Gynecologic oncology最新文献

{"title":"TOC","authors":"","doi":"10.1016/S0090-8258(26)02067-6","DOIUrl":"10.1016/S0090-8258(26)02067-6","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"210 ","pages":"Pages iv-vi"},"PeriodicalIF":4.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148524365","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}

{"title":"The evolving landscape of personalized perioperative care: A commentary on the 2026 ERAS® Gynecologic oncology guidelines","authors":"Richard D. Urman, Olle Ljungqvist","doi":"10.1016/j.ygyno.2026.06.022","DOIUrl":"10.1016/j.ygyno.2026.06.022","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"210 ","pages":"Pages A1-A2"},"PeriodicalIF":4.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470194","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":"Technical evaluation of commercially available homologous recombination deficiency assays using MyChoice CDx as reference in ovarian cancer","authors":"Alexander Yarunin,&nbsp;Ping Qiu,&nbsp;Xiaodun Li,&nbsp;Natalia Lukashchuk,&nbsp;John Longshore,&nbsp;J. Andrew Williams,&nbsp;Lixin Lang,&nbsp;Amy K. Wehn,&nbsp;Jared Lunceford,&nbsp;Razvan Cristescu,&nbsp;Matthew J. Marton","doi":"10.1016/j.ygyno.2026.05.027","DOIUrl":"10.1016/j.ygyno.2026.05.027","url":null,"abstract":"<div><h3>Objective</h3><div>Identifying tumors with homologous recombination deficiency (HRD) is critical to determining appropriate treatment options for advanced ovarian cancer. We investigated concordance of HRD status and other associated biomarkers between Food and Drug Administration–approved MyChoice® CDx and 4 assays commercially available in various regions.</div></div><div><h3>Methods</h3><div>DNA was isolated from pretreatment tissue samples from trial participants with platinum-sensitive relapsed ovarian cancer without a germline <em>BRCA</em> mutation (<em>BRCA</em>m). HRD status was assessed using MyChoice CDx and FoundationOne®CDx, SOPHiA DDM™ Dx HRD Solution, Thermo Fisher Oncomine™ Comprehensive Assay Plus (OCA Plus), and whole-genome copy number variation–based Thermo Fisher OncoScan™. Therapeutic efficacy was simulated <em>in silico</em> using data from the phase 3 PAOLA-1 study.</div></div><div><h3>Results</h3><div>Biomarker assessment success rate was ≥87% for all next-generation sequencing–based assays and 71.6% for Thermo Fisher OncoScan. With MyChoice CDx as reference, for HRD status, overall percentage agreement (OPA) ranged 76.0%–88.7%; positive percentage agreement (PPA) ranged 81.6%–93.8%, and negative percentage agreement (NPA) ranged 70.3%–90.4%. For genomic instability, OPA ranged 74.7%–87.5%, PPA ranged 67.6%–91.5%, and NPA ranged 71.1%–88.4%. For BRCAm status, OPA ranged 90.0%–96.9%, PPA ranged 50.0%–86.4%, and NPA ranged 94.4%–100%. Among simulated HRD-positive participants, mean progression-free survival hazard ratio was 0.40 at PPA of 80% and NPA of 85%, and 0.38 at PPA of 75% and NPA of 90%.</div></div><div><h3>Conclusions</h3><div>Using MyChoice CDx as reference, commercially available assays showed concordance in detecting HRD, genomic instability, and BRCA mutations, indicating their potential clinical utility in identifying appropriate treatment options for ovarian cancer.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"210 ","pages":"Pages 217-225"},"PeriodicalIF":4.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148328855","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)02015-9","DOIUrl":"10.1016/S0090-8258(26)02015-9","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"209 ","pages":"Pages iv-vi"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148178846","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":"En-Do's and En-Don'ts: Navigating the rapidly evolving clinical landscape in endometrial cancer","authors":"Ritu Salani,&nbsp;Dana M. Chase,&nbsp;Beth Y. Karlan","doi":"10.1016/j.ygyno.2026.05.030","DOIUrl":"10.1016/j.ygyno.2026.05.030","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"209 ","pages":"Pages A1-A2"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148178845","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)01968-2","DOIUrl":"10.1016/S0090-8258(26)01968-2","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"208 ","pages":"Pages iv-v"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147956882","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":"Tampon-based methylated DNA testing for endometrial cancer: Promising innovation, but prudence before practice","authors":"Joy M. Davis ,&nbsp;Jonathan C. Dudley ,&nbsp;Amanda N. Fader","doi":"10.1016/j.ygyno.2026.04.014","DOIUrl":"10.1016/j.ygyno.2026.04.014","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"208 ","pages":"Pages A1-A2"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147928714","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":"Cost and efficiency of universal versus selective next generation sequencing for advanced stage endometrial cancer","authors":"Aya Bashi ,&nbsp;Katherine N. Penvose ,&nbsp;Jason D. Wright ,&nbsp;Stephanie V. Blank ,&nbsp;Benjamin B. Albright ,&nbsp;William D. Hazelton ,&nbsp;Emma Rossi ,&nbsp;Evan R. Myers ,&nbsp;Angeles Alvarez Secord ,&nbsp;Laura J. Havrilesky","doi":"10.1016/j.ygyno.2026.02.009","DOIUrl":"10.1016/j.ygyno.2026.02.009","url":null,"abstract":"<div><h3>Objective</h3><div>We sought to identify efficient tumor molecular profiling strategies for patients with newly diagnosed stage III–IVA endometrial cancer.</div></div><div><h3>Methods</h3><div>We constructed a decision tree model to compare molecular profiling strategies. We considered testing options of mismatch repair (MMR), p53, and HER2 immunohistochemistry (IHC), and next generation sequencing (NGS, assessing for MMR protein, <em>TP53</em> and <em>POLE</em> mutations). Strategies included (1) <u>MMR/p53</u>: MMR/p53 IHC at diagnosis, with HER2 IHC if p53 abnormal and NGS reserved for first progression/recurrence; (2) <u>Selective NGS</u>: MMR/p53 IHC at diagnosis, with immediate NGS and HER2 IHC if p53 abnormal, otherwise NGS at recurrence; (3) <u>Universal NGS</u>: NGS and HER2 IHC at diagnosis for all. Molecular subtype prevalence and six-year recurrence-free survival by subtype were derived from the GOG-0258 randomized trial. Outcomes included costs (2024 US$), timely NGS results (results available at recurrence/progression), and unnecessary NGS (NGS performed in patients who remained recurrence-free).</div></div><div><h3>Results</h3><div>Universal NGS resulted in unnecessary NGS in 57% of patients who remained recurrence-free, compared with 7% under the Selective NGS strategy and 0% with MMR/p53. MMR/p53 was the least costly strategy (mean cost $3772), followed by Selective NGS ($4186) and Universal NGS ($6250). Compared with MMR/p53, Selective NGS cost $2571 per additional timely NGS result, while Universal NGS cost $7600 per additional timely NGS result compared with Selective NGS.</div></div><div><h3>Conclusions</h3><div>Selective molecular profiling of newly diagnosed stage III-IVA endometrial cancers using MMR and p53 IHC with reflex to NGS for p53-abnormal tumors improves testing efficiency and reduces unnecessary NGS compared with universal upfront NGS testing.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"207 ","pages":"Pages 67-73"},"PeriodicalIF":4.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147685691","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 GLP-1 RA plus progestin therapy on fertility-sparing management of endometrial intraepithelial neoplasia and endometrial cancer","authors":"Tina Yi Jin Hsieh ,&nbsp;Ting-Tai Yen ,&nbsp;Michele R. Hacker ,&nbsp;Joseph Dottino ,&nbsp;Katharine M. Esselen","doi":"10.1016/j.ygyno.2026.03.010","DOIUrl":"10.1016/j.ygyno.2026.03.010","url":null,"abstract":"<div><h3>Objective</h3><div>We examined whether the addition of GLP-1RA to progestin therapy reduced the risk of hysterectomy in patients with endometrial intraepithelial neoplasia (EIN) and endometrial cancer (EC) in the U.S. managed with fertility-sparing management.</div></div><div><h3>Methods</h3><div>Women ≤45 years old at EIN/EC diagnosis were identified in the TriNetX Research Collaborative Network (1/1/2017–12/01/2025). Patients initiating GLP-1 RA plus progestins (megestrol acetate, medroxyprogesterone acetate, or levonorgestrel-releasing intrauterine device) formed the GLP-1 RA + progestin group and were compared with the progestin-only group. Groups were 1:1 propensity-score matched (PSM) for demographics, BMI, HbA1c, type 2 diabetes, comorbidities, medication use, healthcare utilization, and EIN/EC. Patients were followed up for 6, 12, and 18 months from treatment initiation until the occurrence of hysterectomy; loss to follow-up; or December 1, 2025. Hazard ratios (HRs) with 95% confidence intervals (CI) were estimated using Cox proportional hazards regression. Analyses for subgroups, head-to-head comparisons were also performed.</div></div><div><h3>Results</h3><div>After 1:1 PSM (<em>n</em> = 432 in each group), hysterectomy occurred in 10.2% of the GLP-1RA + progestin group versus 23.4% in the matched progestin-only group (HR 0.41, 95% CI 0.29–0.58) at 18 months, with significant reductions observed as early as 6 months. This protective association was consistent across subgroups, including younger patients (&lt;40 years), EC diagnosis, progestin type (LNG-IUD or oral progestins), and GLP-1RA type (semaglutide or tirzepatide).</div></div><div><h3>Conclusion</h3><div>Adjunct GLP-1 receptor agonist therapy was associated with reduced hysterectomy risk in EIN and EC, supporting prospective fertility-sparing studies.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"207 ","pages":"Pages 23-29"},"PeriodicalIF":4.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147685687","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":"Identifying ovarian cancer with AI analysis of abdominal CT scans","authors":"Katherine Sawaya ,&nbsp;Margot Maraghe ,&nbsp;Samantha Metzger ,&nbsp;Carolina Modena Heming ,&nbsp;Megan McDonald ,&nbsp;Vincent M. Wagner ,&nbsp;David P. Bender ,&nbsp;Michael J. Goodheart ,&nbsp;Jesus Gonzalez Bosquet","doi":"10.1016/j.ygyno.2026.01.774","DOIUrl":"10.1016/j.ygyno.2026.01.774","url":null,"abstract":"<div><h3>Background</h3><div>Epithelial ovarian cancer (EOC) has a high case-fatality rate, largely due to diagnosis at advanced stages and lack of effective screening tools. Conventional screening tools, like CA125 and ultrasound, have limited sensitivity and specificity. Advances in deep learning (DL) applied to medical imaging such as CT scans offer a promising avenue for improving early EOC detection.</div></div><div><h3>Objective</h3><div>To build, develop, and validate prediction models of EOC using deep machine learning (DL) to process and analyze abdominal-pelvic CT scans.</div></div><div><h3>Methods</h3><div>We performed a pilot case-control study to predict EOC using artificial intelligence (AI) methodology and abdominal-pelvic CT scans comparing EOC patients (cases, <em>N</em> = 355) to patients with histology-proven benign adnexal masses (controls, <em>N</em> = 213). CT images were converted to 3D NIFTI format and segmented using the ovseg pipeline. Multiple DL architectures were evaluated, including convolutional neural networks (CNNs) and vision transformers (ViTs). Model performance was assessed using area under the operating characteristic curve (AUC), accuracy, and precision. Model interpretability was evaluated using Gradient-weighted Class Activation Mapping (Grad-CAM). Radiomics-based models were constructed using PyRadiomics features and compared with DL models.</div></div><div><h3>Results</h3><div>Most of women had and advanced FIGO stage, 88%, and high grade histology, 92%. Exploratory analysis of different methods without segmentation (or masking) resulted in poor performances, with AUCs between 0.39 and 0.83. The best performing models were those trained with CNN architecture with masked images, with AUC of 0.92. Validation and testing performances for EOC prediction with PyRadiomics had AUCs of 0.74 and 0.66 respectively.</div></div><div><h3>Conclusions</h3><div>DL using segmented abdominal-pelvic CT scans, particularly CNN-based architecture, demonstrate strong potential for distinguishing EOC from benign pelvic masses. Further studies are needed to create accurate DL models for early EOC detection.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"207 ","pages":"Pages 30-37"},"PeriodicalIF":4.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147685688","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}