Gynecologic Oncology Reports最新文献

{"title":"The effect of polyallergy on ancillary service use among postoperative patients with gynecologic malignancies","authors":"Kaitlyn Coppetti ,&nbsp;Madeline Petty ,&nbsp;Allison R. Walker ,&nbsp;Luis Alvarado ,&nbsp;Sarah P. Huepenbecker ,&nbsp;Nicholas Taylor ,&nbsp;Ashley Graul","doi":"10.1016/j.gore.2026.102127","DOIUrl":"10.1016/j.gore.2026.102127","url":null,"abstract":"<div><h3>Objective</h3><div>To determine if polyallergy (four or more documented allergies in the electronic medical record [EMR]) is an independent predictor of ancillary service use.</div></div><div><h3>Methods</h3><div>Single institution, retrospective cohort study of patients who underwent surgery for gynecologic malignancy between 01/2016 and 05/2024. Demographics, comorbidities, surgical details, postoperative complications, and allergies were abstracted from the EMR. The primary outcome was ancillary service utilization for one year postoperatively including emergency room, psychologic services, primary care, urgent care visits, and hospitalizations. Descriptive statistics, univariate, and multivariate analyses were performed.</div></div><div><h3>Results</h3><div>398 patients met study criteria and 77 patients had polyallergy with a median of 5 allergies (IQR 4–7). Most patients were White (92%) non-smokers (56%) with a median age of 65 (IQR 37–51). Patients with polyallergy had higher rates of anxiety (38% vs 25%, p = 0.03), depression (45% vs 32%, p = 0.03), panic disorder (6% vs 2%, 0.04), and antipsychotic prescriptions (6% vs 2%, p = 0.03). There were more ancillary service encounters among those with polyallergy compared to non-polyallergy (median 4, IQR 2–6 vs 2 IQR 1–5, p = 0.001). On univariate analysis, polyallergy was significantly associated with ancillary service use (p = 0.002), which remained significant on multivariate analysis (RR = 0.21, CI 0.02–0.39, p = 0.03), as was any psychiatric diagnosis (RR = 0.34, CI 0.19–0.48, p &lt; 0.001), and any postoperative complication (RR = 0.29, CI 0.08–0.50, p = 0.006).</div></div><div><h3>Conclusions</h3><div>Polyallergy was an independent risk factor for ancillary service use. Patients with polyallergy may benefit from earlier primary care, case management, and possibly psychological intervention in an effort to prevent increased ancillary service use.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"65 ","pages":"Article 102127"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact on sexual wellbeing after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer treatment","authors":"Luis Felipe Falla-Zuniga ,&nbsp;Armando Sardi ,&nbsp;Mary Caitlin King ,&nbsp;Kathleen Pawlikowski ,&nbsp;Vladislav Kovalik ,&nbsp;Sergei Iugai ,&nbsp;Carol Nieroda ,&nbsp;Vadim Gushchin ,&nbsp;Teresa Diaz-Montes","doi":"10.1016/j.gore.2026.102118","DOIUrl":"10.1016/j.gore.2026.102118","url":null,"abstract":"<div><h3>Background</h3><div>Adding hyperthermic intraperitoneal chemotherapy (HIPEC) to extensive cytoreductive surgery (CRS) for advanced ovarian cancer (OC) raises concerns about sexual morbidity, yet, sexual wellbeing is largely overlooked in CRS/HIPEC trials and practice. We evaluated the sexual wellbeing of OC survivors after CRS/HIPEC.</div></div><div><h3>Methods</h3><div>This single center cross-sectional study surveyed FIGO stage III-IV OC patients who underwent primary CRS/HIPEC ≥ 3 months prior using an anonymous survey and the EORTC QLQ-SHQ22 questionnaire. Sexual satisfaction and pain scales were linearly transformed (0–100), with higher scores indicating higher satisfaction and more pain. Qualitative themes were identified from a single open-ended survey question.</div></div><div><h3>Results</h3><div>Overall, 33/68 (48.5%) patients completed questionnaires. Most were aged 61–80 years (66.7%), heterosexual (97.0%), had CRS/HIPEC &gt; 1 year prior (81.8%), and reported an active sex life as “not at all” / “a little” important (72.7%). Mean sexual satisfaction score was 31 ± 26. A negative change in their sexual wellbeing was reported by 13/14 (92.8%), which was associated with lower sexual satisfaction (p = 0.024). Greater sexual satisfaction was associated with regular exercise (p = 0.025), absence of comorbidities (p = 0.041), and sexual health support from providers (p = 0.019). All patients reported sexual morbidity; vaginal dryness/hot flashes (14/33, 42.4%) were most common. Only 33% (11/33) of patients received sexual wellbeing-related healthcare support, of whom 72.7% found it useful. Of 3 identified themes, “Other Priorities” was the most common.</div></div><div><h3>Conclusions</h3><div>Changes in sexual wellbeing after CRS/HIPEC were common, but healthcare support was limited. Those receiving support reported higher sexual satisfaction. Sexual wellbeing was reframed within broader survivorship priorities.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"65 ","pages":"Article 102118"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Government funding for uterine cancer research lags behind rising incidence","authors":"Rachel P. Mojdehbakhsh ,&nbsp;Ryan J. Spencer ,&nbsp;Natalia Gontarczyk Uczkowski ,&nbsp;Amy L. Godecker","doi":"10.1016/j.gore.2026.102107","DOIUrl":"10.1016/j.gore.2026.102107","url":null,"abstract":"<div><h3>Objectives</h3><div>The second largest government funding source for cancer research is the Department of Defense (DOD). The Peer Reviewed Cancer Research Program (PRCRP) is the funding mechanism for uterine cancer under the DOD. Our objective was to compile cancer research funding granted through the PRCRP by organ site and stratify by incidence of disease to highlight uterine cancer funding.</div></div><div><h3>Methods</h3><div>To gather funding information from the PRCRP, a thorough review was done of the CDMRP website, where records of grants funded and the total budgets for the PRCRP had to be manually abstracted from archives.</div></div><div><h3>Results</h3><div>Uterine cancer has the second highest incidence of these areas (29.4 per 100,000 in 2021), after colorectal cancer (CRC) (37.5 per 100,000 in 2021). CRC has been funded the longest at 15 years. Mesothelioma, for comparison, has the lowest incidence (0.7 per 100,000 in 2021) and has been funded for 14 years. CRC, with the highest incidence and the longest funded area, has received a total of ∼$60 million through the PRCRP. Mesothelioma, with the lowest incidence and the second longest funded area has received ∼$25 million. Uterine cancer, with the second highest incidence, and one of the shortest funded areas, has received only ∼$14 million. Additionally, the incidence of uterine cancer is rising and has seen a 14.8% increase in incidence from 2009 to 2021 whereas CRC has seen a 15.0% decrease.</div></div><div><h3>Conclusions</h3><div>This analysis highlights a proportionate inequity in government funding for uterine cancer when considering the rising incidence of this disease.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"65 ","pages":"Article 102107"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaginal cancer in the second trimester of pregnancy: Successful conservative surgery and 21-year disease-free survival","authors":"Wiebren Tjalma ,&nbsp;Frédéric Caris alias Reynders ,&nbsp;Christa Eelen ,&nbsp;Justin Konje ,&nbsp;Filip Deckers ,&nbsp;Ines Joye ,&nbsp;Konstantinos Papadimitriou ,&nbsp;Anbukkani Subbian","doi":"10.1016/j.gore.2026.102125","DOIUrl":"10.1016/j.gore.2026.102125","url":null,"abstract":"<div><h3>Introduction</h3><div>Primary vaginal cancer during pregnancy is exceedingly rare, and management is not standardized. Treatment requires balancing maternal oncologic outcomes with fetal preservation in the context of limited evidence.</div></div><div><h3>Case:</h3><div>A 38-year-old woman was diagnosed in the second trimester of pregnancy with a 4 cm anterior vaginal lesion. Biopsy showed a Müllerian-type adenocarcinoma with mucinous differentiation associated with HPV-16 infection. Staging revealed no metastatic disease. Following multidisciplinary counselling, extensive surgical excision was performed at 23 + 6 weeks of gestation. Final pathology after surgical excision of the remaining tumor demonstrated microinvasive squamous cell carcinoma with associated high-grade intraepithelial lesions and areas of adenocarcinoma in situ. Pregnancy continued, and a healthy infant was delivered at 36 + 6 weeks. Postpartum intraepithelial recurrence was successfully treated. At 21 years and six months of follow-up, the patient remains disease-free.</div></div><div><h3>Conclusion</h3><div>Conservative surgical management during pregnancy may be feasible in carefully selected patients. Complete surgical excision remains essential for accurate diagnosis and treatment. Multidisciplinary, individualized decision-making is required.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"65 ","pages":"Article 102125"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of anaphylactic reactions involving carboplatin and paclitaxel reported to the FDA from 1970 to 2023","authors":"Halle Petrie ,&nbsp;Taryn Boucher ,&nbsp;Marta A. Crispens ,&nbsp;Elizabeth J. Phillips ,&nbsp;Cosby A. Stone","doi":"10.1016/j.gore.2026.102122","DOIUrl":"10.1016/j.gore.2026.102122","url":null,"abstract":"<div><h3>Introduction</h3><div>Anaphylaxis to carboplatin and paclitaxel are important and potentially life-threatening events that can disrupt chemotherapeutic treatment of gynecologic cancers. Using the FDA Adverse Event Report System (FAERS), we sought to establish the relative incidence of reports of anaphylactic reactions to these drugs compared to other drugs and identify potential associations with age and sex.</div></div><div><h3>Methods</h3><div>Using the search terms “anaphylactic reaction”, “anaphylactic shock”, “anaphylactoid reaction”, or “anaphylactoid shock”, we searched FAERS for reports associated with carboplatin or paclitaxel from 1970 until October 2023. Fatal and non-fatal reactions were included. Linear regression evaluated trends in reported cases.</div></div><div><h3>Results</h3><div>Of 84,702 anaphylactic events reported to the FDA during the study period, 4,988 (5.9%) were fatal. Carboplatin (1,245 reports) and paclitaxel (1,430 reports) ranked 14th and 9th among all drugs associated with anaphylaxis, and 10th and 3rd among those associated with fatal anaphylaxis (8.0% and 10.6% fatality, respectively). Most reactions occurred in adults aged 18–85 (carboplatin 79.0%; paclitaxel 83.7%), and the majority of affected patients were women (carboplatin 70.4%; paclitaxel 68.8%). From 2013 to 2022, yearly anaphylactic reaction means were 77.9 total and 6.6 fatal carboplatin reports (fatal ratio 0.08), and 84.4 total and 8.2 fatal paclitaxel reports (fatal ratio 0.10).</div></div><div><h3>Conclusion</h3><div>The ratio of fatal to total anaphylactic events remained steady over the last decade, suggesting a fatality rate of 8–10% among reports. Additional research is needed to identify biomarkers and improve management of these reactions in gynecologic oncology patients.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"65 ","pages":"Article 102122"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Step-by-step type III total pelvic exenteration with vaginectomy and partial vulvectomy with complex pelvic reconstruction for vaginal recurrence of cervical cancer","authors":"C. Garin ,&nbsp;M. Daix ,&nbsp;L. Bresson ,&nbsp;A-S. Navarro ,&nbsp;S. Schoenen ,&nbsp;P-A. Giroux ,&nbsp;G. Marcq ,&nbsp;F. Narducci ,&nbsp;C. Martinez-Gomez","doi":"10.1016/j.gore.2026.102109","DOIUrl":"10.1016/j.gore.2026.102109","url":null,"abstract":"","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"65 ","pages":"Article 102109"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local immunosuppressive microenvironment underlies reduced responsiveness to imiquimod treatment in recurrent or residual cervical HSIL","authors":"C.L.P. Muntinga ,&nbsp;A.J. van de Sande ,&nbsp;M.J.P. Welters ,&nbsp;L.F.S. Kooreman ,&nbsp;R.L.M. Bekkers ,&nbsp;H. van Beekhuizen ,&nbsp;S.H. van der Burg ,&nbsp;P.J. de Vos van Steenwijk ,&nbsp;E.M.G. van Esch","doi":"10.1016/j.gore.2026.102121","DOIUrl":"10.1016/j.gore.2026.102121","url":null,"abstract":"<div><h3>Objective</h3><div>The topical immune modifier imiquimod is used as alternative treatment for cervical high-grade squamous intraepithelial lesions (cHSIL). While its clinical efficacy in primary cHSIL (pcHSIL) is approximately 60%, this is only 33% for recurrent or residual cHSIL (rrcHSIL) due to reasons that are not well understood. Since the immune microenvironment plays a key role in response to imiquimod in pcHSIL, we performed an in depth comparison of the pcHSIL to the rrcHSIL immune microenvironment.</div></div><div><h3>Methods</h3><div>Transcriptome analysis was performed using the nCounter® Human PanCancer IO360™ panel on 6 pcHSIL and 6 rrcHSIL. Multispectral immunofluorescence (13 markers) was used to analyze T- and myeloid-cell composition of pcHSIL (n = 40) and rrcHSIL (n = 10). Differences in pre-treatment immune infiltrates of rrcHSIL were related to clinical response after imiquimod.</div></div><div><h3>Results</h3><div>Transcriptomic analyses revealed lower expression of genes involved in leukocyte activation, immune cell recruitment, T cell engagement, lymphocyte and B cell infiltration in rrcHSIL compared to pcHSIL. Gene set enrichment analysis (GSEA) supported these findings, demonstrating decreased IL2-STAT 5 signaling in rrcHSIL. Immunofluorescence staining results corroborated the transcriptomic data, with rrcHSIL displaying lower intraepithelial infiltration with CD4+(Tbet + ) T cells, and (CD14 + )CD68 + CD163- M1-like macrophages, but higher numbers of CD8+(PD1 + ) T cells and CD68 + CD163 + M2-like macrophages. RrcHSIL non-responders to imiquimod exhibited an even more immunosuppressive microenvironment than complete responders, characterized by increased infiltration of CD4 + FoxP3 + regulatory T cells and (CD14 + )CD68 + CD163 + M2-like macrophages and CD14 + HLADR- monocytic myeloid derived suppressor cells.</div></div><div><h3>Conclusions</h3><div>The limited efficacy of imiquimod in rrcHSIL may be explained by a strong immunosuppressive microenvironment.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"65 ","pages":"Article 102121"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic extrauterine gestational choriocarcinoma of the cecum mimicking ruptured ectopic pregnancy: A case report","authors":"Ravi Desai ,&nbsp;Cyrus Jalai ,&nbsp;Pelin Onur ,&nbsp;Chuanyong Lu ,&nbsp;Juan Diaz Quinones ,&nbsp;Matthew Cowan","doi":"10.1016/j.gore.2026.102130","DOIUrl":"10.1016/j.gore.2026.102130","url":null,"abstract":"<div><h3>Background</h3><div>Gestational choriocarcinoma (GC) is a rare but highly aggressive form of gestational trophoblastic neoplasia with a strong propensity for early hematogenous spread. Most cases arise within the uterus; extrauterine presentations are exceedingly uncommon and may mimic more common gynecologic conditions, contributing to diagnostic delay.</div></div><div><h3>Case</h3><div>We report a 36-year-old gravida 6 para 4 who presented with markedly elevated β-hCG (455,501 mIU/mL) and no intrauterine pregnancy on ultrasound. She acutely decompensated with hemoperitoneum and was taken emergently to the operating room for presumed ruptured ectopic pregnancy. Laparoscopy revealed a <em>peri</em>-cecal mass grossly concerning for ectopic implantation, while the uterus, tubes, and ovaries appeared normal. Pathology demonstrated atypical trophoblastic proliferation in uterine curettage specimens and choriocarcinoma within the peritoneal mass. Staging imaging showed no additional metastatic disease. She was classified as FIGO stage IV, WHO score 10, and treated with multi-agent EMA-CO chemotherapy, achieving β-hCG normalization and sustained remission after five cycles.</div></div><div><h3>Conclusion</h3><div>Extrauterine abdominal gestational choriocarcinoma is an exceptionally rare entity that can closely resemble ruptured ectopic pregnancy. Markedly elevated β-hCG levels in the absence of an intrauterine gestation should prompt early consideration of gestational trophoblastic neoplasia. While chemotherapy remains the cornerstone of treatment, surgery may play an essential adjunctive role for hemostasis or resection of isolated chemoresistant disease. Early recognition and multidisciplinary management are critical, as timely initiation of risk-adapted chemotherapy yields excellent cure rates even in advanced-stage disease.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"65 ","pages":"Article 102130"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Face-to-face or screen-to-screen: gynecologic oncology fellowship interview applicant perspectives on interview format","authors":"Christopher M. Mayer ,&nbsp;Natasha McGlaun ,&nbsp;Simone A. Sasse ,&nbsp;Grace M. Pipes ,&nbsp;Emily E. O’Brien ,&nbsp;Pamela T. Soliman ,&nbsp;Whitfield Growdon ,&nbsp;Kenneth H. Kim ,&nbsp;Margaret I. Liang","doi":"10.1016/j.gore.2026.102117","DOIUrl":"10.1016/j.gore.2026.102117","url":null,"abstract":"<div><h3>Background</h3><div>Due to the COVID-19 pandemic, in 2020 the medical community modified residency and fellowship interview processes to a virtual-only format. The 2023 application cycle marked the first year that any gynecologic oncology fellowship interviews returned to an in-person format with two programs conducting in-person interviews.</div></div><div><h3>Objective</h3><div>This study evaluated the perspectives of gynecologic oncology fellowship applicants on in-person and virtual interview formats to inform programs’ decision-making around future interview cycles.</div></div><div><h3>Methods</h3><div>Applicant lists from three gynecologic oncology fellowship programs were compiled from the 2023 application cycle. An anonymous survey regarding applicant perspectives on the interview process was electronically distributed.</div></div><div><h3>Results</h3><div>There was a 56% (47/86) response rate. Applicants applied to a median of 50 programs (IQR 42–60), accepted 24 interviews (IQR 20–32), declined 4 interviews (IQR 2–9), and attended 24 interviews (IQR 17–24). Thirty (64%) applicants attended at least one in-person interview. Among the 30 applicants who experienced both interview formats, in-person interviews resulted in a better understanding of the program’s geography, culture, and hospital facilities (p &lt; 0.0001). Applicants who attended in-person interviews were more satisfied with their interview experience, found it easier to interpret body language, and were better able to connect with other applicants and form personal connections with interviewers (p &lt; 0.0001). Of applicants who experienced both formats, 53% preferred in-person format.</div></div><div><h3>Conclusion</h3><div>Applicants who participated in both interview formats reported higher satisfaction and connected better with other applicants and interviewers with in-person interviews; however, there was only a slight (53%) preference for in-person format.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"65 ","pages":"Article 102117"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic radical trachelectomy and pelvic lymphadenectomy without uterine manipulator","authors":"Shaodan Lin ,&nbsp;Chuying Huo ,&nbsp;Zhongqiu Lin ,&nbsp;Huaiwu Lu","doi":"10.1016/j.gore.2026.102034","DOIUrl":"10.1016/j.gore.2026.102034","url":null,"abstract":"<div><h3>Introduction</h3><div>With the postponement of marriage and childbearing in modern society, an increasing proportion of patients diagnosed with cervical cancer are young and have not yet completed their reproductive plans. Fertility-preserving surgery, such as radical trachelectomy, plays an important role in selected patients with early-stage disease. However, the use of a uterine manipulator during minimally invasive surgery remains controversial.</div></div><div><h3>Case/surgical technique</h3><div>We present a surgical film demonstrating laparoscopic radical trachelectomy and pelvic lymphadenectomy without the use of a uterine manipulator in a young woman with early-stage cervical cancer. The patient was a 29-year-old nulliparous woman diagnosed with stage IB1 cervical squamous cell carcinoma following cervical conization, with a strong desire for fertility preservation.</div><div>Instead of a uterine manipulator, uterine suspension was adopted using absorbable sutures to coil the bilateral round ligaments with the anterior uterine wall, allowing controlled uterine traction. Bilateral pelvic lymphadenectomy was performed first, and frozen section analysis confirmed the absence of lymph node metastasis. Radical trachelectomy was subsequently carried out, with careful management of the vesicouterine ligament, preservation of the uterine artery branch, and protection against tumor exposure during colpotomy. Reconstruction of the residual cervix and vagina was performed using the cuff-sleeve suture technique, followed by placement of a cervical stent.</div></div><div><h3>Conclusion</h3><div>This surgical film demonstrates a uterine manipulator–free laparoscopic radical trachelectomy with pelvic lymphadenectomy for early-stage cervical cancer. The described uterine suspension technique provides adequate exposure while maintaining uterine integrity. This approach may facilitate fertility preservation without compromising oncologic principles in carefully selected patients.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"64 ","pages":"Article 102034"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147713919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}