Gynecologic oncology最新文献

{"title":"A phase 2 trial of niraparib plus bevacizumab maintenance therapy following first-line platinum-based chemotherapy with bevacizumab in advanced ovarian cancer: final analysis and overall survival results from OVARIO","authors":"Melissa M. Hardesty ,&nbsp;Thomas C. Krivak ,&nbsp;Gail S. Wright ,&nbsp;Erika Hamilton ,&nbsp;Evelyn L. Fleming ,&nbsp;Jimmy Belotte ,&nbsp;Shelby Gorman ,&nbsp;Natalie Compton ,&nbsp;Aine Clements ,&nbsp;Heidi J. Gray ,&nbsp;Gottfried E. Konecny ,&nbsp;Richard G. Moore ,&nbsp;Debra L. Richardson","doi":"10.1016/j.ygyno.2025.06.014","DOIUrl":"10.1016/j.ygyno.2025.06.014","url":null,"abstract":"<div><h3>Objective</h3><div>To report long-term outcomes from the OVARIO trial of niraparib plus bevacizumab maintenance following first-line platinum-based chemotherapy with bevacizumab in advanced ovarian cancer.</div></div><div><h3>Methods</h3><div>The phase 2, single-arm, open-label trial enrolled adult patients with stage IIIB–IV epithelial ovarian, fallopian tube, or primary peritoneal cancer (<span><span>NCT03326193</span><svg><path></path></svg></span>). Patients were required to have attempted debulking surgery and have a complete or partial response or no evidence of disease following first-line, platinum-based chemotherapy with ≥3 cycles of bevacizumab. The primary endpoint was 18-month progression-free survival (PFS) rate, per RECIST. Secondary endpoints included PFS, overall survival (OS), safety, and health-related quality of life (HRQOL) as assessed by the Functional Assessment of Cancer Therapy–Ovarian Symptoms Index (FOSI). Final analysis cutoff date, August 12, 2024.</div></div><div><h3>Results</h3><div>The median duration of follow-up was 65.7 months. Among evaluable patients (<em>N</em> = 105), PFS results were consistent with the primary analysis. Median OS (95% CI) was 61.1 months (44.9 months–not evaluable [NE]; 52.4% maturity) in the overall population, NE (58.2 months–NE) in the homologous recombination-deficient, 38.7 months (21.9–63.8 months) in the homologous recombination-proficient, and 39.8 months (21.7 months–NE) in the homologous recombination status not determined subgroups. Most patients (73.3%) received subsequent anticancer therapy; 30.5% received subsequent PARP inhibitor therapy. No new safety signals were identified; safety remained consistent with the primary analysis. Per FOSI, HRQOL was not negatively affected.</div></div><div><h3>Conclusion</h3><div>In OVARIO, median OS was 61.1 months in the overall population. Safety was consistent with known safety profiles of niraparib and bevacizumab as monotherapies.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"199 ","pages":"Pages 96-102"},"PeriodicalIF":4.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523807","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":"Patient-reported outcomes from the phase 3, randomized, double-blind, placebo-controlled ENGOT-cx11/GOG-3047/KEYNOTE-A18 study of pembrolizumab plus concurrent chemoradiotherapy in participants with high-risk locally advanced cervical cancer","authors":"Leslie Randall ,&nbsp;Yang Xiang ,&nbsp;Takashi Matsumoto ,&nbsp;Diana Giannarelli ,&nbsp;Dency Pilar Milla ,&nbsp;Karla Alejandra Lopez ,&nbsp;Alejandro Acevedo ,&nbsp;Julia Vizkeleti ,&nbsp;Ritu Salani ,&nbsp;Angelica Nogueira-Rodrigues ,&nbsp;Fernando Contreras Mejia ,&nbsp;Jacob Korach ,&nbsp;Hüseyin Akilli ,&nbsp;Jung-Yun Lee ,&nbsp;Valeriya Vladimirovna Saevets ,&nbsp;Vanessa Samouelian ,&nbsp;Jalid Sehouli ,&nbsp;Ekkasit Tharavichikul ,&nbsp;Vladyslav Sukhin ,&nbsp;Nicoletta Colombo ,&nbsp;Domenica Lorusso","doi":"10.1016/j.ygyno.2025.06.003","DOIUrl":"10.1016/j.ygyno.2025.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>In ENGOT-cx11/GOG-3047/KEYNOTE-A18 (<span><span>NCT04221945</span><svg><path></path></svg></span>), pembrolizumab (vs placebo) + concurrent chemoradiotherapy (CCRT) followed by pembrolizumab (vs placebo) significantly improved progression-free survival and overall survival in participants with newly diagnosed, high-risk locally advanced cervical cancer (LACC). We report patient-reported outcomes (PROs) from the study.</div></div><div><h3>Methods</h3><div>Participants (≥18 years) with high-risk LACC (FIGO 2014 stage IB2–IIB with node-positive disease or stage III–IVA) were randomized 1:1 to 5 cycles of pembrolizumab 200 mg or placebo Q3W plus CCRT, followed by 15 cycles of pembrolizumab 400 mg or placebo Q6W. CCRT was 5 cycles (optional 6th dose) of cisplatin 40 mg/m² Q1W plus external beam radiotherapy followed by brachytherapy. Secondary PRO endpoints included EORTC QLQ-C30 GHS/QoL and physical functioning subscales and EORTC QLQ-CX24 symptom experience scale; EQ-5D-5L visual analogue scale (VAS) was an exploratory endpoint. No alpha was assigned to the PRO analyses.</div></div><div><h3>Results</h3><div>1008 (95.1 %) of 1060 randomized participants were included in the PRO full analysis set population. No meaningful between-group differences were observed for any of the prespecified PRO instruments. Between-group differences (95 % CIs) in least-squares mean score changes from baseline to week 36 (primary time point) were 0.57 (−2.34 to 3.49) for QLQ-C30 GHS/QoL, 0.64 (−1.54 to 2.82) for QLQ-C30 physical functioning, 0.54 (−1.02 to 2.09) for QLQ-CX24 symptom experience, and −0.55 (−2.97 to 1.86) for EQ-5D-5L VAS. Empirical mean score changes over time and the proportions of participants whose scores improved, remained stable, or deteriorated over time were similar between treatment arms.</div></div><div><h3>Conclusions</h3><div>Pembrolizumab+CCRT did not negatively impact participants' health-related quality of life.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"199 ","pages":"Pages 88-95"},"PeriodicalIF":4.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517515","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":"Oncologic and fertility outcomes of progestin therapy for atypical hyperplasia and grade 1 cancer of the endometrium: Results of a specialized oncofertility program","authors":"Oleksandra Dzyubak ,&nbsp;Karen Glass ,&nbsp;Megan Watts ,&nbsp;Oishika Tarafdar ,&nbsp;Andrea N. Simpson ,&nbsp;Manjula Maganti ,&nbsp;Shima Deljoomanesh ,&nbsp;Stephane Laframboise ,&nbsp;Marcus Q. Bernardini ,&nbsp;Sara Pakbaz ,&nbsp;Anjelica Hodgson ,&nbsp;Blaise Clarke ,&nbsp;Marjan Rouzbahman ,&nbsp;Tanya Chawla ,&nbsp;Tara Zad ,&nbsp;Soyoun Rachel Kim ,&nbsp;Sarah E. Ferguson","doi":"10.1016/j.ygyno.2025.06.015","DOIUrl":"10.1016/j.ygyno.2025.06.015","url":null,"abstract":"<div><h3>Objective</h3><div>This study describes the oncological and fertility outcomes of patients with atypical hyperplasia (AH) or low-grade endometrial cancer (EC) desiring fertility preservation, enrolled in a specialized oncofertility program.</div></div><div><h3>Methods</h3><div>Patients referred between 2019 and 2024 were reviewed. This novel program provides integrated oncologic and reproductive endocrinology and infertility (REI) care, following standardized treatment pathways. Enrollment criteria include: AH/EC grade 1 histology, p53 wild-type status, no myometrial invasion or extra-uterine disease, and desire to preserve fertility. Progestin intrauterine device was the main mode of treatment.</div></div><div><h3>Results</h3><div>Of 206 patients initially seen, 119 (58 %) had AH and 87 (42 %) had EC. 170 patients were eligible for progestin treatment. Complete response (CR) rate was 69 % (AH 74 %; EC 60 %). The median time to CR was 8.3 months (AH 7.4; EC 10.4). The probability of CR for the whole cohort at 24 months was 86.6 % (95 %CI, 77.4–92.0). The AH group had a significantly higher probability of CR compared to the EC group, 91.6 % (95 %CI, 79.4–96.6) vs 78.4 % (95 %CI 59.8–88.4); <em>p</em> = 0.02, respectively. Despite continuous endometrial protection with progestin, recurrence probability at 24 months after CR was 32.8 % (95 %CI, 20.0–43.6), with no significant difference between AH and EC (36 % vs 27 %, <em>p</em> = 0.28). Sixty-four patients attempted to conceive, and majority underwent assisted reproductive treatment (98 %). Overall, 36 (56 %) patients conceived and 22 of these pregnancies resulted in a live birth (34 %; 22/64).</div></div><div><h3>Conclusion</h3><div>Patients in a specialized oncofertility program had high rates of CR that continued up to 24 months suggesting that longer periods of treatment are feasible.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"199 ","pages":"Pages 72-78"},"PeriodicalIF":4.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514037","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":"NSGO-FANDANGO/ENGOT-EN1: A randomized phase II study of first-line combination chemotherapy with nintedanib/placebo in advanced/recurrent endometrial cancer","authors":"Kristina Lindemann ,&nbsp;Dominique Berton ,&nbsp;Jalid Sehouli ,&nbsp;René DePont Christensen ,&nbsp;Sevilay Altintas ,&nbsp;Anja Ør Knudsen ,&nbsp;Pierre-Etienne Heudel ,&nbsp;Beyhan Ataseven ,&nbsp;Ignace Vergote ,&nbsp;Gabriel Lindahl ,&nbsp;Coriolan Lebreton ,&nbsp;Fabienne Schochter ,&nbsp;Annika Auranen ,&nbsp;Philippe Follana ,&nbsp;Kristine Madsen ,&nbsp;Frédéric Selle ,&nbsp;Karen Stampe Petersson ,&nbsp;Florence Joly ,&nbsp;Elena Ioana Braicu ,&nbsp;Mansoor Raza Mirza","doi":"10.1016/j.ygyno.2025.06.008","DOIUrl":"10.1016/j.ygyno.2025.06.008","url":null,"abstract":"<div><h3>Objective</h3><div>Patients with advanced or recurrent endometrial cancer (EC) have poor prognosis despite treatment with combination chemotherapy. This study explored the preliminary efficacy of the potent oral tyrosine kinase inhibitor nintedanib (N), in addition to chemotherapy.</div></div><div><h3>Methods</h3><div>Patients with histologically confirmed stage FIGO 2009 stage IIIC2-IV or recurrent EC were randomized 1:1 to receive N 200 mg or placebo (P), twice daily days 2–21 during chemotherapy (six cycles of Carboplatin (AUC5) and paclitaxel (175 mg/m2) every 21 days (TC)) and in maintenance until disease progression, unacceptable toxicity, or withdrawal of consent. The primary endpoint was progression-free survival (PFS).</div></div><div><h3>Results</h3><div>Between November 30th, 2016, and January 11th, 2019 146 participants (mean age 66.1 years) were randomized and had received at least one dose of N/P: 72 patients to the N + TC arm and 74 to the P + TC arm. After median follow-up time of 43.9 months (95 % CI: 41.8–45.6), median PFS was 8.2 63 months (95 % CI: 5.77–10.27) in the N + TC arm and 7.1 months (95 % CI: 5.40–9.10) in the P + TC arm (HR 0.99, 95 % CI: 0.69–1.43, <em>p</em> = 0.992). There was no difference in median overall survival (OS) (HR 0.82; 96 % CI: 0.54–1.25, <em>p</em> = 0.365). Treatment-emergent grade 3–4 adverse events were higher in N + TC vs P + TC arm, in particular increase in blood alanine aminotransferase (18.1 % vs 4.1 %) and diarrhea (10.8 % and 1.3 %).</div></div><div><h3>Conclusions</h3><div>Addition of nintedanib to chemotherapy did not improve PFS nor OS. Phase III evaluation of this regimen is not recommended.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"199 ","pages":"Pages 79-87"},"PeriodicalIF":4.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514038","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":"Datopotamab deruxtecan, a novel TROP2-tareting antibody-drug conjugate with a topoisomerase I inhibitor payload, shows preclinical activity against primary and metastatic uterine and ovarian TROP2 over-expressing carcinosarcoma","authors":"Michelle Greenman ,&nbsp;Stefania Bellone ,&nbsp;Cem Demirkiran ,&nbsp;Tobias Max Philipp Hartwich ,&nbsp;Victoria M. Ettorre ,&nbsp;Blair McNamara ,&nbsp;Namrata Sethi ,&nbsp;Niccolo G. Santin ,&nbsp;Luca Palmieri ,&nbsp;Yang Yang-Hartwich ,&nbsp;Elena Ratner ,&nbsp;Alessandro D. Santin","doi":"10.1016/j.ygyno.2025.06.017","DOIUrl":"10.1016/j.ygyno.2025.06.017","url":null,"abstract":"<div><h3>Background</h3><div>Uterine and ovarian carcinosarcomas (CS) are rare gynecologic tumors with a high recurrence rate and poor prognosis. Datopotamab-deruxtecan (Dato-DXd) is a novel antibody-drug-conjugate (ADC) targeting TROP2. We evaluated the preclinical activity of Dato-DXd in vitro against primary and metastatic CS cell lines with various TROP2 expression and in vivo against CS xenografts in mice.</div></div><div><h3>Methods</h3><div>TROP2 expression was determined using flow-cytometry. Cells were treated with Dato-DXd and a control ADC (CTL ADC) to evaluate IC₅₀ values. Double-strand-DNA-breakage assay evaluated DNA damage while antibody-dependent-cell-cytotoxicity (ADCC) was evaluated using a 4-h chromium-release assay. Mice harboring CS xenografts were treated via retro-orbital Dato-DXd administration.</div></div><div><h3>Results</h3><div>TROP2 expressing CS cell lines were highly sensitive to killing induced by Dato-DXd<em>.</em> In contrast, low-expressing CS cell lines had no significant difference in cell cytotoxicity. Dato-DXd induced ADCC in the presence of peripheral blood lymphocytes from healthy donors. When TROP2-negative cells were admixed with TROP2-overexpressing cells, a significant bystander effect with Dato-DXd was appreciated. In vivo, mouse xenografts overexpressing TROP2 treated with Dato-DXd demonstrated tumor growth suppression and longer overall survival compared to CTL ADC-treated xenografts.</div></div><div><h3>Conclusions</h3><div>Dato-DXd is active against primary and metastatic uterine and ovarian CS overexpressing TROP2 in vitro and in vivo. Our preclinical results warrant future clinical trials for patients with advanced/recurrent gynecologic CS resistant to chemotherapy.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"199 ","pages":"Pages 64-71"},"PeriodicalIF":4.5,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501261","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":"Association between glucagon-like peptide-1 receptor agonists and ovarian cancer survival: A population-based cohort study","authors":"Min Wang ,&nbsp;Tong Dong ,&nbsp;Maria Lucero ,&nbsp;Wanchun Pan ,&nbsp;Xin Wang ,&nbsp;Ling Zhou ,&nbsp;Yuanguang Meng","doi":"10.1016/j.ygyno.2025.06.012","DOIUrl":"10.1016/j.ygyno.2025.06.012","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the association between glucagon-like peptide-1 receptor agonist (GLP-1RA) use and all-cause mortality in women with ovarian cancer, using real-world data from a global federated health database.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using the TriNetX global health records network. Female patients diagnosed with ovarian cancer between 2014 and 2023 were included. Patients were divided into two cohorts based on GLP-1RA exposure. A 1:1 propensity score matching was performed to balance demographics, comorbidities, medications, and cancer stage. Kaplan–Meier survival curves and Cox proportional hazards models were used to estimate overall survival. Subgroup and sensitivity analyses were performed.</div></div><div><h3>Results</h3><div>After matching, 1023 patients were included in each group. GLP-1RA users had a significantly lower all-cause mortality rate compared with non-users (7.94 % vs. 19.71 %; hazard ratio [HR], 0.45; 95 % confidence intervals [CI], 0.35–0.59; log-rank <em>P</em> &lt; 0.001). The survival benefit was consistent across most subgroups, including patients receiving chemotherapy or Poly(ADP-ribose) polymerase (PARP) inhibitors. No significant benefit was observed in patients with heart failure or chronic kidney disease. Sensitivity analysis supports the primary analysis.</div></div><div><h3>Conclusions</h3><div>Use of GLP-1RA was associated with substantially improved overall survival in women with ovarian cancer. Given their widespread clinical use and favorable safety profile, GLP-1RA may represent a promising adjunctive strategy for improving outcomes in women with ovarian cancer, particularly those with coexisting metabolic disorders. Further prospective studies are warranted.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"199 ","pages":"Pages 57-63"},"PeriodicalIF":4.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313467","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":"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}