David Viveros-Carreño, Nuria Agustí, Juliana Rodríguez, Nathalia Mora-Soto, Javier Burbano, Adriana Mayor, René Pareja
{"title":"Inadvertent cervical cancer: a narrative review.","authors":"David Viveros-Carreño, Nuria Agustí, Juliana Rodríguez, Nathalia Mora-Soto, Javier Burbano, Adriana Mayor, René Pareja","doi":"10.1016/j.ijgc.2025.101986","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101986","url":null,"abstract":"<p><p>Inadvertent cervical cancer, defined as infiltrative cervical carcinoma diagnosed after a simple hysterectomy for presumed benign disease, remains clinically significant yet understudied. Despite the potential for eradication of cervical carcinoma through vaccination, screening, and early treatment, disparities in health care access continue to result in preventable cases, some of which are identified only postoperatively. This condition has long been recognized, yet its management remains undefined and is supported primarily by low- or very low-quality evidence. Diagnostic failures often stem from inadequate preoperative evaluation, missed follow-up of abnormal screening results, and insufficient re-excision with conization when indicated. Social determinants of health, including race and ethnicity, socioeconomic status, and insurance status, contribute significantly to these lapses. The identification of invasive disease only postoperatively may negatively impact prognosis, even in early stages. Treatment strategies for inadvertent cervical cancer include observation, radiotherapy with or without chemotherapy, and completion surgery, such as lymph node assessment with or without parametrectomy. While retrospective studies suggest similar oncologic outcomes across some strategies (eg, additional surgery or radiotherapy), the absence of prospective trials limits definitive conclusions. Furthermore, morbidity and quality-of-life outcomes are frequently underreported. To support clinical decision-making, we propose a risk-based classification of this condition, categorizing patients as very low, low, medium, or high risk. Until stronger evidence emerges, treatment decisions should be individualized based on tumor features, surgical approach, and patient preferences. This review summarizes current evidence, highlights gaps in knowledge, and offers a pragmatic algorithm for managing this complex clinical entity.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 8","pages":"101986"},"PeriodicalIF":4.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649405","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 \"Large-scale analysis to identify risk factors for ovarian cancer\" by Madakkatel et al.","authors":"Souichi Oka, Yoshiyasu Takefuji","doi":"10.1016/j.ijgc.2025.102000","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102000","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102000"},"PeriodicalIF":4.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690141","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 \"Association of clinical and laboratory variables with risk of venous thromboembolism in high-grade serous ovarian cancer\" by Peippo et al.","authors":"Yinjie Lv, Xiaorong Lu","doi":"10.1016/j.ijgc.2025.102001","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102001","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102001"},"PeriodicalIF":4.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690140","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}
Ha Young Woo, Na Yeon Kim, Jinok Jun, Jung-Yun Lee, Eun Ji Nam, Sang Wun Kim, Sung-Hoon Kim, Young-Tae Kim, Yong Jae Lee
{"title":"Corrigendum to 'Changes in the tumor immune microenvironment during disease progression in clear cell ovarian cancer' [International Journal of Gynecological Cancer, Volume 34 Issue 11 (2024) 1780-1786].","authors":"Ha Young Woo, Na Yeon Kim, Jinok Jun, Jung-Yun Lee, Eun Ji Nam, Sang Wun Kim, Sung-Hoon Kim, Young-Tae Kim, Yong Jae Lee","doi":"10.1016/j.ijgc.2025.101976","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101976","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 8","pages":"101976"},"PeriodicalIF":4.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567426","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":"Accuracy of human papillomavirus testing using self-collected urine samples for detecting high-grade squamous intra-epithelial lesion or worse: a diagnostic meta-analysis.","authors":"Ke-Yu Hsiao, Hsiu-Ling Lin, Hui-Mei Chen, Cheng-Chieh Chen","doi":"10.1016/j.ijgc.2025.101904","DOIUrl":"10.1016/j.ijgc.2025.101904","url":null,"abstract":"<p><strong>Objective: </strong>Self-collection methods are regarded as a strategy to promote human papillomavirus (HPV) testing for cervical cancer screening. HPV testing using urine specimens is non-invasive and could eliminate barriers such as embarrassment and discomfort. However, concerns regarding the accuracy of this method persist. Hence, the current meta-analysis aims to verify the accuracy of urine HPV nucleic acid amplification testing.</p><p><strong>Methods: </strong>A comprehensive search was conducted in the PubMed, Embase, and Cochrane Library databases to identify studies that evaluated the performance of urine HPV nucleic acid amplification testing. The inclusion criteria were as follows: studies that evaluated the diagnostic accuracy of HPV testing for high-grade squamous intra-epithelial lesion or worse (HSIL+) with self-collected urine specimens. In addition, studies that provided sufficient data for conducting a meta-analysis were assessed. To ensure the rigor of the study, those using histopathology or colposcopy as the reference standard were deemed sufficiently rigorous for inclusion. The meta-analysis was conducted using the bi-variate random-effects model.</p><p><strong>Results: </strong>A total of 21 studies with 6603 samples were identified. The meta-analysis yielded a pooled sensitivity of 83.0% (95% CI 77.5% to 87.3%) and a pooled specificity of 51.3% (95% CI 39.2% to 63.3%) of HPV nucleic acid amplification testing with self-collected urine specimens for HSIL+. In terms of detection technology, a pooled sensitivity of 85.2% and a pooled specificity of 49.4% were obtained from the sub-group analysis of manuscripts that used DNA-based testing.</p><p><strong>Conclusions: </strong>Our meta-analysis indicates that urine HPV nucleic acid amplification testing achieves high sensitivity for detecting HSIL+. A notable benefit of DNA-based urine HPV nucleic acid amplification testing is its heightened sensitivity compared with RNA-based methods.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101904"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093877","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}
Koji Matsuo, Katelyn B Furey, Matthew W Lee, Christian Pino, Denise S McIntyre, Maximilian Klar, Lynda D Roman, Jason D Wright
{"title":"International Federation of Gynecology and Obstetrics 2023 stage IIIB2 endometrial cancer with pelvic peritoneal metastasis: assessment of adjuvant therapy effect on survival.","authors":"Koji Matsuo, Katelyn B Furey, Matthew W Lee, Christian Pino, Denise S McIntyre, Maximilian Klar, Lynda D Roman, Jason D Wright","doi":"10.1016/j.ijgc.2025.101773","DOIUrl":"10.1016/j.ijgc.2025.101773","url":null,"abstract":"<p><p>The 2023 International Federation of Gynecology and Obstetrics (FIGO) endometrial cancer staging schema classifies pelvic peritoneum only metastasis as stage IIIB2 disease. In this retrospective cohort study of 193 patients with FIGO 2023 stage IIIB2 endometrial cancer who underwent primary hysterectomy from 2006 to 2015 identified in the Commission-on-Cancer's National Cancer Database, systemic chemotherapy without external beam radiotherapy was the most frequent adjuvant therapy type (48.7%), followed by combination systemic chemotherapy and external beam radiotherapy (42.0%) and external beam radiotherapy without systemic chemotherapy (9.3%). After controlling for patient age, race and ethnicity, co-morbidity, and histology, combination systemic chemotherapy and external beam radiotherapy was associated with 40% reduction of all-cause mortality compared with systemic chemotherapy without external beam radiotherapy (5-year rates: 63.1% vs 45.7%, adjusted-hazard ratio 0.60, 95% confidence interval 0.40-0.92). This reduction of all-cause mortality for combination systemic chemotherapy and external beam radiotherapy compared with systemic chemotherapy without external beam radiotherapy increased to 55% among non-endometrioid histology (5-year overall survival rates: 52.0% vs 33.4%, adjusted-hazard ratio 0.45, 95% confidence interval 0.23-0.88). In conclusion, the results of this investigation suggest that, despite peritoneal disease spread, multi-modal treatment with combination systemic and local therapies may improve survival in FIGO 2023 stage IIIB2 endometrial cancer, especially in non-endometrioid histology.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101773"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119654","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}
Stacey Davie, Andreas Obermair, Zoe Elizabeth West
{"title":"Patterns of care for vulval cancer treatment: the Queensland experience.","authors":"Stacey Davie, Andreas Obermair, Zoe Elizabeth West","doi":"10.1016/j.ijgc.2025.101956","DOIUrl":"10.1016/j.ijgc.2025.101956","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate patterns of care, post-operative adverse events, and recurrence rates in patients with vulval squamous cell carcinoma, undergoing sentinel node biopsy or inguino-femoral lymph node dissection.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on a cohort of 124 patients with vulval squamous cell carcinoma between 2016 and 2020 who met the study eligibility criteria. We compared the proportion of patients who underwent sentinel node biopsy versus inguino-femoral lymph node dissection, along with their rates of post-operative adverse events, recurrences, and associated socioeconomic factors.</p><p><strong>Results: </strong>Of the 124 patients, 58 (46.8%) underwent inguino-femoral lymph node dissection, and 66 (53.2%) underwent sentinel node biopsy. The utilization of sentinel node biopsy increased over the study period from 34.5% to 57.1%. Overall, 67 of 121 patients (55.4%) experienced at least one post-operative adverse event. The incidence of adverse events was significantly higher in the inguino-femoral lymph node dissection group compared to the sentinel node biopsy group (87.9% vs 24.4%, p < .0001). Lymphoedema (n = 26, 44.8% vs n = 4, 6.4%), seroma (n = 30, 24.6% vs n = 6, 9.5%), and infections (n = 23, 19.0% vs n = 8, 12.7%) were more frequent in the inguino-femoral lymph node dissection group than in the sentinel node biopsy group. Recurrence rates and time to recurrence were comparable between groups. Socioeconomic factors had no impact on patient outcomes.</p><p><strong>Conclusions: </strong>Only approximately half of the patients requiring a groin lymph node assessment had a sentinel node biopsy. Morbidity associated with vulval cancer treatment remains high. Further research is warranted to reduce the treatment burden without compromising survival outcomes.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101956"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484314","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}
Jacqueline Nunes de Menezes, Daniel Mioto Mataruco, Raíssa Êmily Andrade Souza, Gabriela Branquinho Guerra, Beatriz Pâmella Costa Bomfim, Isadora da Silveira, Ana Thereza da Cunha Uchoa, Glauco Baiocchi, Pedro T Ramirez
{"title":"Oncologic outcomes of sentinel lymph node mapping in patients with high-intermediate- and high-risk endometrial cancer: a systematic review and meta-analysis.","authors":"Jacqueline Nunes de Menezes, Daniel Mioto Mataruco, Raíssa Êmily Andrade Souza, Gabriela Branquinho Guerra, Beatriz Pâmella Costa Bomfim, Isadora da Silveira, Ana Thereza da Cunha Uchoa, Glauco Baiocchi, Pedro T Ramirez","doi":"10.1016/j.ijgc.2025.101901","DOIUrl":"10.1016/j.ijgc.2025.101901","url":null,"abstract":"<p><strong>Objective: </strong>Sentinel lymph node (SLN) mapping has not been widely adapted in the setting of high-intermediate and high-risk endometrial cancer. The goal of this study was to determine oncologic outcomes in this high-intermediate or high-risk population undergoing SLN mapping compared with systematic pelvic ± para-aortic lymphadenectomy.</p><p><strong>Methods: </strong>In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, MEDLINE, Embase, and Cochrane databases were searched for trials comparing SLN with lymphadenectomy for patients with high- or high-intermediate-risk endometrial cancer. Studies were excluded if they lacked a control group, involved overlapping populations, were only available as abstracts, or were not in English. The main outcomes were overall survival, disease-free survival, recurrence, and adjuvant therapy rates. A pre-specified sub-group analysis was carried out that included high-risk patients, high-intermediate-risk patients, and only propensity score-matched studies. Statistical analysis was performed using RStudio Version 4.4.0. Heterogeneity was assessed using I<sup>2</sup> statistics.</p><p><strong>Results: </strong>A total of 10 observational studies (2 with population data from the National Center for Biotechnology Information - NCBI and the Surveillance, Epidemiology and End Results - SEER databases) were included, evaluating a total of 6127 patients. There were no randomized control trials. There were no differences regarding overall survival (HR 0.82, 95% CI 0.60 to 1.11, p = .19, I<sup>2</sup> = 36%) or disease-free survival (HR 0.85, 95% CI 0.67 to 1.08, p = .19, I<sup>2</sup> = 0%) between SLN mapping and lymphadenectomy. Recurrence rates (OR 0.79, 95% CI 0.58 to 1.06, p = .12, I<sup>2</sup> = 0%) and adjuvant therapy (OR 1.39, 95% CI 0.78 to 2.48, p = .26, I<sup>2</sup> = 85%) were also similar between the groups. In a sub-group analysis including only the high-risk population, a statistically significant difference in overall survival favored SLN mapping compared with the lymphadenectomy (OR 0.62, 95% CI 0.44 to 0.89, p < .01, I<sup>2</sup> = 0%). Similarly, the analysis of propensity score-matched studies showed better overall survival in the SLN cohort (OR 0.61, 95% CI 0.43 to 0.87, p < .01, I<sup>2</sup> = 0%).</p><p><strong>Conclusions: </strong>SLN mapping is associated with similar oncologic outcomes to lymphadenectomy in patients with high-intermediate and high-risk endometrial cancer. Routine lymphadenectomy should no longer be considered a standard of care.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101901"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215766","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}
Esther Lems, Jordy E Mongula, Caroline L P Muntinga, Jaklien C Leemans, Janneke S Hoogstad-van Evert, Rixt A Smit, Jan W van der Steeg, Brenda M Pijlman, Sjors F P J Coppus, Marlies Y Bongers, Christianne A R Lok, Jurgen M J Piek, Peggy M A J Geomini
{"title":"Real-world performance of the Assessment of Different NEoplasias in the adneXa (ADNEX) model for the pre-operative classification of ovarian tumors.","authors":"Esther Lems, Jordy E Mongula, Caroline L P Muntinga, Jaklien C Leemans, Janneke S Hoogstad-van Evert, Rixt A Smit, Jan W van der Steeg, Brenda M Pijlman, Sjors F P J Coppus, Marlies Y Bongers, Christianne A R Lok, Jurgen M J Piek, Peggy M A J Geomini","doi":"10.1016/j.ijgc.2025.101917","DOIUrl":"10.1016/j.ijgc.2025.101917","url":null,"abstract":"<p><strong>Objective: </strong>To predict the risk of malignancy in ovarian tumors, the multi-class risk prediction Assessment of Different NEoplasias in the adneXa (ADNEX) model of the International Ovarian Tumor Analysis group is used internationally. This study aimed to perform an external validation of this model in a real-world clinical setting in the Netherlands.</p><p><strong>Methods: </strong>A multi-center, retrospective diagnostic accuracy study was performed. Women aged ≥18 years who attended the outpatient clinic between May 2020 and December 2021 and had a first ultrasound assessment for an ovarian tumor with application of the International Ovarian Tumor Analysis ADNEX model were included. The reference standard was the pathology result in case of surgery or follow-up with ultrasound according to the current Dutch guideline in case of conservative management.</p><p><strong>Results: </strong>Of the 363 women included, 286 (78.8%) had benign, 24 (6.6%) had borderline, and 53 (14.6%) had malignant pathology. Most (62.5%) of the included patients underwent surgery. The area under the receiver operating characteristic (ROC) curve was 0.92 (95% CI 0.89 to 0.96) if borderline tumors were considered malignant and 0.93 (95% CI 0.89 to 0.96) if borderline tumors were considered benign. Cutoff values between 7% and 14% yielded the highest Youden index. The model was moderately able to differentiate between malignant histologic sub-types.</p><p><strong>Conclusions: </strong>The ADNEX model showed excellent diagnostic performance in daily clinical practice and retained its value in a population in which a proportion of patients were treated with conservative management.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101917"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186974","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}