Gynecologic oncology最新文献

{"title":"ATR inhibition increases reliance on PARP-mediated DNA repair revealing an improved therapeutic strategy for cervical cancer","authors":"Sugantha Priya Elayapillai ,&nbsp;Samrita Dogra ,&nbsp;James Lausen ,&nbsp;Madison Parker ,&nbsp;Amy Kennedy ,&nbsp;Doris M. Benbrook ,&nbsp;Katherine M. Moxley ,&nbsp;Bethany N. Hannafon","doi":"10.1016/j.ygyno.2024.10.009","DOIUrl":"10.1016/j.ygyno.2024.10.009","url":null,"abstract":"<div><h3>Objective</h3><div>Cervical cancer results from persistent infection with high-risk human papillomavirus (HR-HPV) and the expression of E6 and E7 oncoproteins. E6 and E7 compromise the activity of p53 and Rb, the G1-S cell cycle checkpoint, and ATM-mediated DNA damage repair (DDR), which in turn increases reliance on ATR- and PARP-mediated DDR at the G2 cell cycle checkpoint. This study aimed to determine the effects of an ATR inhibitor (ATRi, AZD6738) and a PARP-inhibitor (PARPi, AZD2281) on HR-HPV+ cervical cancer cell lines.</div></div><div><h3>Methods</h3><div>The effects of ATRi and PARPi, alone and in combination, on metabolic viability, cell cycle arrest, apoptosis, and DDR pathways in cervical cancer cell lines were evaluated in vitro, and the in vivo tumor response was evaluated using a xenograft model.</div></div><div><h3>Results</h3><div>Cervical cancer cells were sensitive to ATRi and PARPi monotherapy. The combination therapy was only synergistic in reducing metabolic viability when exposed to ATRi first, followed by PARPi, owing to ATRi-mediated upregulation of PARP expression. Combination of ATRi and PARPi induced G2 cell cycle arrest and apoptosis. PARPi induced DNA damage and γH2AX phosphorylation, which was further increased by ATRi treatment. However, PARPi-induced Rad51 foci formation was reduced by ATRi treatment, suggesting the inhibition of homologous recombination repair. ATRi significantly reduced cervical cancer xenograft tumor growth and was not affected by simultaneous PARPi treatment at the doses studied.</div></div><div><h3>Conclusions</h3><div>Our findings show that ATRi increased reliance on PARP for metabolic viability, the combination of ATRi and PARPi induced synthetic lethality in cervical cancer in vitro, and reduced tumor burden in vivo.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463324","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":"Mild symptoms matter: Results from a prospective, longitudinal study on the relationship between symptoms, lymphedema and health-related outcomes post-gynecological cancer","authors":"Melanie L. Plinsinga ,&nbsp;Sheree Rye ,&nbsp;Tamara Jones ,&nbsp;Dimitrios Vagenas ,&nbsp;Leigh Ward ,&nbsp;Monika Janda ,&nbsp;Andreas Obermair ,&nbsp;Sandra C. Hayes","doi":"10.1016/j.ygyno.2024.10.011","DOIUrl":"10.1016/j.ygyno.2024.10.011","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe lower-limb symptoms pre- through to 2-years post-surgery following newly diagnosed gynecological cancer; to explore relationships between lower-limb symptoms, lower-limb lymphedema, body image, quality of life, anxiety and depression; and to determine whether lower-limb symptoms predict lower-limb lymphedema.</div></div><div><h3>Methods</h3><div>Fourteen lower-limb symptoms, lymphedema, body image, anxiety, depression, and quality of life were prospectively collected in 408 women with gynecological cancer pre-surgery, and at 6-, 12-, and 24-months post-surgery. Point prevalence and cumulative incidence were calculated for symptoms. Cross-sectional relationships were explored between symptoms, lower-limb lymphedema and health-related outcomes at all timepoints, while regression analyses were used to assess the predictive relationships between lower-limb symptoms at 6-months post-surgery, and lymphedema at 12- and 24-months post-surgery.</div></div><div><h3>Results</h3><div>Participants were on average 59 (SD: 11) years of age, and 58 %, 28 %, 9 % and 5 % were diagnosed with endometrial, ovarian, cervical, and vulvar/vaginal cancer, respectively. Prevalence of any given lower limb symptom among all cancer types ranged between 11 and 59 %, with the most prevalent symptoms being pain, stiffness, and aching (prevalence &gt;40 % across all time-points). The presence of symptoms was associated with higher anxiety and depression, poorer overall quality of life and body image (<em>p</em> &lt; 0.01). Compared to those without symptoms, one or more lower limb symptoms of at least mild severity increased the odds of developing lymphedema up to 24 months post-surgery (OR &gt; 1.3).</div></div><div><h3>Conclusions</h3><div>Self-reported symptoms are associated with adverse health-related outcomes. Assessment and management of symptoms, irrespective of symptom severity, has potential for improving health outcomes, including lymphedema, in those following gynecological cancer.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445878","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":"Less is more? Comparison between genomic profiling and immunohistochemistry-based models in endometrial cancer molecular classification: A multicenter, retrospective, propensity-matched survival analysis.","authors":"Emanuele Perrone, Ilaria Capasso, Diana Giannarelli, Rita Trozzi, Luigi Congedo, Elisa Ervas, Vincenzo Tarantino, Giovanni Esposito, Luca Palmieri, Arianna Guaita, Anne-Sophie van Rompuy, Giulia Scaglione, Gian Franco Zannoni, Giovanni Scambia, Frédéric Amant, Francesco Fanfani","doi":"10.1016/j.ygyno.2024.10.010","DOIUrl":"https://doi.org/10.1016/j.ygyno.2024.10.010","url":null,"abstract":"<p><strong>Background: </strong>Genomic profiling-based model (GP-M) is the gold-standard for endometrial cancer (EC) molecular classification, but several issues related to the availability of genomic sequencing in low-income settings remain and health disparities in the management are increasing. This study aims to investigate the non-inferiority of the immunohistochemistry-alone model in classifying ECs compared to the standard genomic profiling-based model in terms of oncologic outcomes.</p><p><strong>Methods: </strong>All preoperative uterine-confined ECs undergoing surgical staging were retrospectively included. Patients classified by IHC-M were stratified into: MMR-proficient (MMRp), p53 wild type (p53wt) and estrogen receptor (ER) positive, 2) MMRp, p53wt and ER-negative, 3) MMRd, and 4) p53abn. A case-control comparison was performed between the IHC-M and GP-M cohorts. Then, a propensity-matched analysis was performed: ECs classified by IHC-M were matched in a 3:1 ratio with patients classified by GP-M.</p><p><strong>Results: </strong>1587 patients with EC were included. The Kaplan-Meier survival curves for disease-free survival and overall survival demonstrated that the two models performed similarly in risk-stratifying the study population (p < 0.0001). Moreover, the AUC-ROC showed overlapping results: 0.77 (0.66-0.87) for IHC-M and 0.72 (0.63-0.81) for GP-M, indicating that both models were able to successfully identify patients at high-risk and low-risk of disease recurrence/progression.</p><p><strong>Conclusion: </strong>The IHC-M showed overlapping classification performance compared to the GP-M in terms of oncologic outcomes. This study may lay the basis to further investigate the real-life clinical impact of POLE sequencing in molecular classification and the potential stand-alone prognostic role of ER status for further allocation of EC patients into risk classes.</p>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463325","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":"Surgery after upfront chemoradiation in locally advanced squamous cell vulvar cancer: Analysis of postoperative outcomes and survival","authors":"Alex Federico ,&nbsp;Valentina Lancellotta ,&nbsp;Simona M. Fragomeni ,&nbsp;Gabriella Macchia ,&nbsp;Sara Ammar ,&nbsp;Tina Pasciuto ,&nbsp;Angela Santoro ,&nbsp;Giacomo Corrado ,&nbsp;Alessia Piermattei ,&nbsp;Valerio Gallotta ,&nbsp;Luca Tagliaferri ,&nbsp;Gianfranco Zannoni ,&nbsp;Maria A. Gambacorta ,&nbsp;Giovanni Scambia ,&nbsp;Giorgia Garganese","doi":"10.1016/j.ygyno.2024.10.005","DOIUrl":"10.1016/j.ygyno.2024.10.005","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of the study was to assess the survival rates and surgery-related toxicity in patients with locally advanced squamous cell vulvar cancer (LAVC) managed by upfront chemoradiation (CRT) with/without following by surgery.</div><div>CRT is the primary treatment for patients with unresectable locally advanced squamous cell vulvar carcinoma (LAVC), followed by surgery in case of residual tumor.</div></div><div><h3>Methods</h3><div>Patients with AJCC stage II-IV squamous cell vulvar carcinoma referred to Gynecologic Oncology Unit at Fondazione Policlinico Universitario Agostino Gemelli I.R.C.C.S. from January 2016 to February 2023, managed by upfront CRT, were included.</div></div><div><h3>Results</h3><div>63 patients were included, 21 (33 %) had complete response (cCR) to CRT, 26 (41 %) had partial response (cPR), 1 (2 %) stable disease (cSD), 15 (24 %) had disease progression (cPD).</div><div>In the whole population, cPR/SD and cPD were associated with reduced PFS (<em>p</em> &lt; 0.001) and overall survival (OS) (p &lt; 0.001), p16 expression was associated with improved PFS (p &lt; 0.001) and OS (<em>p</em> = 0.001).</div><div>Among patients with clinical residual disease after CRT, 23 patients undergoing surgery experienced improved PFS (<em>p</em> = 0.003) and OS (p = 0.003) compared to those receiving other treatments.</div><div>Eight (35 %) patients experienced severe (grade ≥ III) postoperative complications; vulvar and groin wound dehiscence/infection were the most common complications; one (4 %) patient died in the postoperative. Patients with pathological residual disease experienced worse PFS (<em>p</em> = 0.013) and OS (<em>p</em> = 0.034).</div></div><div><h3>Conclusions</h3><div>Clinical response to CRT and p16 expression strongly predict survival in LAVC. Surgery for residual disease might be associated with improved survival but is burdened by high rates of complications. Pathologic residual disease correlates with high recurrence rates and poor survival.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442529","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":"Immunological impact of intraperitoneal and intravenous chemotherapy in ovarian cancer, translational analyses of the Phase 3 iPocc trial","authors":"Aiko Ogasawara ,&nbsp;Hirokazu Matsushita ,&nbsp;Tuan Zea Tan ,&nbsp;Daisuke Shintani ,&nbsp;Jieru Ye ,&nbsp;Shoji Nagao ,&nbsp;Ayako Demachi-Okamura ,&nbsp;Daisuke Muraoka ,&nbsp;Yukari Kobayashi ,&nbsp;Kazuhiro Kakimi ,&nbsp;Rui Yamaguchi ,&nbsp;Keitaro Matsuo ,&nbsp;Kouji Yamamoto ,&nbsp;Keiichi Fujiwara ,&nbsp;Ruby Yun-Ju Huang ,&nbsp;David Shao Peng Tan ,&nbsp;Kosei Hasegawa","doi":"10.1016/j.ygyno.2024.09.023","DOIUrl":"10.1016/j.ygyno.2024.09.023","url":null,"abstract":"<div><h3>Background</h3><div>The iPocc trial, a randomized, global phase 3 study that compared intraperitoneal (IP) and intravenous (IV) carboplatin with dose-dense paclitaxel chemotherapy in epithelial ovarian cancer (EOC) patients, demonstrated improved progression-free survival in patients who received IP chemotherapy. The present study aimed to investigate the role of preexisting tumor immunity in the clinical outcomes of patients receiving IP chemotherapy.</div></div><div><h3>Methods</h3><div>This study involved analyzing patient data from the iPocc trial, selectively of those whose tumor specimens were preserved at the time of primary surgery. A total of 116 cases ((IP; <em>n</em> = 59), (IV; <em>n</em> = 57)) were subjected to microarray analysis. Single-sample gene set enrichment analyses were performed to evaluate the tumor immune microenvironment.</div></div><div><h3>Results</h3><div>Patients with enhanced tumor infiltration of T cells, natural killer (NK) cells, and cytotoxic lymphocytes in the IP group had a longer overall survival (OS) than those in the IV group, but not in the group with low infiltration. IP therapy improved the OS of patients with high expression of immune-related genes such as CD8A and FOXP3. In patients' subdivided into “immune Hot” and “immune Cold” groups based on hierarchical clustering analysis using four parameters representing “Innate immunity,” “T cells,” “IFNG response” and “Inhibitory molecules,” IP therapy significantly improved prognosis in the “immune Hot” group, but not in the “immune Cold” group compared to that of IV therapy.</div></div><div><h3>Conclusions</h3><div>IP chemotherapy enhances the survival rates of patients with EOC with an immune-Hot phenotype in the tumor microenvironment prior to treatment.</div><div>(Japan Registry of Clinical Trials number, jRCTs031180141.)</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442530","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":"Comparative analysis of hormonal therapy in low-grade endometrial stromal sarcoma: A retrospective study","authors":"Reem Saab ,&nbsp;Bryan M. Fellman ,&nbsp;Alejandra Flores Legarreta ,&nbsp;Larissa A. Meyer ,&nbsp;Nicole D. Fleming ,&nbsp;Ravin Ratan ,&nbsp;Elise F. Nassif Haddad ,&nbsp;Michael Frumovitz ,&nbsp;Pamela T. Soliman","doi":"10.1016/j.ygyno.2024.10.008","DOIUrl":"10.1016/j.ygyno.2024.10.008","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the disease course of patients with low grade endometrial stromal sarcoma (LG-ESS) and compare oncologic outcomes associated with hormonal therapy in primary and recurrent disease.</div></div><div><h3>Methods</h3><div>This is a retrospective study of patients with LG-ESS who underwent active treatment between January 2000 and July 2023. Recurrence-free survival (RFS) and overall survival (OS) were estimated using the Kaplan-Meier product-limit estimator and modeled via Cox proportional hazards regression.</div></div><div><h3>Results</h3><div>A total of 221 patients were included; 58 % of patients (91/157) were stage I, 12 % (19/157) stage II, 13 % (20/157) stage III, and 17 % (27/157) stage IV. Surgery was the primary treatment for 98 % (213/218). Only 79 patients received hormonal adjuvant therapy, 58 % (46/79) Megace, 24 % (19/79) Letrozole, and 18 % (14/79) received other hormonal therapy. There was no significant difference in RFS (<em>p</em> = 0.159) and OS (<em>p</em> = 0.167) between patients receiving Megace versus Letrozole as adjuvant therapy. At first recurrence, patients given Megace had a similar RFS to those on Letrozole (<em>p</em> = 0.302), but a better OS (27 vs 10 months, <em>p</em> = 0.018).  Negative status of estrogen, smooth muscle actin, and desmin were associated with lower RFS (<em>p</em> = 0.039, <em>p</em> = 0.002, and <em>p</em> = 0.015, respectively) and OS (<em>p</em> = 0.008, <em>p</em> = 0.012, and <em>p</em> = 0.013, respectively). Lymphovascular invasion was associated with lower RFS (<em>p</em> = 0.033), and negative status of progesterone was associated with lower OS (<em>p</em> = 0.003).</div></div><div><h3>Conclusion</h3><div>There was no difference in oncologic outcomes between Megace and Letrozole in patients who received adjuvant therapy for LG-ESS. Megace may have potential survival advantage in recurrent disease. Further study is warranted to determine the most effective agents and their sequence in the treatment of LG-ESS.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419819","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":"LGBTQIA+ populations still neglected in trials and their health needs","authors":"Gianluca Azzellino ,&nbsp;Lia Ginaldi ,&nbsp;Massimo De Martinis","doi":"10.1016/j.ygyno.2024.10.002","DOIUrl":"10.1016/j.ygyno.2024.10.002","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400037","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":"Tirzepatide as an innovative treatment strategy in a pre-clinical model of obesity-driven endometrial cancer","authors":"Weimin Kong ,&nbsp;Boer Deng ,&nbsp;Xiaochang Shen ,&nbsp;Catherine John ,&nbsp;Jennifer Haag ,&nbsp;Nikita Sinha ,&nbsp;Douglas Lee ,&nbsp;Wenchuan Sun ,&nbsp;Shuning Chen ,&nbsp;Haomeng Zhang ,&nbsp;Angela Clontz ,&nbsp;Stephen D. Hursting ,&nbsp;Chunxiao Zhou ,&nbsp;Victoria Bae-Jump","doi":"10.1016/j.ygyno.2024.10.004","DOIUrl":"10.1016/j.ygyno.2024.10.004","url":null,"abstract":"<div><h3>Objective</h3><div>Interventions that combat obesity and its associated metabolic perturbations may decrease incidence and improve outcomes of endometrial cancer (EC). Potential options for weight loss include pharmacotherapeutic interventions such as tirzepatide, a dual-acting glucagon-like peptide 1 (GLP-1) and gastric inhibitory polypeptide (GIP) receptor agonist. Given this, we explored the anti-obesity and anti-tumorigenic effects of tirzepatide in our pre-clinical mouse model of endometrioid EC.</div></div><div><h3>Methods</h3><div>Starting at 4 weeks of age, <em>Lkb1</em>^{<em>fl/fl</em>}<em>p53</em>^{<em>fl/fl</em>} mice were fed a low-fat diet vs a high-fat diet to generate a lean or obese phenotype. Nine weeks after induction of EC, obese and lean mice were randomized to receive tirzepatide for 4 weeks. Body and tumor weights, tumor transcriptomic and metabolomic profiles, and serum metabolic markers and chemokines were assessed.</div></div><div><h3>Results</h3><div>Both obese and lean mice began to lose body weight after 2 weeks of tirzepatide treatment, ultimately achieving a significant weight loss of 20.1 % in obese mice and 16.8 % in lean mice. Tirzepatide improved obesity-induced serum adiponectin, leptin, GIP, and C-reactive protein levels. Furthermore, tirzepatide relative to vehicle, effectively reduced tumor growth in obese and lean mice, inhibited the ErbB signaling and glycolysis/gluconeogenesis in tumors of obese mice, and increased O-linked glycosylation biosynthesis and phospholipase D signaling in tumors of lean mice.</div></div><div><h3>Conclusion</h3><div>Tirzepatide decreased both mouse weight and tumor growth via effects on metabolic and immune pathways in the EC tumors that differed between obese and lean mice. This novel weight loss treatment deserves further evaluation as an innovative strategy in the management of EC.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400038","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":"Prediction of non-resectability in tubo-ovarian cancer patients using Peritoneal Cancer Index – A prospective multicentric study using imaging (ISAAC study)","authors":"Patrícia Pinto ,&nbsp;Francesca Moro ,&nbsp;Juan Luis Alcázar ,&nbsp;Sarah Alessi ,&nbsp;Giacomo Avesani ,&nbsp;Klára Benesova ,&nbsp;Andrea Burgetova ,&nbsp;Giuseppina Calareso ,&nbsp;Valentina Chiappa ,&nbsp;David Cibula ,&nbsp;Anna Fagotti ,&nbsp;Dorella Franchi ,&nbsp;Filip Frühauf ,&nbsp;Jiri Jarkovsky ,&nbsp;Roman Kocian ,&nbsp;Lukas Lambert ,&nbsp;Martin Masek ,&nbsp;Camilla Panico ,&nbsp;Paola Pricolo ,&nbsp;Giovanni Scambia ,&nbsp;Daniela Fischerová","doi":"10.1016/j.ygyno.2024.10.003","DOIUrl":"10.1016/j.ygyno.2024.10.003","url":null,"abstract":"<div><h3>Background</h3><div>The aim was to evaluate the performance of the Peritoneal Cancer Index (PCI) using imaging (ultrasound, contrast-enhanced computed tomography (CT), and whole-body diffusion-weighted magnetic resonance imaging (WB-DWI/MRI) in assessing peritoneal carcinomatosis and predicting non-resectability in tubo-ovarian carcinoma patients.</div></div><div><h3>Methods</h3><div>This was a prospective multicenter observational study. We considered all patients with suspected primary ovarian/tubal/peritoneal cancer who underwent preoperative ultrasound, CT, and WB-DWI/MRI (if available). The optimal cut off value for assessing the performance of the methods in predicting non-resectability was identified at the point at which the sensitivity and specificity were most similar. The reference standard to predict non-resectability was surgical outcome in terms of residual disease &gt;1 cm or surgery not feasible. Agreement between imaging methods and surgical exploration in assessing sites included in the PCI score was evaluated using the Intraclass Correlation Coefficient (ICC).</div></div><div><h3>Results</h3><div>242 patients were included from January 2020 until November 2022. The optimal PCI cut-off for predicting non-resectability for surgical exploration was &gt;12, which achieved the best AUC of 0.87, followed by ultrasound with a cut-off of &gt;10 and AUC of 0.81, WB-DWI/MRI with a cut-off of &gt;12 and AUC of 0.81, and CT with a cut-off of &gt;11 and AUC of 0.74. Using ICC, ultrasound had very high agreement (0.94) with surgical PCI, while CT and WB-DWI/MRI had high agreement (0.86 and 0.87, respectively).</div></div><div><h3>Conclusion</h3><div>Ultrasound performed by an expert operator had the best agreement with surgical findings compared to WB-DWI/MRI and CT in assessing radiological PCI. In predicting non-resectability, ultrasound was non-inferior to CT, while its non-inferiority to WB-DWI/MRI was not demonstrated.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406328","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":"Research funding disparity in uterine cancer: An analysis of funding and race in relation to the burden of disease","authors":"Arielle Katcher,&nbsp;Megan Gorman,&nbsp;Divya Gowthaman,&nbsp;Meaghan Coles,&nbsp;Lisa Dos Santos,&nbsp;Gary Goldberg,&nbsp;Dennis Yi-Shin Kuo,&nbsp;Andrew Menzin,&nbsp;Lauren Scanlon,&nbsp;Karin Shih,&nbsp;Joan Tymon-Rosario,&nbsp;Fidel Valea,&nbsp;Jill Whyte,&nbsp;Marina Frimer","doi":"10.1016/j.ygyno.2024.07.103","DOIUrl":"10.1016/j.ygyno.2024.07.103","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420273","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}