International Journal of Gynecological Cancer最新文献

{"title":"ISUOG/ESGO Consensus Statement on ultrasound-guided biopsy in gynecological oncology.","authors":"D Fischerova, F Planchamp, J L Alcázar, P Dundr, E Epstein, A Felix, F Frühauf, G Garganese, I Salvesen Haldorsen, D Jurkovic, R Kocian, D Lengyel, F Mascilini, A Stepanyan, M Stukan, S Timmerman, T Vanassche, Z Yuan Ng, U Scovazzi","doi":"10.1016/j.ijgc.2025.101732","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101732","url":null,"abstract":"<p><p>The International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) with the European Society of Gynaecological Oncology (ESGO) jointly developed clinically relevant and evidence-based statements on performing ultrasound-guided biopsies in gynecological oncology. The objective of this Consensus Statement is to assist clinicians, including gynecological sonographers, gynecological oncologists and radiologists, to achieve the best standards of practice in ultrasound-guided biopsy procedures. ISUOG/ESGO nominated a multidisciplinary international group of 16 experts who have demonstrated leadership in the use of ultrasound-guided biopsy in the clinical management of patients with gynecological cancer. In addition, two early-career gynecological fellows were nominated to participate from the European Network of Young Gynae Oncologists (ENYGO) within ESGO and from ISUOG. The group also included a patient representative from the European Network of Gynaecological Cancer Advocacy Groups. The document is divided into six sections: (1) general recommendations; (2) image-guided biopsy (imaging guidance, sampling methods); (3) indications and contraindications; (4) technique; (5) reporting; and (6) training and quality assurance. To ensure that the statements are evidence-based, the current literature was reviewed and critically appraised. Preliminary statements were drafted based on this review of the literature. During a conference call, the whole group discussed each preliminary statement, and a first round of voting was carried out. The group achieved consensus on all 46 preliminary statements without the need for revision. These ISUOG/ESGO statements on ultrasound-guided biopsy in gynecological oncology, together with a summary of the evidence supporting each statement, are presented herein. This Consensus Statement is supplemented by detailed narrated videoclips presenting different approaches and indications for ultrasound-guided biopsy, a patient leaflet, and an extended version which includes a detailed review of the evidence.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101732"},"PeriodicalIF":4.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692041","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":"Outcomes of low-risk endometrial cancer with isolated tumor cells in the sentinel lymph nodes: a prospective, multi-center, single-arm, observational study (ENDO-ITC study).","authors":"Luigi A De Vitis, Giorgio Bogani, Francesco Raspagliesi, Octavio Arencibia Sanchez, Beatriz Navarro, Francesco Multinu, Vanna Zanagnolo, Glauco Baiocchi, Louise De Brot, Francesco Fanfani, Ilaria Capasso, Sabrina Piedimonte, Lara DeGuerke, Alessandro Buda, Jessica Mauro, Manuela Alessio, Federica Filipello, Mario Beiner, Yfat Kadan, Andrea Papadia, Giuseppe Vizzielli, Stefano Restaino, Tommaso Grassi, Fabio Landoni, Tommaso Bianchi, Christoph Grimm, Stephan Polterauer, Giulio Ricotta, Alejandra Martinez, Paul Buderath, Rainer Kimmig, Vito Chiantera, Behrouz Zand, Ignacio Zapardiel, Alicia Hernandez, Stephanie Gill, Allan Covens, Christian Dagher, Tommaso Meschini, Giuseppe Cucinella, Gabriella Schivardi, Tommaso Occhiali, Antonio Lembo, Emilia Palmieri, Maryam Shahi, Angela J Fought, Michaela E McGree, Vera J Suman, Nadeem R Abu-Rustum, Pedro T Ramirez, Andrea Mariani, Gretchen E Glaser","doi":"10.1016/j.ijgc.2025.101764","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101764","url":null,"abstract":"<p><strong>Background: </strong>It is unclear whether isolated tumor cells (ITCs) in sentinel lymph nodes (SLNs) adversely affect prognosis, especially in low-risk endometrial cancer. In a retrospective study, we showed a worse recurrence-free survival for low-risk endometrial cancer with ITCs than the node-negative group.</p><p><strong>Primary objective: </strong>Our aim is to evaluate whether the likelihood of disease recurrence differs between a prospective cohort of patients with low-risk endometrial cancer with ITCs and an historical cohort with negative SLNs.</p><p><strong>Study hypothesis: </strong>We hypothesize that patients with low-risk endometrial cancer and ITCs will have a worse recurrence-free survival than patients who are node-negative.</p><p><strong>Trial design: </strong>This is a prospective, multi-center, single-arm observational study. Consecutive patients with low-risk endometrial cancer with ITCs in the SLNs will be accrued. Observation only will be suggested after surgery.</p><p><strong>Major inclusion/exclusion criteria: </strong>We will include patients with endometrial cancer undergoing pelvic SLN biopsy and ultra-staging with the following characteristics: endometrioid histology, grades 1 to 2, <50% myometrial invasion, without substantial/extensive lympho-vascular space invasion. ITCs in SLNs are defined as tumor cell aggregates ≤0.2 mm or <200 cells.</p><p><strong>Primary end point: </strong>The primary end point is recurrence-free survival, measured from the date of surgery to the date of recurrence, death, or last disease evaluation.</p><p><strong>Sample size: </strong>With a sample size of 132 women with low-risk endometrial cancer and ITCs, a 1-sided log-rank test achieves 85% power at a 0.05 significance level to detect an HR of 2.1. The expected number of events during the study is 17.3.</p><p><strong>Estimated dates for completing accrual and presenting results: </strong>The study duration will be 60 months: 24 for enrollment and 36 for follow-up. The results are expected in 2029.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT06689956.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101764"},"PeriodicalIF":4.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730120","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":"The unresolved dilemma of lymphovascular space invasion in endometrial cancer: keeping the debate open.","authors":"Luigi De Vitis, Emilia Palmieri, Andrea Mariani","doi":"10.1016/j.ijgc.2025.101762","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101762","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101762"},"PeriodicalIF":4.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709692","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":"Correspondence on Laparoscopic bariatric surgery with hysterectomy for endometrial cancer to improve long-term outcomes: A review article by Goddard et al.","authors":"Francesco Mezzapesa, Pierandrea De Iaco, Anna Myriam Perrone","doi":"10.1016/j.ijgc.2025.101763","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101763","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101763"},"PeriodicalIF":4.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709690","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":"HPV-associated and HPV-independent vulvar squamous cell carcinoma: is there an impact of resection margins on local recurrence?","authors":"Marilyn Boo, Lynn Sadler, Susan Bigby, Lois Eva","doi":"10.1016/j.ijgc.2025.101757","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101757","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the impact of resection margins on the first local recurrence of vulvar squamous cell carcinoma, stratified by human papillomavirus (HPV) status: HPV-associated (HPV-A) and HPV-independent (HPV-I). It also investigated the association between precursor lesions of vulvar squamous cell carcinoma at the resection margins and the risk of first local vulvar squamous cell carcinoma recurrence.</p><p><strong>Methods: </strong>This was a retrospective single-center clinicopathological case note review of patients treated with primary surgery for vulvar squamous cell carcinoma between January 1990 and December 2020, with follow-up until February 2024. The impact of pathological margins on first local recurrence was assessed for HPV-A and HPV-I tumors separately in univariable and multi-variable survival analyses.</p><p><strong>Results: </strong>A total of 360 vulvar squamous cell carcinoma cases were identified. Local recurrences were reported in 12 of 166 (7.2%) HPV-A and 53 of 194 (27.3%) HPV-I tumors (p < .001). Pathological margins <8 mm were significantly associated with increased local recurrence in HPV-I vulvar squamous cell carcinoma, with both univariable (HR 2.34, 95% CI 1.33-4.10, p = .003) and multi-variable analysis (adjusted HR 2.06, 95% CI 1.14 to 3.71, p = .0017) confirming this association. No significant association was observed in HPV-A vulvar squamous cell carcinoma (HR 0.70, 95% CI 0.22 to 2.24, p = .55). The number of HPV-A recurrences precluded multi-variable analysis. After stratifying by HPV sub-type, there was no association between precursors at the margins and local recurrence.</p><p><strong>Conclusions: </strong>Local recurrences are more common in HPV-I than HPV-A vulvar squamous cell carcinoma. Surgical margins may not influence the risk of local recurrence in HPV-A vulvar squamous cell carcinoma. However, in HPV-I vulvar squamous cell carcinoma, narrow resection margins of <8 mm appear to increase the risk of local recurrence. Therefore, HPV status should be incorporated into management protocols to risk-stratify follow-up care.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101757"},"PeriodicalIF":4.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718830","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":"Correspondence on \"Effect of uterine manipulator on oncologic outcome in early-stage, low-grade endometrial cancer\" by Ye et al.","authors":"Fazil Avci","doi":"10.1016/j.ijgc.2025.101761","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101761","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101761"},"PeriodicalIF":4.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718822","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":"Neuroendocrine cervical carcinomas: genomic insights, controversies in treatment strategies, and future directions: a NeCTuR study.","authors":"Gloria Salvo, Larissa A Meyer, Naomi R Gonzales, Michael Frumovitz, R Tyler Hillman","doi":"10.1016/j.ijgc.2025.101639","DOIUrl":"10.1016/j.ijgc.2025.101639","url":null,"abstract":"<p><p>Neuroendocrine cervical carcinomas are rare, aggressive tumors with a high risk of early metastasis and poor survival outcomes. Despite existing therapies, over half of patients experience recurrence or progression after primary treatment, and survival after recurrence remains limited. Survival rates have not significantly improved over the past several decades, underscoring an urgent need for better therapeutic options. The rarity of neuroendocrine cervical carcinoma has precluded randomized trials, leaving treatment strategies to be guided by small retrospective studies or adapted from protocols for small cell lung cancer. However, as we gain a deeper understanding of its unique origin, genomic landscape, and biological characteristics, it has become clear that neuroendocrine cervical carcinoma requires distinct management strategies. Key questions in managing neuroendocrine cervical carcinoma remain unanswered: does adjuvant radiation therapy improve outcomes for early-stage disease? Should neoadjuvant chemotherapy be considered for patients with bulky, localized tumors? Can immunotherapy improve outcomes when added to chemoradiation in locally advanced cases? Should immunotherapy be a standard option for recurrent disease? Addressing these questions requires a thorough understanding of the unique molecular and biological characteristics of neuroendocrine cervical carcinoma and its clinical behavior. This review aims to provide an updated summary of the molecular landscape of neuroendocrine cervical carcinoma, highlighting features that distinguish it from small cell lung cancer and align with other types of cervical cancer. We discuss current treatment approaches, identify gaps in knowledge, and examine paradigm-shifting clinical trials that have significantly impacted survival outcomes in cervical cancer and small cell lung cancer, translating these insights into potential strategies for neuroendocrine cervical carcinoma. By focusing on the unique aspects of neuroendocrine cervical carcinoma, this review emphasizes the need for specialized treatment strategies for this challenging disease.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 3","pages":"101639"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189124","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":"Controversies in the Management of Mesonephric and Mesonephric-Like Adenocarcinomas of the Female Genital Tract.","authors":"Aaron Praiss, Kay Park, Simran Makker, Jeffrey Girshman, Carol Aghajanian, Rachel N Grisham","doi":"10.1016/j.ijgc.2025.101638","DOIUrl":"10.1016/j.ijgc.2025.101638","url":null,"abstract":"<p><p>Mesonephric and mesonephric-like adenocarcinomas of the gynecologic tract are a rare subset of gynecologic tumors that are frequently associated with the presence of somatic KRAS mutations. Owing to their rare nature and ability to arise in different gynecologic sites, pathologic diagnosis is often challenging and under-represented. Immunohistochemistry and routine use of next-generation sequencing has allowed these cases to be more readily identified; however, there is still a paucity of clinical outcomes data, and the efficacy of treatment paradigms remains largely unknown. Historically, mesonephric and mesonephric-like adenocarcinomas were considered to be less responsive to systemic treatment, but response rates to first-line platinum-doublet chemotherapy for metastatic disease may be higher than initially suspected. Recurrent disease is often distant and located in the lungs, suggesting an important role of surveillance chest imaging. Given that most of these tumors are associated with somatic mitogen-activated protein kinase pathway mutations, a currently open phase II trial is assessing the dual RAF/MEK clamp avutometinib in combination with the FAK inhibitor defactinib in patients with recurrent mesonephric and mesonephric-like adenocarcinomas. Continued multi-institutional prospective trials are necessary to elucidate additional treatment options for these rare tumors.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 3","pages":"101638"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364670","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":"Controversies in vulvar cancer: revisiting the margin of error.","authors":"Maureen E Byrne, Mario M Leitao, Nadeem R Abu-Rustum","doi":"10.1016/j.ijgc.2025.101678","DOIUrl":"10.1016/j.ijgc.2025.101678","url":null,"abstract":"<p><p>Despite an oftentimes radical surgical approach when treating patients with early-stage vulvar cancer, local recurrence occurs in approximately 40% of cases. Surgery in this setting can result in significant morbidity; however, treatment failure is associated with high mortality rates. Historically, many guidelines recommended a tumor-free margin ≥8 mm in the surgical treatment of vulvar cancer, although this is largely consensus-based and supported by a few small retrospective case series. Recently, numerous retrospective studies have found no association between a tumor-free margin of <8 mm and locoregional recurrence. Emerging evidence suggests that the presence of differentiated vulvar intra-epithelial neoplasia and lichen sclerosis at the pathologic margin may also play a role in local recurrence; however, data are retrospective and heterogenous, and the definition of what a \"safe\" tumor-free margin is remains unclear. However, increasing evidence has failed to demonstrate the beneficial role of re-excision or adjuvant radiation in the setting of margins of <8 mm. These additional treatments are associated with significant morbidity and have a negative impact on patients' quality of life; thus, they should be reserved solely for patients with positive margins. One of the main challenges in finding the ideal tumor-free margin is that the rarity of vulvar cancer makes prospective and randomized controlled trials difficult to conduct. Therefore, it is imperative that we make a concerted effort as a field to collaborate across nations and institutions, promote centralization of care for rare tumors, and prioritize future work to better understand the nature of this disease.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 3","pages":"101678"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468156","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":"Controversies in malignant ovarian germ cell tumors.","authors":"Michael J Seckl, Baljeet Kaur, Ehsan Ghorani, Alice Bergamini, Giorgia Mangili","doi":"10.1016/j.ijgc.2025.101670","DOIUrl":"10.1016/j.ijgc.2025.101670","url":null,"abstract":"<p><p>Malignant ovarian germ cell tumors (MOGCT) are rare and often aggressive cancers that predominantly affect young women. Fortunately, combined surgery and chemotherapy results in high cure rates. In this review, we will consider some of the many controversies and poorly understood areas in the management of MOGCT that have arisen largely because of the lack of randomized trial data. This paucity of strong evidence is unsurprising, given the rarity of MOGCT and their multiple subtypes which differ biologically and in their clinical behavior. We will explore what is known about the biology and prognostic factors, and how the disease differs from its much more common and robust evidence-based male testicular counterpart. The type and extent of surgery, the value of surveillance in early-stage disease, and the role of neoadjuvant chemotherapy in advanced cases remain uncertain. In addition, optimizing outcomes in relapsed disease following initial chemotherapy is a key area for future development, as survival in this situation is worse than that in patients with testicular germ cell tumors. Fertility preservation remains of central importance, but the best way to achieve it remains debated. Finally, the type and duration of surveillance after treatment remain unclear. These and other controversies are discussed below.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 3","pages":"101670"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531521","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}