Gynecologic oncology最新文献

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CDO1 and CELF4 methylation assay as the dominant predictor of endometrial cancer: A cohort analysis across pre- and post-menopausal cohorts CDO1和CELF4甲基化检测作为子宫内膜癌的主要预测因子:绝经前和绝经后队列的队列分析
IF 4.1 2区 医学
Gynecologic oncology Pub Date : 2026-03-01 Epub Date: 2026-02-14 DOI: 10.1016/j.ygyno.2026.01.776
Xiuzhen Wang , Lang Zheng , Genhai Zhu , Shengtan Wang , Wei Li , Jun Liu , Haocheng Gao , Xiaohang Liu , Guifei Li , Lei Li , Lan Hong
{"title":"CDO1 and CELF4 methylation assay as the dominant predictor of endometrial cancer: A cohort analysis across pre- and post-menopausal cohorts","authors":"Xiuzhen Wang ,&nbsp;Lang Zheng ,&nbsp;Genhai Zhu ,&nbsp;Shengtan Wang ,&nbsp;Wei Li ,&nbsp;Jun Liu ,&nbsp;Haocheng Gao ,&nbsp;Xiaohang Liu ,&nbsp;Guifei Li ,&nbsp;Lei Li ,&nbsp;Lan Hong","doi":"10.1016/j.ygyno.2026.01.776","DOIUrl":"10.1016/j.ygyno.2026.01.776","url":null,"abstract":"<div><h3>Background</h3><div>The rising global incidence of endometrial cancer (EC) necessitates the development of non-invasive, accurate detection methods to improve early diagnosis and optimize referrals for hysteroscopy. This study evaluated the diagnostic and triage value of a CDO1 and CELF4 methylation (CISENDO) assay using cervical scrapings for EC detection, and its independent association with EC across menopausal statuses.</div></div><div><h3>Methods</h3><div>In this prospective cohort study, 573 participants for diagnostic hysteroscopy were enrolled, including 524 non-EC, 41 EC, and 8 endometrial intraepithelial neoplasia (EIN) cases. The diagnostic performance of the CISENDO assay, alone and combined with endometrial thickness (ET) measured by transvaginal ultrasound (TVS), was assessed. Analyses were stratified by menopausal status. Univariate and multivariate logistic regression identified independent EC predictors.</div></div><div><h3>Results</h3><div>The CISENDO assay demonstrated high discriminatory performance. In premenopausal women with EC, sensitivity was 89.7%, specificity 93.0%, and AUC 0.91. In postmenopausal women with EC, sensitivity was 91.7%, specificity 91.8%, and AUC 0.92. Combining CISENDO with ET increased sensitivity (96.6% premenopausal; 100% postmenopausal) but reduced specificity. Notably, 55.2% of premenopausal EC cases had ET &lt;11 mm but were CISENDO-positive, while 52.7% of non-EC postmenopausal women with ET ≥5 mm were CISENDO-negative. Multivariable analysis identified the CISENDO assay as the strongest independent predictor of EC (adjusted OR = 103.9 in premenopausal and 118.0 in postmenopausal women; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The non-invasive CDO1 and CELF4 methylation assay demonstrates high diagnostic accuracy for EC and represents a promising tool for non-invasive diagnosis and triage, particularly in women at high risk for EC and those with early-stage disease.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 82-92"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201438","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}
引用次数: 0
Risk of memory impairment in gynecologic cancer survivors in the Women's Health Initiative: Untangling effects of age, comorbidities, and cancer 妇女健康倡议中妇科癌症幸存者的记忆障碍风险:年龄、合并症和癌症的影响
IF 4.1 2区 医学
Gynecologic oncology Pub Date : 2026-03-01 Epub Date: 2026-01-26 DOI: 10.1016/j.ygyno.2026.01.006
Benjamin J. Matthews , Electra D. Paskett , Eric McLaughlin , Diane Von Ah , Rowan Chlebowski , Chloe M. Hery , Michael Pennell , Tracy Vannorsdall , Longjian Liu , Aladdin H. Shadyab , Kathy Pan , Stephanie L. Wethington
{"title":"Risk of memory impairment in gynecologic cancer survivors in the Women's Health Initiative: Untangling effects of age, comorbidities, and cancer","authors":"Benjamin J. Matthews ,&nbsp;Electra D. Paskett ,&nbsp;Eric McLaughlin ,&nbsp;Diane Von Ah ,&nbsp;Rowan Chlebowski ,&nbsp;Chloe M. Hery ,&nbsp;Michael Pennell ,&nbsp;Tracy Vannorsdall ,&nbsp;Longjian Liu ,&nbsp;Aladdin H. Shadyab ,&nbsp;Kathy Pan ,&nbsp;Stephanie L. Wethington","doi":"10.1016/j.ygyno.2026.01.006","DOIUrl":"10.1016/j.ygyno.2026.01.006","url":null,"abstract":"<div><h3>Objective</h3><div>To assess whether gynecologic cancer history predicts worsened self-reported memory outcomes, accounting for the interaction of age and comorbidities.</div></div><div><h3>Methods</h3><div>Nested case-control study of cancer survivors enrolled in the ancillary Life and Longevity After Cancer (LILAC) study of the Women's Health Initiative (WHI) and matched cancer-free WHI participants, longitudinally followed after initial enrollment from 1993 to 1998. Postmenopausal women with incident endometrial or ovarian cancer during the WHI were compared to cancer-free women matched up to 5:1 to survivors. Participants with pre-existing cognitive dysfunction, neurodegenerative disease, or multiple cancers were excluded. The primary outcome was self-reported “moderate/severe memory problems” ≥12 months following cancer diagnosis of the index survivor. Associations of pre-diagnosis conditions with later memory problems were examined through cause-specific hazards models, accounting for competing mortality risk.</div></div><div><h3>Results</h3><div>Primary analyses included 1395 survivors and 5364 cancer-free controls. In multivariable analysis, cancer history was associated with decreased self-reported memory problems (cause-specific hazard ratio [csHR] 0.71 [0.57–0.87], <em>p</em> = 0.001). The only factors independently predictive of future memory concerns were increasing age (5-year increase; csHR 1.96 [1.84–2.09], <em>p</em> &lt; 0.001), cardiovascular disease (hypertension csHR 1.24 [1.03–1.50]; major cardiovascular events csHR 1.85 [1.28–2.68], <em>p</em> = 0.002), diabetes (csHR 1.47 [1.10–1.96], <em>p</em> = 0.01), and depression (csHR 1.47 [1.11–1.95], <em>p</em> = 0.008).</div></div><div><h3>Conclusions</h3><div>After accounting for mortality differences, gynecologic cancer survivors experienced reduced hazard for self-reported moderate/severe memory problems. In this population, significant memory symptoms may represent aging and comorbidity effects more than cancer-related outcomes.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 1-8"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146045261","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}
引用次数: 0
Pre-operative cross-sectional imaging of chest, abdomen, pelvis is not cost-effective for low-grade endometrial cancer 术前胸部、腹部、骨盆的横断成像对于低级别子宫内膜癌来说是不划算的。
IF 4.1 2区 医学
Gynecologic oncology Pub Date : 2026-03-01 Epub Date: 2026-02-18 DOI: 10.1016/j.ygyno.2026.02.001
Isabel Beshar MD MPhil , Arian Khorshid MD , Sahana Somasegar MD, MS , L’Oréal Kennedy MD, DNP , Danielle Blemur MD , Lauren Tostrud MD , Amer Karam MD
{"title":"Pre-operative cross-sectional imaging of chest, abdomen, pelvis is not cost-effective for low-grade endometrial cancer","authors":"Isabel Beshar MD MPhil ,&nbsp;Arian Khorshid MD ,&nbsp;Sahana Somasegar MD, MS ,&nbsp;L’Oréal Kennedy MD, DNP ,&nbsp;Danielle Blemur MD ,&nbsp;Lauren Tostrud MD ,&nbsp;Amer Karam MD","doi":"10.1016/j.ygyno.2026.02.001","DOIUrl":"10.1016/j.ygyno.2026.02.001","url":null,"abstract":"<div><h3>Objective</h3><div>Increasing numbers of patients are presenting with metastatic burden of endometrial cancer. Currently, guidelines recommend that pre-operative imaging for surgical planning be guided by patient symptoms, risk assessment, and clinical suspicion for disease. Cross-sectional computerized tomography (CT) imaging is not recommended for low-grade disease due to the low risk of distant spread in this group; however, longitudinal data has demonstrated a marked increase in the utilization of preoperative CT imaging in this patient population over the last decade.</div></div><div><h3>Methods</h3><div>In this cost-effectiveness analysis, a decision analytic model was made to compare the utility of pre-operative CT imaging versus standard-of-care transvaginal ultrasound (TVUS) in low-risk patients with presumed grade 1–2 endometrioid endometrial cancer. Costs adjusted for 2025 $USD healthcare perspective and quality-adjusted life years (QALY) were inputted into the model. A probabilistic sensitivity analysis (PSA) nested within a Monte Carlo simulation was used to assess outcomes over 5-years.</div></div><div><h3>Results</h3><div>The mean cost in the CT imaging arm was marginally increased compared to undergoing care in the TVUS arm: $41,462 (95% CI $41,407-41,517) versus $40,144 (95% CI $40,104-40,184). In addition, CT imaging had nominally lower quality of life (3.92 QALY versus 4.05 QALY). Overall, foregoing CT imaging results in a higher incremental net monetary benefit ($14,716) compared to performing CT imaging.</div></div><div><h3>Conclusion</h3><div>Routine addition of CT imaging for pre-operative evaluation in low-risk endometrial cancer does not represent a value-based use of healthcare resources.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 93-98"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226571","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}
引用次数: 0
Granulosa cell tumors: Initial surgical approach and recurrence 颗粒细胞瘤:最初的手术入路和复发
IF 4.1 2区 医学
Gynecologic oncology Pub Date : 2026-03-01 Epub Date: 2026-01-27 DOI: 10.1016/j.ygyno.2025.12.012
Erin Dwyer , L’Oreal Kennedy , Danika Bethune , Ronit Katz , Barbara Goff
{"title":"Granulosa cell tumors: Initial surgical approach and recurrence","authors":"Erin Dwyer ,&nbsp;L’Oreal Kennedy ,&nbsp;Danika Bethune ,&nbsp;Ronit Katz ,&nbsp;Barbara Goff","doi":"10.1016/j.ygyno.2025.12.012","DOIUrl":"10.1016/j.ygyno.2025.12.012","url":null,"abstract":"<div><div>Objective: Granulosa cell tumors account for 3–5% of ovarian cancers with a risk of recurrence of 10–25% in those with stage I disease. Our objective was to evaluate clinical factors associated with disease recurrence, with special attention to the role of initial surgical approach (minimally invasive vs. open abdominal) in recurrence risk.</div><div>Methods: All patients treated for GCT at University of Washington between 1980 and 2020 were included in the study. Retrospective review of demographic, medical/family/history, treatment and recurrence was performed. Descriptive statistical analysis of clinical and pathologic features, Kaplan-Meier curves, and Cox proportional hazards regression were performed.</div><div>Results: 174 patients were evaluated and 62 were eliminated due to incomplete data. 112 patients were included in the analysis sample with a median follow up time of 126 months (range 12–482 months) and median age of 46 years (IQR 37–55). Stage at diagnosis was primarily IA or IC. Surgical approach was open in 59% (<em>N</em> = 66), laparoscopic in 34% (<em>N</em> = 38), and robotic in 5% (<em>N</em> = 5) of patients. Tumor rupture was more common among the minimally invasive surgical approaches, compared to an open approach. Stage, need for adjuvant chemotherapy, and tumor rupture were associated with an increased risk of recurrence during the follow up period. Among patients with tumor rupture, 55% of patients had a recurrence event during the follow up period.</div><div>Conclusion: Tumor rupture at the time of surgery is a significant risk factor for recurrence. There is a higher risk of tumor rupture with minimally invasive surgery. Care should be taken to avoid iatrogenic tumor rupture.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 9-14"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076708","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}
引用次数: 0
Clear cell carcinoma of cervix and vagina: A review of 63 cases in the post-DES era 后des时代63例宫颈阴道透明细胞癌回顾性分析。
IF 4.1 2区 医学
Gynecologic oncology Pub Date : 2026-03-01 Epub Date: 2026-02-05 DOI: 10.1016/j.ygyno.2026.01.773
Reem Saab, Alejandra Brazan, Gary B. Chisholm, Naomi R. Gonzales, Michael Frumovitz, Pamela T. Soliman
{"title":"Clear cell carcinoma of cervix and vagina: A review of 63 cases in the post-DES era","authors":"Reem Saab,&nbsp;Alejandra Brazan,&nbsp;Gary B. Chisholm,&nbsp;Naomi R. Gonzales,&nbsp;Michael Frumovitz,&nbsp;Pamela T. Soliman","doi":"10.1016/j.ygyno.2026.01.773","DOIUrl":"10.1016/j.ygyno.2026.01.773","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the clinical characteristics and oncologic outcomes of cervical and vaginal clear cell carcinoma (cCCC, vCCC) in the post-DES era.</div></div><div><h3>Methods</h3><div>This is a retrospective cross-sectional study of patients diagnosed with cCCC and vCCC between 2000 and 2024. Cervical cancer was staged using the International Federation of Gynecology and Obstetrics (FIGO) 2018 system and categorized as early stage (IA1-IB2, IIA1), locally advanced (IB3, IIA2-IVA) and advanced (IVB). Overall survival (OS) and recurrence-free survival (RFS) were estimated with the Kaplan-Meier product-limit estimator and modeled via Cox proportional hazards regression.</div></div><div><h3>Results</h3><div>A total of 63 patients were included: 51 cervical and 12 vaginal. Among cCCC, recurrence occurred in 21 patients (41.2%), with a median OS of 12.96 years (95% CI 8.83, 15.5). Early-stage disease was associated with a higher OS (<em>p</em>-value = 0.01) and RFS (p-value = 0.00049) compared to locally advanced and advanced disease. Lymph node metastasis was associated with poor OS (<em>p</em>-value = 0.0001) and RFS (p-value = 0.0113). In the vCCC group, recurrence was identified in 10 patients (83.3%), with a median OS of 3.26 years (95% CI 0.77, 6.75). Compared to cCCC, vCCC had worse prognosis with lower OS (<em>p</em>-value = 0.0009) and RFS (p-value = 0.0029).</div></div><div><h3>Conclusion</h3><div>Patients with cCCC have more favorable outcomes than those with vCCC, with stage and lymph node metastasis serving as predictors of survival outcomes in cCCC.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 39-44"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131691","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}
引用次数: 0
Biomarker heterogeneity and efficacy of durvalumab plus carboplatin/paclitaxel followed by durvalumab with or without olaparib in patients with mismatch repair proficient endometrial cancer: exploratory analyses of the DUO-E/GOG-3041/ENGOT-EN10 trial 杜伐单抗加卡铂/紫杉醇后再加或不加奥拉帕尼治疗错配修复精通的子宫内膜癌患者的生物标志物异质性和疗效:DUO- E/GOG-3041/ENGOT-EN10试验的探索性分析
IF 4.1 2区 医学
Gynecologic oncology Pub Date : 2026-03-01 Epub Date: 2026-02-13 DOI: 10.1016/j.ygyno.2026.01.777
Shannon N. Westin , Kathleen Moore , Hye Sook Chon , Jessica Thomes Pepin , Erin A. Salinas , David Starks , Paul A. Disilvestro , Brian Slomovitz , Elen Vettus , Fernando Gálvez-Montosa , Kofi Agyemang-Prempeh , Flora Zagouri , Jae-Weon Kim , Qinglei Gao , Fernando Contreras Mejia , Andreia Cristina De Melo , Tadaaki Nishikawa , Matthew Kowgier , Sonia Iyer , Ying Wang , Els Van Nieuwenhuysen
{"title":"Biomarker heterogeneity and efficacy of durvalumab plus carboplatin/paclitaxel followed by durvalumab with or without olaparib in patients with mismatch repair proficient endometrial cancer: exploratory analyses of the DUO-E/GOG-3041/ENGOT-EN10 trial","authors":"Shannon N. Westin ,&nbsp;Kathleen Moore ,&nbsp;Hye Sook Chon ,&nbsp;Jessica Thomes Pepin ,&nbsp;Erin A. Salinas ,&nbsp;David Starks ,&nbsp;Paul A. Disilvestro ,&nbsp;Brian Slomovitz ,&nbsp;Elen Vettus ,&nbsp;Fernando Gálvez-Montosa ,&nbsp;Kofi Agyemang-Prempeh ,&nbsp;Flora Zagouri ,&nbsp;Jae-Weon Kim ,&nbsp;Qinglei Gao ,&nbsp;Fernando Contreras Mejia ,&nbsp;Andreia Cristina De Melo ,&nbsp;Tadaaki Nishikawa ,&nbsp;Matthew Kowgier ,&nbsp;Sonia Iyer ,&nbsp;Ying Wang ,&nbsp;Els Van Nieuwenhuysen","doi":"10.1016/j.ygyno.2026.01.777","DOIUrl":"10.1016/j.ygyno.2026.01.777","url":null,"abstract":"<div><h3>Objective</h3><div>The phase 3 DUO-E trial demonstrated statistically significant progression-free survival (PFS) benefit with carboplatin/paclitaxel plus durvalumab followed by durvalumab with/without olaparib maintenance versus carboplatin/paclitaxel alone in advanced/recurrent endometrial cancer. We report exploratory analyses of key biomarkers and histology in the mismatch repair proficient (pMMR) subpopulation.</div></div><div><h3>Methods</h3><div>Patients were randomised 1:1:1 to carboplatin/paclitaxel (control arm), carboplatin/paclitaxel plus durvalumab followed by durvalumab (durvalumab arm) or carboplatin/paclitaxel plus durvalumab followed by durvalumab plus olaparib (durvalumab + olaparib arm). The presence of and relationship between selected biomarkers and histology, and PFS were investigated in the pMMR subpopulation.</div></div><div><h3>Results</h3><div>Biomarkers of interest (programmed death-ligand 1 [PD-L1] expression and mutations in <em>BRCA</em>1/<em>BRCA</em>2 genes, homologous recombination repair genes, DNA polymerase epsilon and tumour protein 53 [<em>TP53</em>m]) were evaluable in 486/575 patients in the pMMR subpopulation, with 84% (<em>n</em> = 407) positive for ≥ 1 biomarker; PD-L1 positive (67%) and <em>TP53</em>m (59%) were the most prevalent biomarkers. In the biomarker-known subpopulation, 52% and 27% of patients had tumours of endometrioid and serous histology, respectively. In exploratory analyses, PFS hazard ratios were improved versus control for both treatment arms across multiple biomarker and histology known subgroups, and favoured the durvalumab + olaparib arm in the majority of assessed biomarker/histological subgroups.</div></div><div><h3>Conclusions</h3><div>The DUO-E pMMR subpopulation was highly heterogeneous with frequent overlap of biomarkers and histology. Consistent with the primary analysis, durvalumab plus olaparib improved the PFS benefit observed with durvalumab versus control across a range of biomarker and histological subgroups.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 54-64"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197607","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}
引用次数: 0
Lifetime ovulations and endometrial cancer risk: A systematic review and meta-analysis 终生排卵与子宫内膜癌风险:系统回顾和荟萃分析。
IF 4.1 2区 医学
Gynecologic oncology Pub Date : 2026-03-01 Epub Date: 2026-02-20 DOI: 10.1016/j.ygyno.2026.02.006
Niki Talebian , Mahdi Falah Tafti , Sogol Alikarami , Francesmary Modugno
{"title":"Lifetime ovulations and endometrial cancer risk: A systematic review and meta-analysis","authors":"Niki Talebian ,&nbsp;Mahdi Falah Tafti ,&nbsp;Sogol Alikarami ,&nbsp;Francesmary Modugno","doi":"10.1016/j.ygyno.2026.02.006","DOIUrl":"10.1016/j.ygyno.2026.02.006","url":null,"abstract":"<div><h3>Background</h3><div>Lifetime ovulatory years (LOY) estimate the period women are exposed to gonadal hormones in their reproductive life. Research on the relationship between endometrial cancer (EC) and lifetime ovulations is limited. This study investigates the association between LOY and EC risk.</div></div><div><h3>Methods</h3><div>Scopus, PubMed/MEDLINE, and Embase were systematically searched through February 8, 2026, to identify studies reporting the association between lifetime ovulations and EC risk. Two independent reviewers screened the records for eligibility, performed quality assessment, and extracted the relevant data, with disagreements resolved by a third senior reviewer. The pooled effect estimate with a 95% confidence interval was calculated using the random-effects and the meta-regression models.</div></div><div><h3>Results</h3><div>Eleven articles were included in the meta-analysis, of which 6 reported odds ratios, 3 reported hazard ratios, 1 reported incidence rate ratios, and 1 reported risk ratios. Two studies reporting LOY as a continuous variable were included only in the qualitative review. Higher LOY was associated with increased risk of EC with a pooled effect estimate of 2.73 (95% CI: 2.00–3.71). Women with the highest LOY had 2.07 times the odds of EC than women with the lowest LOY (95% CI: 1.50–2.85). Moreover, the pooled hazard ratio was 5.27 (95% CI: 3.43–8.10). Leave-one-out analysis did not significantly change the pooled estimates.</div></div><div><h3>Conclusions</h3><div>LOY is a risk factor for EC. Further studies with a standard definition of LOY are necessary to assess its association with EC risk more precisely.</div><div>PROSPERO Registration: 13 September 2025, CRD420251146449.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 106-116"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776303","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}
引用次数: 0
Survival outcomes and time toxicity of Sandwich versus Sequential chemoradiation in Stage III endometrial cancer: A real-world study stratified by molecular classification 三明治与序贯放化疗在III期子宫内膜癌中的生存结果和时间毒性:一项按分子分类分层的现实世界研究。
IF 4.1 2区 医学
Gynecologic oncology Pub Date : 2026-03-01 Epub Date: 2026-02-23 DOI: 10.1016/j.ygyno.2026.02.007
Kuang-Yen Lee , Tzu-Hsin Tseng , Wen-Chun Chang , Yi-Jou Tai , Chin-Jui Wu , Ying-Cheng Chiang , Lin-Hung Wei , Bor-Ching Sheu
{"title":"Survival outcomes and time toxicity of Sandwich versus Sequential chemoradiation in Stage III endometrial cancer: A real-world study stratified by molecular classification","authors":"Kuang-Yen Lee ,&nbsp;Tzu-Hsin Tseng ,&nbsp;Wen-Chun Chang ,&nbsp;Yi-Jou Tai ,&nbsp;Chin-Jui Wu ,&nbsp;Ying-Cheng Chiang ,&nbsp;Lin-Hung Wei ,&nbsp;Bor-Ching Sheu","doi":"10.1016/j.ygyno.2026.02.007","DOIUrl":"10.1016/j.ygyno.2026.02.007","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the survival outcomes of Sandwich (Chemo-RT-Chemo) versus Sequential (Chemo-RT) therapy in Stage III endometrial cancer, focusing on the interplay between treatment intervals, time toxicity, and molecular classification.</div></div><div><h3>Methods</h3><div>We analyzed 119 patients with Stage III EC (2015–2025) receiving either Sequential (<em>n</em> = 42) or Sandwich (<em>n</em> = 77) regimens. Endpoints included overall survival (OS), progression-free survival (PFS), relative dose intensity (RDI), and overall treatment time (OTT). Outcomes were stratified by p53 and MMR status.</div></div><div><h3>Results</h3><div>Among 119 patients (42 Sequential, 77 Sandwich) with well-balanced characteristics, no significant differences were observed in OS (<em>P</em> = .73) or PFS (<em>P</em> = .93). However, subgroup analysis favored the Sandwich regimen in pMMR tumors (PFS benefit, <em>P</em> = .026) and p53-mutant tumors (improved time-to-recurrence, <em>P</em> = .034). Regarding time toxicity, the Sandwich cohort demonstrated significantly shorter median overall treatment time (198.0 vs. 223.0 days; <em>P</em> &lt; .001) and earlier radiotherapy initiation (77.0 vs. 171.5 days; P &lt; .001). Chemotherapy dose intensity remained comparable (<em>P</em> = .878). While low-grade diarrhea was more frequent in the Sandwich arm (43% vs. 21%; <em>P</em> = .027), grade≧3 adverse events were rare and similar between groups.</div></div><div><h3>Conclusions</h3><div>The Sandwich regimen offers a dual advantage: it reduces patient time toxicity and ensures earlier pelvic control without sacrificing chemotherapy intensity. This optimized temporal sequencing appears particularly beneficial for high-risk molecular subtypes (p53-mutant/pMMR) and supports the paradigm of molecular-directed adjuvant therapy.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 117-124"},"PeriodicalIF":4.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283505","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}
引用次数: 0
Ready, Set, GYO: Lessons learned from a fellow-developed podcast in gynecologic oncology 准备,准备,GYO:从妇科肿瘤学的一个同伴开发的播客中学到的教训
IF 4.1 2区 医学
Gynecologic oncology Pub Date : 2026-02-01 Epub Date: 2026-02-14 DOI: 10.1016/j.ygyno.2026.01.211
Maya Gross , Skye Jacobson , Bunja Rungruang , Kilee Knight , Sydney Oesch
{"title":"Ready, Set, GYO: Lessons learned from a fellow-developed podcast in gynecologic oncology","authors":"Maya Gross ,&nbsp;Skye Jacobson ,&nbsp;Bunja Rungruang ,&nbsp;Kilee Knight ,&nbsp;Sydney Oesch","doi":"10.1016/j.ygyno.2026.01.211","DOIUrl":"10.1016/j.ygyno.2026.01.211","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"205 ","pages":"Page S19"},"PeriodicalIF":4.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146185086","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}
引用次数: 0
Oxidative DNA damage as a predictive biomarker for recurrence and survival in high-grade serous ovarian cancer 氧化DNA损伤作为高级别浆液性卵巢癌复发和生存的预测性生物标志物
IF 4.1 2区 医学
Gynecologic oncology Pub Date : 2026-02-01 Epub Date: 2026-02-14 DOI: 10.1016/j.ygyno.2026.01.207
Carson Edwards , Dhruva Dave , Rebecca Arend , Valeria Dal Zotto , Natalie Gassman
{"title":"Oxidative DNA damage as a predictive biomarker for recurrence and survival in high-grade serous ovarian cancer","authors":"Carson Edwards ,&nbsp;Dhruva Dave ,&nbsp;Rebecca Arend ,&nbsp;Valeria Dal Zotto ,&nbsp;Natalie Gassman","doi":"10.1016/j.ygyno.2026.01.207","DOIUrl":"10.1016/j.ygyno.2026.01.207","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"205 ","pages":"Page S17"},"PeriodicalIF":4.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146185087","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}
引用次数: 0
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