza ,&nbsp;Pei Hui ,&nbsp;Emanuele Perrone ,&nbsp;Francesco Fanfani ,&nbsp;Anna Fagotti ,&nbsp;Elena Ratner ,&nbsp;Alessandro D. Santin","doi":"10.1016/j.ygyno.2026.02.004","DOIUrl":"10.1016/j.ygyno.2026.02.004","url":null,"abstract":"<div><h3>Objective</h3><div>Antibody-drug conjugates (ADCs) targeting the human epidermal growth factor receptor 2 (HER2) such as trastuzumab deruxtecan (T-DXd) may offer a novel therapeutic option for endometrial cancer patients with HER2-overexpressing tumors. However, the activity of T-DXd in endometrial cancer patients with low HER2 expression (IHC 2+ or 1+, FISH negative) remains unreported. Accordingly, the objectives of this study were to evaluate T-DXd preclinical activity both in-vitro and in-vivo against primary FISH-negative endometrial endometrioid cancer (EEC) cell lines with IHC 1+ to 2+ HER2 expressions.</div></div><div><h3>Methods</h3><div>Primary FISH-negative EEC cell lines with low HER2 expression were characterized by immunohistochemistry (IHC), flow cytometry (mean fluorescence intensity, MFI) and FISH assays.</div><div>T-DXd efficacy was investigated in vitro by evaluating cell viability, DNA damage, antibody-dependent cell cytotoxicity and bystander killing. In vivo activity was assessed in HER2 2+ and 1+ FISH-negative EEC xenograft mouse model.</div></div><div><h3>Results</h3><div>T-DXd demonstrated significant in-vitro cytotoxicity in HER2 FISH-negative, IHC 2+ and 1+ cell lines. By contrast, in the HER2 IHC 0 cell line, no significant difference in cell death was observed between T-DXd and Control ADC. In vivo, T-DXd was highly effective in tumor growth suppression and significantly prolonged overall survival in both HER2 IHC 2+ and 1+ xenograft mouse models.</div></div><div><h3>Conclusions</h3><div>T-DXd showed remarkable preclinical activity against HER2 FISH-negative, IHC-low EEC both in-vitro and in-vivo. These findings support its use beyond HER2-high expression and may represent a novel and effective treatment option for patients with HER2-low EEC who have progressed on standard chemotherapy and immunotherapy.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 65-73"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197610","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 benefit of platinum-based chemotherapy in non-surgically treated advanced ovarian cancer: A nationwide study","authors":"Prakriti Garkhail ,&nbsp;Petrisia C. de Bruin ,&nbsp;Ingrid A. Boere ,&nbsp;Maaike A. van der Aa ,&nbsp;Willemien J. van Driel ,&nbsp;Heleen J. van Beekhuizen ,&nbsp;Gatske M. Nieuwenhuyzen-de Boer","doi":"10.1016/j.ygyno.2026.01.772","DOIUrl":"10.1016/j.ygyno.2026.01.772","url":null,"abstract":"<div><h3>Objective</h3><div>Patients with ovarian cancer who do not undergo surgery are underreported in literature. This study evaluated the impact of chemotherapy on survival in ovarian cancer patients who did not undergo cytoreductive surgery. Survival was compared between those who initiated chemotherapy and those who did not, and between patients who continued beyond three cycles and those who discontinued, adjusting for patient characteristics.</div></div><div><h3>Methods</h3><div>All patients diagnosed with ovarian cancer between 2018 and 2022 and not surgically treated were identified from the Netherlands Cancer Registry. Kaplan-Meier and Accelerated Failure Time models were used to evaluate the association between chemotherapy and survival.</div></div><div><h3>Results</h3><div>In total, 1780 patients who did not undergo cytoreductive surgery were included, 57.2% (<em>N</em> = 1018) were treated with platinum-based chemotherapy. Median overall survival in patients who initiated chemotherapy was 11.1 months (95% CI: 10.48–12.16) versus 1.8 months (95% CI: 1.74–2.07) in patients who did not (<em>p</em> &lt; 0.0001). In multivariable analysis, chemotherapy was associated with longer survival (Time Ratio: 4.10, 95% CI: 3.35–5.01, p &lt; 0.0001). Of patients who started chemotherapy, 70.5% (<em>N</em> = 691) received at least three cycles, and 47.9% (<em>N</em> = 469) received six cycles. Median overall survival in patients who stopped after three cycles was 9.9 months (95% CI: 8.1–12.4) versus 17.4 months (95% CI: 16.0–19.1) in patients who continued (<em>p</em> &lt; 0.001). Continuation beyond three cycles was associated with longer survival (Time Ratio: 1.58, 95% CI: 1.24–2.01, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>These findings support continuing platinum-based chemotherapy for up to six cycles in patients who do not undergo surgery, as this is associated with improved overall survival.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 45-53"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146179127","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":"Clinico-pathological characteristics of adult granulosa cell tumors of the ovary and the role of staging surgery: A national database study","authors":"Liselotte Petersen Due ,&nbsp;Zohreh Ketabi ,&nbsp;Claus Høgdall ,&nbsp;Emma Louise Kaderly Rasmussen ,&nbsp;Sven Hoedt Karstensen ,&nbsp;Finn Friis Lauszus ,&nbsp;Tine Henrichsen Schnack","doi":"10.1016/j.ygyno.2026.01.769","DOIUrl":"10.1016/j.ygyno.2026.01.769","url":null,"abstract":"<div><h3>Objective</h3><div>The role of staging surgery in women with Adult Ovarian Granulosa Cell Tumors (AGCT) remains uncertain. This study aimed to assess if omitting secondary staging surgery is safe amongst women who were incompletely staged at primary surgery using recurrence rate as the primary outcome. Furthermore, we sought to identify risk factors for recurrence which may be informative for selection of patients for conservative treatment.</div></div><div><h3>Methods</h3><div>Women diagnosed with AGCT between 2005 and 2019 were identified using data from nationwide Danish Databases (DGCD and NPR). Patients undergoing primary staging surgery, those undergoing incomplete staging surgery with secondary staging and those undergoing incomplete staging not followed by secondary staging. Adjusted binary logistic regression and Cox analyses were used to assess recurrence risk and recurrence free survival.</div></div><div><h3>Results</h3><div>We identified 223 cases with AGCT in Denmark. The recurrence rates were 17%, and 4.8% in patients undergoing complete and incomplete primary staging surgery, respectively (<em>p</em> &lt; 0.015). FIGO Stage (1A vs. ≥IC), tumor size, and high mitotic activity were identified as risk factors of recurrence. The risk of recurrence among patients who were conservatively treated after incomplete primary staging surgery was very low (4.8%), which could be explained by a low-risk profile (high proportion of stage IA, small tumors, and low/moderate mitotic activity) among these patients.</div></div><div><h3>Conclusion</h3><div>In a real-world setting, omitting secondary staging surgery seems safe in primary incompletely staged patients with a low-risk recurrence profile.</div><div>We confirmed that FIGO stage, tumor size, and mitotic activity are all significantly associated with the risk of recurrence in incompletely staged patients.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 74-81"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197577","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":"Para-aortic lymphadenectomy after negative PET-CT in locally advanced cervical cancer: a continuous monocentric series of 320 cases","authors":"Mathilde Daix-Moreux ,&nbsp;Houssein EL Hajj ,&nbsp;Stéphanie Schérier ,&nbsp;Désirée Deandréis ,&nbsp;Ines Chaffai ,&nbsp;Elaine Limkin ,&nbsp;Sophie Espenel ,&nbsp;Patricia Pautier ,&nbsp;Alexandra Leary ,&nbsp;Judith Michels ,&nbsp;Catherine Genestie ,&nbsp;Philippe Morice ,&nbsp;Sébastien Gouy","doi":"10.1016/j.ygyno.2026.02.012","DOIUrl":"10.1016/j.ygyno.2026.02.012","url":null,"abstract":"<div><h3>Objective</h3><div>Assess the accuracy of preoperative PET-CT in detecting para-aortic nodal metastasis in patients with locally-advanced cervical cancer, using routine laparoscopic para-aortic lymphadenectomy and evaluate its impact on patient outcomes.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed a cohort of 320 patients with locally advanced cervical cancer patients (2007–2020). All patients had negative para-aortic PET-CT findings and underwent staging laparoscopic para-aortic lymphadenectomy up to the left renal vein. Collected data included patients and tumors' characteristics, surgical procedures, and complications. The association between nodal status, size of metastatic nodes and survivals were also analyzed.</div></div><div><h3>Results</h3><div>Twenty-nine (9%) patients had para-aortic nodal metastases: 11 &lt; 5 mm and 18 &gt; 5 mm. The rates of false negative results for para-aortic nodal metastases were significantly correlated with the pelvic lymph node status on PET-CT imaging: 3.3% in patients without pelvic uptake compared to 16.9% in patients with pelvic uptake (<em>p</em> &lt; 0.001), but not significantly linked with its laterality, uni or bilateral uptake. Patients with nodal metastases ≤5 mm did not have a different survival from pN0 patients but those with metastases &gt;5 mm had an increased risk of death (HR = 2.79 (95%CI [1.19–6.54], <em>p</em> = 0.02). Among 12 patients in whom para-aortic nodal metastases location is known, 4 (33%) had isolated nodes above the inferior mesenteric artery).</div></div><div><h3>Conclusion</h3><div>Para-aortic lymphadenectomy may be omitted in locally advanced cervical cancer patients without pelvic lymph node uptake on PET-CT. It remains valuable in patients with pelvic uptake. If performed, dissection up to the left renal vein allows for an accurate assessment of the para-aortic area.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 99-105"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258027","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}