Gynecologic Oncology Reports最新文献

{"title":"Barriers to the recognition and evaluation of abnormal uterine bleeding among individuals at increased risk for endometrial Cancer","authors":"Shariska P. Harrington,&nbsp;Negar Taheri,&nbsp;Manisha Salinas,&nbsp;Andilyn Mehltretter,&nbsp;Nicholas McConnell,&nbsp;Martha O'Neill,&nbsp;Arushi Agarwal,&nbsp;Donna Hochberg,&nbsp;Tomasz Beer,&nbsp;Mark Camardo,&nbsp;Elle Kielar-Grevstad,&nbsp;Jamie N. Bakkum-Gamez","doi":"10.1016/j.gore.2026.102214","DOIUrl":"10.1016/j.gore.2026.102214","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate knowledge of abnormal uterine bleeding (AUB) and postmenopausal bleeding (PMB) as symptoms of endometrial cancer (EC), assess understanding of diagnostic evaluation, and identify barriers and facilitators to care.</div></div><div><h3>Methods</h3><div>We conducted a web-based survey of participants (<em>N</em> = 603) with a history of AUB/PMB and increased risk for EC. The survey, informed by semi-structured interviews, assessed symptom recognition, knowledge of EC, familiarity with diagnostic evaluation, and healthcare-seeking behaviors. Descriptive statistics, chi-square tests, and multivariable logistic regression evaluated associations between demographic, clinical factors and study outcomes.</div></div><div><h3>Results</h3><div>Although 78% recognized abnormal bleeding within six months, 21% reported delayed recognition and 25% had not sought evaluation. Only 12% identified AUB/PMB as a potential symptom of cancer, with participants aged ≥45 years less likely to make this association. While 75% sought medical care, 28% reported that their healthcare provider was not concerned about their bleeding; among these participants, 60% reported experiencing symptom dismissal. Familiarity with endometrial biopsy was lower among Medicaid-insured participants (OR 0.50, 95% CI 0.33–0.77). More convenient testing options increased self-reported motivation to seek evaluation.</div></div><div><h3>Conclusions</h3><div>Knowledge gaps, delayed symptom recognition, and experiences of symptom dismissal identify potential barriers along the pathway to evaluation of abnormal bleeding.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"67 ","pages":"Article 102214"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149107756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analytical and clinical validation of the EdenDx methylation assay as a noninvasive supportive triage tool for early detection of endometrial cancer in cervical scraping specimens","authors":"Rojeet Shrestha,&nbsp;Bo-Ram Bang,&nbsp;Safedin Beqaj","doi":"10.1016/j.gore.2026.102221","DOIUrl":"10.1016/j.gore.2026.102221","url":null,"abstract":"<div><h3>Objective</h3><div>Endometrial cancer (EC) is the most common gynecologic malignancy; however, early detection remains challenging due to overlapping symptoms and the absence of validated noninvasive triage testing. Diagnosis relies on invasive procedures such as endometrial biopsy or dilation and curettage. The EdenDx assay detects hypermethylation of <em>CDO1</em> and <em>CELF4</em> genes, which are specifically associated with EC and have been shown to be epigenetically altered prior to symptom onset. Here, we evaluate the clinical and analytical performance of the EdenDx assay as a noninvasive triage tool for the early detection of endometrial cancer in cervical cytology specimens.</div></div><div><h3>Methods</h3><div>Analytical validation, including limit of detection (LoD), precision, analytical specificity, and adequacy, was performed using contrived specimens. Clinical performance was evaluated in two specimen types: cervical scraping specimens collected from 18 patients with histologically confirmed EC and 62 patients without EC, and formalin-fixed paraffin-embedded (FFPE) tissue from 20 patients with EC and 20 without EC, with histopathology as the reference standard.</div></div><div><h3>Results</h3><div>The LoD was 1.5% cancer cells; the coefficient of variation (CV) was &lt;10% across runs and operators, and no interference from common vaginal pathogens or substances was observed. In cervical scraping specimens, sensitivity was 72.2% (13/18; 95% confidence interval [CI], 46.5%–90.3%) and specificity was 96.8% (60/62; 95% CI, 88.8%–99.6%); in FFPE tissue, sensitivity was 85.0% (17/20) and specificity was 90.0% (18/20); in contrived specimens, both sensitivity and specificity were 100%. Overall, the assay demonstrated a pooled sensitivity of 90.2% and specificity of 96.2%.</div></div><div><h3>Conclusions</h3><div>The EdenDx assay is analytically robust and detects CDO1/CELF4 hypermethylation in both cervical scraping specimens and FFPE endometrial tissue, with high specificity and sensitivity in cervical scrapings. These findings support further prospective evaluation of the EdenDx assay as a noninvasive triage adjunct to identify high-risk women with or without abnormal uterine bleeding who warrant endometrial sampling.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"67 ","pages":"Article 102221"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myotonic dystrophy type 1 as a cancer predisposition syndrome: A case report of quadruple primary malignancies with review of the literature","authors":"Koya Fujiyama,&nbsp;Mariko Nakahara,&nbsp;Yosuke Ito,&nbsp;Hiroki Yamada,&nbsp;Miho Aoki,&nbsp;Mayu Takahashi,&nbsp;Saki Kuki,&nbsp;Sumie Kaya,&nbsp;Saya Nagasawa,&nbsp;Yuri Ishida,&nbsp;Atsuko Yamada,&nbsp;Hanako Kasahara,&nbsp;Daiki Ogishima","doi":"10.1016/j.gore.2026.102228","DOIUrl":"10.1016/j.gore.2026.102228","url":null,"abstract":"<div><h3>Background</h3><div>Myotonic dystrophy type 1 (DM1) is the most common adult-onset muscular dystrophy and is increasingly recognized as a cancer predisposition syndrome, with 2- to 8.5-fold elevated risks of endometrial, ovarian, thyroid, and colorectal cancers. Evidence on the oncological management of DM1 patients—including perioperative care, chemotherapy tolerability, and cancer surveillance—remains scarce.</div></div><div><h3>Case presentation</h3><div>A 56-year-old woman with DM1 developed four primary malignancies over 16 years: papillary thyroid carcinoma at age 40, breast carcinoma at age 49, and synchronous endometrial carcinoma and low-grade serous ovarian carcinoma at age 56. Progressive respiratory muscle weakness necessitated tracheostomy and nocturnal ventilation from age 49, and DM1 was diagnosed at age 50. Three general anesthesia surgeries were completed without complications under multidisciplinary DM1-tailored perioperative protocols. For FIGO stage IIIB ovarian carcinoma, four cycles of paclitaxel–carboplatin chemotherapy were administered without dose reduction. First-degree atrioventricular block and left ventricular function remained stable, and treatment was discontinued for Grade 2 nausea rather than a DM1-specific toxicity.</div></div><div><h3>Conclusion</h3><div>Standard-intensity multimodal cancer treatment was feasible in this DM1 patient with appropriate perioperative and cardiac monitoring. DM1 should be recognized as a cancer predisposition syndrome, and individualized surveillance strategies analogous to those used in hereditary cancer syndromes warrant further investigation.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"67 ","pages":"Article 102228"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149141509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical foley tamponade as a bridge to chemotherapy for hemorrhagic postpartum choriocarcinoma","authors":"Misaki Ogawa,&nbsp;Hirokazu Usui,&nbsp;Asuka Sato,&nbsp;Natsuko Nakamura,&nbsp;Eri Katayama,&nbsp;Makio Shozu,&nbsp;Kaori Koga","doi":"10.1016/j.gore.2026.102224","DOIUrl":"10.1016/j.gore.2026.102224","url":null,"abstract":"<div><h3>Background</h3><div>Postpartum choriocarcinoma is highly chemosensitive but may cause life-threatening uterine hemorrhage requiring urgent hemostatic intervention. Uterine artery embolization or hysterectomy may be necessary when bleeding is uncontrolled. We report a patient in whom cervical Foley catheter tamponade reduced massive uterine bleeding sufficiently to permit prompt chemotherapy while preserving the uterus.</div></div><div><h3>Case presentation</h3><div>A 24-year-old primiparous woman developed recurrent massive uterine bleeding after term vaginal delivery. Histopathologic examination of tissue obtained during repeat uterine evacuation was consistent with choriocarcinoma. At referral, transvaginal ultrasonography showed a 12-mm hypervascular myometrial lesion, chest computed tomography revealed multiple pulmonary metastases, and serum human chorionic gonadotropin was 143,249 mIU/mL. Three days later, she was admitted emergently with recurrent massive bleeding; the lesion had enlarged to 33 mm and serum human chorionic gonadotropin had increased to 317,589 mIU/mL. A 16-French Foley catheter was placed within the cervical canal, reducing the bleeding to a clinically manageable level. Combination chemotherapy with methotrexate, etoposide, and actinomycin D (MEA) was initiated the following day. Although bleeding did not cease completely, uterine artery embolization and hysterectomy were avoided. The patient completed 16 cycles of MEA chemotherapy, including consolidation therapy, achieved complete remission, and retained her uterus.</div></div><div><h3>Conclusion</h3><div>Cervical Foley catheter tamponade may provide a simple and rapidly available temporizing option for severe uterine bleeding in selected patients with postpartum choriocarcinoma. It may serve as a bridge to definitive chemotherapy while avoiding more invasive hemostatic procedures.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"67 ","pages":"Article 102224"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149141512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Folate receptor alpha expression in uterine serous carcinoma: a single-institution analysis","authors":"Sadhvi Batra,&nbsp;Tao Huang,&nbsp;Stephanie Skala,&nbsp;Bori Lesser-Lee,&nbsp;Shitanshu Uppal,&nbsp;Zhen Ni Zhou","doi":"10.1016/j.gore.2026.102230","DOIUrl":"10.1016/j.gore.2026.102230","url":null,"abstract":"<div><div>Uterine serous carcinoma (USC) is an aggressive histologic subtype of endometrial cancer for which limited targeted therapeutic options exist. Folate receptor alpha (FOLRα) is an established therapeutic target in high-grade serous ovarian carcinoma, but its expression patterns in USC remain poorly characterized. We sought to evaluate the prevalence and distribution of FOLRα expression in USC and assess the applicability of ovarian cancer-derived FOLRα thresholds to this histology. We conducted a retrospective review of patients with pathologically confirmed USC treated at a single institution from 2017 to 2024. FOLRα expression was assessed using the VENTANA FOLR1 (FOLR1–2.1) RxDx assay. Positivity was defined as ≥75% of tumor cells demonstrating moderate-to-strong membranous staining (PS2+ scoring). Seventy-three patients were included. Median age was 71 years; 53% had uterine-confined disease at presentation. In our cohort, nine tumors (12.3%) met the high-expression threshold for FOLRα positivity. An additional 13 tumors (17.8%) demonstrated intermediate expression, while 69.9% showed &lt;50% staining. FOLRα expression in USC is variable, and only a minority of tumors met the high-expression threshold used for mirvetuximab soravtansine (MIRV) eligibility in ovarian cancer. However, nearly one-third demonstrated medium-to-high expression, suggesting that FOLRα targeting may not be fully captured by ovarian cancer-derived biomarker cutoffs in this disease process. These descriptive, hypothesis-generating findings support further evaluation of FOLRα-directed strategies, including combination approaches, in prospective studies of USC.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"67 ","pages":"Article 102230"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149141511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistently elevated estradiol after bilateral salpingo-oophorectomy in recurrent low-grade endometrial stromal sarcoma: a case report","authors":"Ali Sanjari Moghaddam,&nbsp;Benjamin Pastore,&nbsp;Maria Fernandez Turzio,&nbsp;Samuel McCash,&nbsp;Jennifer J. Mueller,&nbsp;Roisin E. O'Cearbhaill","doi":"10.1016/j.gore.2026.102227","DOIUrl":"10.1016/j.gore.2026.102227","url":null,"abstract":"<div><h3>Background</h3><div>Low-grade endometrial stromal sarcoma (LGESS) is a rare uterine mesenchymal neoplasm that frequently expresses estrogen and progesterone receptors. Endocrine therapy is a cornerstone of treatment for recurrent or metastatic LGESS. In premenopausal patients, bilateral salpingo-oophorectomy (BSO) is commonly performed to reduce endogenous estrogen production and would be expected to result in a postmenopausal hormonal profile.</div></div><div><h3>Case</h3><div>We report the case of a patient with recurrent, metastatic estrogen receptor (ER)/progesterone receptor (PR)-positive LGESS who had previously undergone BSO. Her disease initially responded to aromatase inhibitor therapy; however, she subsequently experienced pulmonary progression, including a large endobronchial metastasis requiring bronchoscopic cytoreduction. Despite pathologically confirmed BSO, further evaluation revealed a hormone profile more consistent with persistent premenopausal estrogen exposure. Given concern that ongoing estrogen exposure may have been contributing to progression of this hormone-sensitive malignancy, treatment was changed to combined leuprolide and letrozole. Three months after initiation of combined endocrine therapy, imaging demonstrated a partial response, which was confirmed at 6 months, accompanied by estradiol levels in the postmenopausal range.</div></div><div><h3>Conclusion</h3><div>This case raises the possibility that surgical menopause may not always result in complete estrogen deprivation in LGESS. Potential explanations include assay limitations, undetectable residual gonadotropin-responsive steroidogenic tissue, peripheral aromatization, and tumor-associated estrogenic activity. Biochemical evaluation of estrogen status may be informative in select patients whose disease behavior appears discordant with presumed post-oophorectomy menopausal status.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"67 ","pages":"Article 102227"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149141508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric lynch-associated melanoma arising in ovarian teratoma: a case report","authors":"Rana Alcheikh,&nbsp;Jaime O. Boyd,&nbsp;Shahrazad Saab,&nbsp;Pedro Albuquerque,&nbsp;Rachel Egler,&nbsp;Sarah K. Lynam","doi":"10.1016/j.gore.2026.102226","DOIUrl":"10.1016/j.gore.2026.102226","url":null,"abstract":"<div><h3>Background</h3><div>Mature teratomas of the ovary are a benign entity. However, rare secondary malignant transformation of germ cell components may occur and give rise to a teratoma of malignant transformation (TMT). While reports of this pathology have been described in peri- and postmenopausal patients, this represents the first case of teratoma-associated malignant melanoma in a pediatric patient with Lynch syndrome. There is a lack of consensus recommendations regarding management of this rare phenomenon.</div></div><div><h3>Case Presentation</h3><div>We present the case of a 12-year-old premenarchal female with a pelvic mass who underwent surgical resection with final pathology consistent with a melanoma in a teratoma of malignant transformation. She was subsequently diagnosed with a germline MSH6 mutation during postoperative evaluation. She received adjuvant ipilimumab and nivolumab for 3 cycles complicated by grade 3 transaminitis responding to medical therapy. An interval laparoscopic ovarian cystectomy was performed on the contralateral ovary due to concern for recurrence, which was negative. The patient remains on single agent nivolumab without evidence of detectable disease almost 18 months after initial diagnosis.</div></div><div><h3>Conclusion</h3><div>Melanoma arising from a teratoma of malignant transformation is an exceedingly rare pathological diagnosis, especially in the pediatric population. Surgical management is the mainstay of treatment with addition of systemic therapy including immunotherapy. Lynch syndrome in a pediatric patient presents additional considerations for future cancer risk and fertility. Finally, while ctDNA may have a role in the detection of recurrence and treatment planning, this remains investigational.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"67 ","pages":"Article 102226"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149141510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometrial tuberculosis mimicking gynecological malignancy in a postmenopausal woman","authors":"Kamilla L. Dávid,&nbsp;Eva Orrego,&nbsp;Andres Macari-Jorge,&nbsp;Diletta Fumagalli,&nbsp;Rebecca Yorke,&nbsp;Mary R. Schwartz,&nbsp;Aparna A. Kamat","doi":"10.1016/j.gore.2026.102223","DOIUrl":"10.1016/j.gore.2026.102223","url":null,"abstract":"<div><h3>Background</h3><div>Female genital tuberculosis is a rare form of extrapulmonary tuberculosis that may mimic gynecologic malignancy, particularly when clinical and imaging findings are nonspecific. Diagnosis can be especially challenging in postmenopausal women.</div></div><div><h3>Case Presentation</h3><div>A 78-year-old postmenopausal woman presented with pelvic pain and was found to have marked endometrial cavity distention, hematometra, and a cervical lesion concerning for malignancy. Severe cervical stenosis prevented adequate endometrial sampling despite examination under anesthesia, attempted hysteroscopy, and dilation and curettage. Because malignancy could not be excluded, she underwent robotic-assisted total laparoscopic hysterectomy with bilateral salpingo-oophorectomy. Histopathologic examination demonstrated extensive necrotizing granulomatous inflammation involving the endometrium, myometrium, endocervix, and left adnexal soft tissue, without evidence of malignancy. Although acid-fast staining was negative, tissue mycobacterial culture grew <em>Mycobacterium tuberculosis</em> complex, and molecular testing confirmed <em>M. tuberculosis</em> complex DNA. Subsequent evaluation showed no evidence of active pulmonary tuberculosis, and antituberculosis therapy was initiated.</div></div><div><h3>Conclusion</h3><div>Female genital tuberculosis should be considered in the differential diagnosis of suspicious intrauterine or cervical lesions, even in postmenopausal women, particularly when cervical stenosis prevents adequate preoperative sampling and epidemiologic risk factors, including migration from a country with a higher tuberculosis burden, are present.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"67 ","pages":"Article 102223"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149141507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing patient understanding of ovarian cancer: creation, validation and user-readability evaluation of an education booklet","authors":"Sabith Ahmed,&nbsp;Allen Pinto,&nbsp;Sheavon Serrao,&nbsp;T. Krishna Sharan,&nbsp;Merin Mathew,&nbsp;Sharad Chand,&nbsp;Nandakumar U.P.","doi":"10.1016/j.gore.2026.102220","DOIUrl":"10.1016/j.gore.2026.102220","url":null,"abstract":"<div><h3>Background</h3><div>Patient education booklets serve as supplemental educational tools, delivering essential information to patients and caregivers about medical conditions, safe medication use, and necessary lifestyle adjustments. Compared to verbal education, validated written materials are more effective in accurately conveying critical information without losing its core message.</div></div><div><h3>Aim and objectives</h3><div>To prepare a patient education booklet on ovarian cancer, perform its validation and translation; and to carry out its user-readability assessment.</div></div><div><h3>Materials and methods</h3><div>The booklet was developed by referring various primary, secondary and tertiary sources. The prepared booklet was validated by a committee of 10 experts, translated into Kannada and then back-translated for accuracy. Ten MCQs based on the booklet were prepared, validated and translated. Readability was assessed among 35 participants. The opinion of the participants on the content, layout and design of the booklet was also attained.</div></div><div><h3>Results</h3><div>35 subjects were included for user-readability testing. The overall readability score of 52.28 ± 15.16 was increased to 85.71 ± 11.95. 91.4% of the subjects had good opinion on the booklet's content, layout and design.</div></div><div><h3>Conclusion</h3><div>This study concluded that the validated booklet had a significant effect on the study subjects' level of knowledge.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"67 ","pages":"Article 102220"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apparent diffusion coefficient values on MRI as biomarkers for pre operative prediction of prognostic factors in endometrial cancer","authors":"Ashika Padival,&nbsp;Bijal Manish Patel,&nbsp;Chetana D. Parekh,&nbsp;Ruchi Arora,&nbsp;Hitesh Rajpura,&nbsp;Kedar Padhiyar","doi":"10.1016/j.gore.2026.102218","DOIUrl":"10.1016/j.gore.2026.102218","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Magnetic resonance imaging (MRI) is essential for preoperative assessment of endometrial carcinoma. Diffusion-weighted imaging (DWI)-derived apparent diffusion coefficient (ADC) values are being explored as quantitative, non-invasive biomarkers of tumor biology and aggressiveness. This study assessed the performance and interobserver reproducibility of ADC measurements for predicting prognostic factors.</div></div><div><h3>Methods</h3><div>This study was conducted from June 2023 to June 2025 and included histologically confirmed endometrial carcinoma patients who underwent preoperative pelvic MRI. Patients with 3 T MRI outside the institute or unfit for primary surgery were excluded. Two radiologists independently measured focused-region and whole-lesion ADC values. Interobserver agreement was assessed using paired <em>t</em>-tests and Bland–Altman analysis. Associations with histopathological prognostic factors were assessed using Pearson's coefficient. MRI and histopathological staging concordance was measured using weighted Cohen's kappa. ROC and ANOVA assessed diagnostic performance.</div></div><div><h3>Results</h3><div>Fifty-one patients were included, with endometrioid adenocarcinoma being the predominant histological subtype (92.2%). The mean ADC was 747.13 × 10⁻⁶ mm²/s. MRI staging showed excellent agreement with histopathology (weighted κ = 0.866). Focused-ROI ADC demonstrated no significant interobserver variability, whereas whole-lesion ADC showed significant interobserver variation. Lower ADC values were associated with serous histology and deep myometrial invasion. ADC significantly differentiated tumor grade, myometrial invasion, and histological subtype. ROC analysis demonstrated good diagnostic performance of focused ADC for tumor grade and pelvic lymph-node involvement.</div></div><div><h3>Conclusion</h3><div>Focused ROI-based ADC assessment is practical, reproducible, contrast-free, and may improve risk stratification, surgical planning, and individualized management, especially where molecular testing is limited.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"67 ","pages":"Article 102218"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}