Gynecologic oncology最新文献

{"title":"Missed opportunities: Germline testing following tumor sequencing","authors":"Hannah C. Karpel ,&nbsp;Simone Sasse ,&nbsp;Bhavana Pothuri","doi":"10.1016/j.ygyno.2025.06.011","DOIUrl":"10.1016/j.ygyno.2025.06.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Tumor next generation sequencing (NGS) may identify potential germline DNA mutations associated with cancer susceptibility. We describe the frequency of tumor NGS results in patients meeting ESMO 2019 recommendations for germline genetic testing (GT) and reasons for not undergoing germline GT.</div></div><div><h3>Methods</h3><div>A retrospective study (Sept. 2019-Feb. 2022) in a large, urban healthcare system identified patients meeting ESMO guidelines for potentially actionable germline mutations on NGS.</div></div><div><h3>Results</h3><div>Of 3470 patients who underwent tumor NGS, 326 (9.4 %) had at least one potential actionable germline mutation. Of eligible patients, 189 (58.0 %) did not receive germline GT. Reasons for not undergoing GT include: 127 (67.2 %), not referred for GT; 30 (15.9 %), referred but did not attend genetic counseling; 32 (16.9 %), declined, died before GT, had insufficient samples, lacked insurance or lost to follow-up. Among 127 patients not referred for germline GT (39.0 % of the total eligible cohort), the most common cancer types were lung (33.0 %), colorectal (9.4 %), and cancer of unknown primary (9.4 %). Overall, 64 (50.4 %) patients not referred for germline GT had mutations in <em>BRCA1</em>/2 and/or Lynch syndrome genes. Of 137 patients who underwent germline GT, 86 (62.8 %) had positive GT.</div></div><div><h3>Conclusions</h3><div>In this cohort, 60 % of the eligible population by ESMO criteria did not receive GT, most commonly due to lack of referral (over 2/3 of patients). Further, 50 % of patients not referred for GT had mutations in commonly known genes (i.e., <em>BRCA1</em>/<em>2</em>). Education on germline eligibility and reflex clinical protocols are needed to ensure patients receive germline GT.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"199 ","pages":"Pages 51-56"},"PeriodicalIF":4.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313466","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":"Optimizing therapy for cervical cancers – Translating trial data into clinical decision-making","authors":"John K. Chan ,&nbsp;Krishnansu Tewari ,&nbsp;Bradley J. Monk ,&nbsp;Thomas J. Herzog ,&nbsp;Robert L. Coleman ,&nbsp;Michael T. McHale ,&nbsp;Ritu Salani ,&nbsp;Alex A. Francoeur ,&nbsp;Daniel S. Kapp ,&nbsp;Michael T. Richardson","doi":"10.1016/j.ygyno.2025.06.001","DOIUrl":"10.1016/j.ygyno.2025.06.001","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"199 ","pages":"Pages 47-50"},"PeriodicalIF":4.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313603","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":"Adjuvant radiotherapy outcomes and prognostic factors in FIGO 2023 stage IIC endometrial cancer: One sea, different depths","authors":"Alper Kahvecioglu ,&nbsp;Melis Gultekin ,&nbsp;Ecem Yigit ,&nbsp;Sezin Yuce Sari ,&nbsp;Alp Usubutun ,&nbsp;Deniz Ates Ozdemir ,&nbsp;Zafer Arik ,&nbsp;Murat Gultekin ,&nbsp;Ferah Yildiz","doi":"10.1016/j.ygyno.2025.06.007","DOIUrl":"10.1016/j.ygyno.2025.06.007","url":null,"abstract":"<div><h3>Objective</h3><div>FIGO 2023 Stage IIC endometrial cancer (EC) comprises a heterogeneous group of uterine-confined, myoinvasive tumors with aggressive histological subtypes. This study aimed to evaluate treatment outcomes and identify prognostic factors in patients treated with adjuvant radiotherapy (RT), with or without chemotherapy (CTX).</div></div><div><h3>Methods</h3><div>A retrospective evaluation was conducted on 1297 EC patients treated with adjuvant RT following surgical staging between 1994 and 2023. Among these, 229 patients met the FIGO 2023 Stage IIC criteria and were included in this study.</div></div><div><h3>Results</h3><div>The cohort included 59 % high-grade endometrioid and 41 % non-endometrioid EC. Vaginal brachytherapy was the primary RT modality (63 %), with 38 % receiving combined CTX and RT. Over a median follow-up of 64.5 months, recurrences occurred in 14 %, primarily as distant metastases (DM), while locoregional control (LRC) was 95 %. Five-year overall survival (OS) and progression-free survival (PFS) rates were 88 % and 82 %, respectively. Advanced age (≥ 60 years) predicted worse OS (HR: 5.9, <em>p &lt; 0.001</em>) and PFS (HR: 7.1, <em>p &lt; 0.001</em>), and endocervical stromal invasion was independently associated with worse PFS (HR: 2.79, <em>p = 0.003</em>). CTX improved OS and PFS in non-endometrioid tumors but showed no benefit in high-grade endometrioid cancer.</div></div><div><h3>Conclusions</h3><div>Although FIGO 2023 Stage IIC EC shows diverse outcomes, adjuvant RT provides excellent LRC, while DM remain challenging. Endocervical stromal invasion remains a key prognostic factor, predicting poorer PFS, while CTX shows benefit exclusively in non-endometrioid tumors. These findings emphasize the critical need for personalized risk-grouping and adjuvant treatment strategies.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"199 ","pages":"Pages 40-46"},"PeriodicalIF":4.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298679","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":"REACT bowel REcovery after CyToreductive surgery for advanced ovarian cancer","authors":"Virginia Vargiu ,&nbsp;Andrea Rosati ,&nbsp;Francesco Santullo ,&nbsp;Matteo Figà ,&nbsp;Giovanni Esposito ,&nbsp;Silvio Andrea Russo ,&nbsp;Guido Lancellotti ,&nbsp;Carlo Abatini ,&nbsp;Claudio Lodoli ,&nbsp;Matteo Loverro ,&nbsp;Diana Giannarelli ,&nbsp;Barbara Costantini ,&nbsp;Angelica Naldini ,&nbsp;Anna Fagotti","doi":"10.1016/j.ygyno.2025.06.005","DOIUrl":"10.1016/j.ygyno.2025.06.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to assess the prevalence of low anterior resection syndrome (LARS) in patients undergoing cytoreductive surgery for primary or recurrent ovarian cancer. Additionally, it identifies risk factors for bowel dysfunction, assesses urinary and sexual symptoms, examines the impact of diverting ostomy on quality-of-life.</div></div><div><h3>Methods</h3><div>Validated questionnaires assessed postoperative bowel (LARS score, KESS), urinary (BFLUTS), and sexual (FSFI) dysfunction, as well as quality-of-life in ostomized patients (STOMA-QoL). Logistic regression analyses identified predictive factors.</div></div><div><h3>Results</h3><div>Among 430 patients assessed for bowel dysfunction 8.8 % reported LARS (5.3 % minor, 3.5 % major), while chronic constipation was more prevalent (48.4 %, including 13.5 % severe cases). Low bowel resection (≤5 cm) was the strongest predictor of both minor and major LARS (<em>p</em> &lt; 0.001) and minor and major constipation (<em>p</em> = 0.009 and <em>p</em> = 0.019). Severe constipation was additionally associated with lumboaortic lymphadenectomy (OR 1.937, <em>p</em> = 0.031) and disease recurrence (OR 2.095, <em>p</em> = 0.021). Urinary dysfunction affected 35.2 % of patients, impacting quality-of-life in 8.9 %. Sexual dysfunction was highly prevalent (68 %). Among ostomized patients, quality-of-life improved over time (<em>p</em> = 0.001) but remained suboptimal.</div></div><div><h3>Conclusions</h3><div>This study highlights the significant burden of postoperative bowel dysfunction in ovarian cancer patients undergoing cytoreductive surgery. While major LARS was uncommon, chronic constipation emerged as a more prominent issue. Low resection height (≤5 cm) was the strongest predictor of dysfunction, with additional associations identified for lymphadenectomy and disease recurrence. High rates of urinary and sexual dysfunction highlight the need for a multidisciplinary approach to optimize survivorship care.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"199 ","pages":"Pages 32-39"},"PeriodicalIF":4.5,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280386","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":"Fertility sparing surgery in patients with advanced borderline ovarian tumors: Oncologic outcomes of a single-institution cohort","authors":"Tommaso Bianchi ,&nbsp;Tommaso Grassi ,&nbsp;Elena De Ponti ,&nbsp;Marta Jaconi ,&nbsp;Marta Seca ,&nbsp;Alessandra Inzoli ,&nbsp;Martina Bombelli ,&nbsp;Giorgia Pecis Cavagna ,&nbsp;Valeria Carazita ,&nbsp;Daniela Giuliani ,&nbsp;Stefania Chiari ,&nbsp;Gaetano Trezzi ,&nbsp;Alessandra Casiraghi ,&nbsp;Andrea Alberto Lissoni ,&nbsp;Robert Fruscio","doi":"10.1016/j.ygyno.2025.06.009","DOIUrl":"10.1016/j.ygyno.2025.06.009","url":null,"abstract":"<div><h3>Introduction</h3><div>The purpose of this single-center retrospective analysis is to evaluate the long-term feasibility and oncologic safety of fertility-sparing surgery (FSS) in patients with advanced borderline ovarian tumors (BOTs).</div></div><div><h3>Methods</h3><div>Patients with FIGO stage IIA-IIIC BOTs treated with FSS between 1985 and 2021 were evaluated.</div></div><div><h3>Results</h3><div>A total of 86 patients were included, the majority having serous histology (90.7 %), bilateral ovarian involvement (61.6 %), and stage III disease (54.6 %) with non-invasive implants (80.2 %). The most common surgical approach was unilateral adnexectomy with/without contralateral cystectomy (58.1 %)</div><div>After a median follow-up of 182 months, 66 patients (76,7 %) experienced recurrence, with a median RFS of 148 months; among them, 36 relapsed more than once. Most patients experienced isolated ovarian recurrence at both first (69.7 %) and second relapse (60.0 %); in these patients, a rechallenge with FSS was offered in most cases, whereas radical surgery was preferred (53.3 %) at third recurrence. Three patients with recurrent disease developed invasive low-grade serous ovarian carcinoma (LGSOC). At univariable analysis, the laterality of ovarian involvement (<em>p</em> = 0.027) and the type of adnexal procedure (<em>p</em> = 0.019) were significant predictors of recurrence. At last follow-up 83 patients (96.5 %) were alive without evidence of disease, 2 patients (2.3 %) were alive with persistent/recurrent disease and death occurred in only one patient (1.2 %).</div></div><div><h3>Conclusions</h3><div>Despite the high recurrence rate, our series demonstrates that FSS has excellent oncologic outcomes in managing advanced BOTs. Therefore, fertility preservation is advised in young women with advanced BOTs who have not yet fulfilled their desire for childbearing.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"199 ","pages":"Pages 10-16"},"PeriodicalIF":4.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279104","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":"GTN misdiagnosed as ectopic pregnancy: a 17-year retrospective cohort study","authors":"Yuanyuan Liu ,&nbsp;Yusen Zhou ,&nbsp;Ziying Zhou ,&nbsp;Xuan Rao ,&nbsp;Liang Feng ,&nbsp;Weiguo Lu ,&nbsp;Xiao Li","doi":"10.1016/j.ygyno.2025.06.010","DOIUrl":"10.1016/j.ygyno.2025.06.010","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of misdiagnosis on the chemotherapy response and prognosis of gestational trophoblastic neoplasia (GTN), and to explore strategies to enhance precision management of uncertain GTN.</div></div><div><h3>Methods</h3><div>GTN patients misdiagnosed as ectopic pregnancies were retrospectively enrolled. GTN without misdiagnosis were randomly selected as control group at a 1:1 ratio, matching by age, WHO risk score and admission year. All patients were followed up for pregnancy, recurrence, and survival. Mann-Whitney test was used for continuous variables. Categorical variables were assessed using the Chi-square test or Fisher's exact test.</div></div><div><h3>Results</h3><div>Among 35 misdiagnosed cases, high-risk GTN accounted for 57.1 %. Antecedent nonmolar pregnancy in misdiagnosed group was 88.6 %. Pretreatment human chorionic gonadotropin (hCG) was lower (3477 vs 18,121 IU/L) while recurrence rate was significantly higher in misdiagnosed group than in control group (28.6 % vs 5.7 %, <em>p</em> = 0.011). The resistance rate showed an increasing trend in misdiagnosed group (22.9 % vs 14.3 %, <em>p</em> = 0.356). For subgroup analysis, the resistance rate was increased in group A (treated with methotrexate) than group B (without methotrexate), while decreased in patients with lesion resection (group C) than without resection (group D), especially for low-risk patients. Histopathological misdiagnosis for antecedent pregnancy and GTN in primary hospitals were 2 and 6 cases respectively.</div></div><div><h3>Conclusions</h3><div>GTN after nonmolar pregnancy with low hCG are prone to be misdiagnosed, which might lead to increased WHO risk scores, resistance, and relapse rates. Surgical intervention, especially lesion resection instead of methotrexate, is recommended for atypical GTN.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"199 ","pages":"Pages 27-31"},"PeriodicalIF":4.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280385","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":"An exploratory analysis of driver gene alterations and their potential prognostic relevance in endometrial cancer with POLE exonuclease domain mutations","authors":"Tsai-Yin Wei ,&nbsp;Chao-Chih Wu ,&nbsp;Yun-Ting Hsu ,&nbsp;Wen-Hsuan Lin ,&nbsp;Li-Chu Tsai ,&nbsp;Dar-Bin Shieh ,&nbsp;Chih-Long Chang","doi":"10.1016/j.ygyno.2025.06.006","DOIUrl":"10.1016/j.ygyno.2025.06.006","url":null,"abstract":"<div><h3>Objective</h3><div>Endometrial cancer represents a significant gynecologic malignancy affecting women globally, including Taiwan. This study aimed to analyze mutation patterns in endometrial cancer genes related to POLE exonuclease domain mutations and their association with patient prognosis.</div></div><div><h3>Methods</h3><div>We analyzed 100 endometrial cancer tissue samples from patients at MacKay Memorial Hospital (February 2014–February 2017). DNA sequencing was conducted on an Illumina MiSeq platform with subsequent QIAGEN CLC Workbench analysis. We applied Kaplan-Meier analysis and Fisher's exact test for statistical evaluations.</div></div><div><h3>Results</h3><div>Mutations in POLE were primarily located in the exonuclease domain, with 36 missense variants identified, of which 19 were in this specific domain. Tumors with POLE exonuclease domain mutations (POLEmut) exhibited a significantly higher tumor mutation burden (<em>p</em> &lt; 0.0001), and Kaplan-Meier analysis revealed better overall survival for patients with POLEmut tumors compared to POLE wild-type tumors (POLEwt, <em>p</em> &lt; 0.0388; HR: 3.624). In POLEmut cases, tumor suppressor genes showed scattered mutations with higher nonsense rates (TP53, PIK3R1, FBXW7; all <em>p</em> &lt; 0.01), contrasting with oncogenes (PIK3CA, CTNNB1, KRAS). Mutations in tumor suppressor genes (TP53, PIK3R1, FBXW7) conferred significantly better survival outcomes in POLEmut cases compared to their POLEwt counterparts with identical gene mutations (HR: 3.929–6.598, all <em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>This exploratory study finds that POLE exonuclease domain mutations are associated with distinct mutational patterns that vary between tumor suppressor genes and oncogenes. These observations provide hypothesis-generating insights into potential mechanisms underlying the favorable prognosis of POLEmut tumors and may inform future molecular investigations in endometrial cancer.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"199 ","pages":"Pages 17-26"},"PeriodicalIF":4.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279105","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":"Definitive intensity-modulated radiotherapy for organ preservation in vulvar cancer: A multicenter study","authors":"Anupam Rishi ,&nbsp;Kevin V. Albuquerque ,&nbsp;Anuja Jhingran ,&nbsp;Elysia K. Donovan ,&nbsp;Zachary D. Horne ,&nbsp;Michelle S. Ludwig ,&nbsp;Piyush Pathak ,&nbsp;Ronald Goldsberry ,&nbsp;Scott M. Glaser ,&nbsp;Aditya Garg ,&nbsp;Vivien Yin ,&nbsp;Daniel C. Fernandez ,&nbsp;Sushil Beriwal ,&nbsp;Kamran A. Ahmed ,&nbsp;Michael E. Montejo","doi":"10.1016/j.ygyno.2025.05.024","DOIUrl":"10.1016/j.ygyno.2025.05.024","url":null,"abstract":"<div><h3>Introduction</h3><div>To evaluate outcome and toxicity of definitive intensity-modulated radiation therapy (IMRT) for vulvar squamous cell cancers (VSCC).</div></div><div><h3>Methods</h3><div>DRIVE (Definitive IMRT in Vulvar Cancer) multicenter cohort study analyzed VSCC treated with definitive-IMRT across institutions in US/Canada. Outcomes, toxicity, and patterns of failure were investigated. Locoregional control (LRC), metastasis-free survival (MFS) and overall survival (OS) were estimated using Kaplan-Meier methods. Univariable/multivariable analysis were conducted using Cox-regression method.</div></div><div><h3>Results</h3><div>A total of 159 patients received definitive-IMRT between 2012 and 2022. Median age was 62-years (IQR 54–74). Forty (25 %) patients had stage I-II, and 119 (75 %) stage III-IV disease. Clinical or pathological nodal metastases were identified in 111 (70 %). Among 56 patients with available HPV/p16 status, 38(68 %) were positive. The median radiation dose was 64Gy, and 128 (80.5 %) patients received concurrent chemotherapy. Complete clinical response (CCR) was achieved in 73.6 % at primary and 77.3 % at regional nodes. Median OS was 73-months (95 %CI 45–100), with actuarial 2- and 5-year OS rates of 67.5 % and 58.3 %, respectively. The 5-year LC, RC, and MFS were 70.7 %, 86.2 %, and 81 %, respectively. Only 1 of the cN0 (1/48, 2 %) patients experienced regional failure. Predictors of inferior OS included age &gt; 70-years (<em>p</em> = 0.03), diabetes (<em>p</em> = 0.01), node-positivity (p = 0.01), no chemotherapy (<em>p</em> = 0.009), and lack of CCR (<em>p</em> &lt; 0.001). Planned treatment was completed by 94 % patients. Vaginal stenosis occurred in 40 %, and late grade 3–4 soft-tissue toxicity in 9 %.</div></div><div><h3>Conclusion</h3><div>Definitive-IMRT provides an excellent LRC with acceptable toxicity. High regional control in cN0 patients supports avoiding elective nodal surgery in those planned for definitive RT.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"199 ","pages":"Pages 1-9"},"PeriodicalIF":4.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270543","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":"Prognostic indicators of recurrence and treatment-free interval in uterine carcinosarcoma","authors":"William Vintzileos,&nbsp;Hannah Beer,&nbsp;Yukta Sunkara,&nbsp;Jessica Pruszynski,&nbsp;Jayanthi Lea","doi":"10.1016/j.ygyno.2025.06.004","DOIUrl":"10.1016/j.ygyno.2025.06.004","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate prognostic factors influencing recurrence and treatment-free interval in patients with uterine carcinosarcoma (UCS).</div></div><div><h3>Methods</h3><div>A single-institution cohort study of 73 patients with UCS from 2009 to 2023 was conducted. Patients underwent surgery and adjuvant chemotherapy ± radiation. Demographic and clinicopathologic data were collected and analyzed using Kruskal-Wallis, chi-square, and Fisher's exact tests. Multivariate Cox regression and Kaplan-Meier analyses assessed predictors of recurrence and survival outcomes.</div></div><div><h3>Results</h3><div>A total of 118 patients with UCS were identified, 73 of whom underwent surgery followed by platinum-doublet chemotherapy ± radiation. Forty-six patients (63 %) had recurrence, with 23 (50 %), 14 (30 %), and 9 (20 %) recurring &lt;6 months, between 6 and 12 months, and &gt; 12 months after completing chemotherapy, respectively. Independent predictors of recurrence included stage (<em>p</em> = 0.013), age (<em>p</em> &lt; 0.001), adjuvant radiation (<em>p</em> = 0.003), and tumor size (<em>p</em> = 0.002). Adjuvant radiation with chemotherapy was associated with significant PFS (<em>p</em> &lt; 0.001) and OS (p = 0.002) benefit. Among those who recurred, primary treatment-free interval was significantly associated with overall survival. Adjuvant radiation (<em>p</em> = 0.002) and tumor size (<em>p</em> &lt; 0.001) were also independent predictors of treatment-free interval.</div></div><div><h3>Conclusion</h3><div>There are clinically significant predictors of recurrence and treatment-free interval in UCS, including tumor size and the additional of adjuvant radiation. Treatment-free interval is a strong prognostic indicator of overall survival. Adjuvant radiation with chemotherapy provides a significant PFS and OS benefit.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"198 ","pages":"Pages 154-160"},"PeriodicalIF":4.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A phase II trial of palbociclib plus letrozole after progression on second-line chemotherapy for women with hormone receptor-positive high-grade serous or endometrioid ovarian, fallopian tube, or peritoneal cancer (LACOG 1018)","authors":"Fernanda Bronzon Damian ,&nbsp;Andreia Cristina De Melo ,&nbsp;Graziela Z. Dal Molin ,&nbsp;Angélica Nogueira-Rodrigues ,&nbsp;Aknar Calabrich ,&nbsp;Gustavo Werutsky ,&nbsp;Elias Abdo Filho ,&nbsp;Taiane Francieli Rebelatto ,&nbsp;Rafaela Gomes de Jesus ,&nbsp;Mirela Foresti Jiménez","doi":"10.1016/j.ygyno.2025.05.022","DOIUrl":"10.1016/j.ygyno.2025.05.022","url":null,"abstract":"<div><h3>Objective</h3><div>Treatment options for patients with ovarian high-grade serous carcinoma (HGSC) and high-grade endometrioid carcinoma (HGEC) who progress after receiving chemotherapy are limited. Considering that over 80 % of those patients express ER and/or PR, we aimed to evaluate the effectiveness of endocrine therapy combined with CDK inhibitors in this population.</div></div><div><h3>Methods</h3><div>LACOG 1018, a phase II, single-arm, multicenter trial assessed the efficacy of letrozole 2.5 mg/day continuously plus palbociclib 125 mg/day for 21 days in 28-day cycles in patients with histologically proven ovarian HGSC or HGEC, fallopian tube or peritoneal cancer who had received at least two lines of chemotherapy (including one platinum-based regimen) and progressed on prior chemotherapy. Patients had centrally confirmed hormone positivity – estrogen or progesterone (&gt;10 % by immunohistochemistry). The primary endpoint was investigator-assessed progression-free survival rate at 12 weeks (PFS-week12) by RECIST 1.1.</div></div><div><h3>Results</h3><div>41 eligible patients were included (February/2020 to January/2022). The median age was 61 years (range 43–83). The PFS-week12 rate was 63.4 % (95 % CI, 46.8 to 76.1), median PFS 4.2 months (95 % CI, 2.7 to 5.5), and median overall survival 13.4 months (95 % CI, 10.4 to 20.1). The objective response rate was 7.7 % (3 partial responses) and the disease control rate 71.8 %. Treatment-related adverse event rates of any grade and grade 3–4 were 95.1 % and 51.2 %, respectively. Grade 3–4 neutropenia was reported in 17 patients (41.5 %), and febrile neutropenia in 1 (2.4 %).</div></div><div><h3>Conclusions</h3><div>The combination of Palbociclib plus letrozole has a favorable toxicity profile and appears to have clinical activity in recurrent hormone receptor-positive high-grade ovarian cancer.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"198 ","pages":"Pages 161-167"},"PeriodicalIF":4.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263985","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}