International Journal of Gynecological Cancer最新文献

{"title":"Authors' response to: \"Methodological concerns regarding AGO score validation in low-grade ovarian cancers\".","authors":"Emel Canaz, Eser S Ozyurek, Jalid Sehouli","doi":"10.1016/j.ijgc.2025.102658","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102658","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102658"},"PeriodicalIF":4.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199165","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":"Role of artificial intelligence applied to ultrasound in endometrial cancer: a systematic review.","authors":"Marianna Ciancia, Francesca Moro, Martina Bertoni, Giulia Baldassari, Pierpaolo Schips, Francesco Fanfani, Anna Fagotti, Antonia Carla Testa","doi":"10.1016/j.ijgc.2025.102653","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102653","url":null,"abstract":"<p><strong>Objective: </strong>To synthesize the application of artificial intelligence (AI) in ultrasound imaging for the assessment of endometrial cancer, with a focus on methodological approaches and diagnostic accuracy in predicting different outcomes.</p><p><strong>Methods: </strong>PubMed, Scopus, and Web of Science databases were searched from inception up to January 16, 2025. Studies applying AI to ultrasound imaging in the diagnosis, staging, and management of endometrial malignant pathology were included. Quality assessment of the retrieved studies was performed using the Quality Assessment Tool for Artificial Intelligence-Centered Diagnostic Test Accuracy Studies (QUADAS-AI). The protocol was registered in the PROSPERO database (registration record CRD42025648961).</p><p><strong>Results: </strong>Thirty studies were included: 18 (60%) distinguished between benign and malignant endometrial lesions, 4 (13.3%) focused on predicting lymph node metastases, 3 (10%) evaluated myometrial invasion, and 2 (6.6%) classified tumor risk. Additionally, 2 studies assessed disease-free survival (6.6%), while another developed a model for the automated identification of endometrial lesions (3.3%). According to QUADAS-AI, most studies were at high risk of bias for subject selection (eg, sample size not specified, imaging preprocessing not performed) (27/30, 90%) and the index test (no external validation) (27/30, 90%) domains, and at low risk of bias for the reference standard (target condition correctly classified by the reference standard) (29/30, 97%) and the workflow (reasonable time between index test and reference standard) (29/30, 97%) domains. Models were externally validated in 3/30 studies (10%), internally cross-validated in 3/30 (10%), internally hold-out validated in 13/30 (43.3%), and not validated in 11/30 (36.7%).</p><p><strong>Conclusions: </strong>Published research on AI applications in ultrasound for endometrial cancer primarily focuses on developing classification models to distinguish benign from malignant endometrial lesions and to stage the disease. Overall, ultrasound-based AI models have demonstrated strong predictive performance. However, most studies are limited by small sample sizes and a lack of external validation.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 11","pages":"102653"},"PeriodicalIF":4.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199175","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":"Prognostic value of \"aggressive\" histology in surgically staged clinically uterine-confined endometrial carcinoma.","authors":"Christian Dagher, Jennifer J Mueller, Yukio Sonoda, Amir Momeni-Boroujeni, Vicky Makker, Roisin E O'Cearbhaill, Kaled Alektiar, Nadeeem R Abu-Rustum, Mario M Leitao","doi":"10.1016/j.ijgc.2025.102656","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102656","url":null,"abstract":"<p><strong>Objective: </strong>We compared oncologic outcomes across \"aggressive\" histopathological subtypes of apparent early-stage, high-grade endometrial carcinoma.</p><p><strong>Methods: </strong>Patients who underwent surgical staging at our institution for newly diagnosed high-grade endometrial adenocarcinoma between January 1, 2009, and June 30, 2021, were retrospectively identified. We defined \"aggressive\" histology as International Federation of Obstetrics and Gynecology grade 3 endometrioid, serous, clear cell, carcinosarcoma, mixed, and undifferentiated/dedifferentiated subtypes. Clinicopathologic details were extracted from medical records. Continuous variables were analyzed using the Kruskal-Wallis test, categorical variables using Fisher's exact test or the χ² test, and survival outcomes using the Kaplan-Meier method and Cox proportional hazards models.</p><p><strong>Results: </strong>Of 1087 patients, 308 (28.3%) had grade 3 endometrioid adenocarcinoma, 357 (32.8%) serous adenocarcinoma, 64 (5.9%) clear cell carcinoma, 194 (17.8%) carcinosarcoma, 101 (9.3%) mixed adenocarcinoma, and 63 (5.8%) undifferentiated/dedifferentiated adenocarcinoma. Overall, 719 patients (66.1%) had International Federation of Obstetrics and Gynecology 2009 stage I, 51 (4.7%) stage II, 232 (21.3%) stage III, and 85 (7.8%) stage IV disease. Median age at surgery was 65.1 years (range; 24.8-92.1) and varied among histologies (p < .001). Overall, 462 patients (42.5%) had lymphovascular invasion, 333 (30.6%) had deep myometrial invasion (≥50%), and 160 (15.0%) had positive peritoneal cytology; all varied across histologies (p < .001). Rates of 5-year progression-free and overall survivals were 79% (standard error [SE] ± 3%) and 83% (SE ± 2%) for grade 3 endometrioid, 63% (SE ± 3%) and 66% (SE ± 3%) for serous, 73% (SE ± 6%) and 77% (SE ± 6%) for clear cell, 51% (SE ± 4%) and 54% (SE ± 4%) for carcinosarcoma, 59% (SE ± 5%) and 65% (SE ± 5%) for mixed, and 71% (SE ± 6%) and 76% (SE ± 6%) for undifferentiated/dedifferentiated (P<.001 for both). Peritoneal cytology, lymphovascular invasion, and age at surgery were independent predictors of worse progression-free and overall survivals on multivariable analysis.</p><p><strong>Conclusions: </strong>High-grade \"aggressive\" histologies in endometrial cancer are diverse tumors with distinct oncologic outcomes; therefore, they should not be treated as a single entity or used as a staging criterion.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 11","pages":"102656"},"PeriodicalIF":4.7,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199227","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":"Practical strategies for environmentally sustainable practices in gynecologic oncology.","authors":"Ilker Kahramanoglu, Joanna Kacperczyk-Bartnik, Remi Nout, Francois Planchamp, Jacek Sienko, Kari Tanderup, Diana Zach, Frédéric Amant","doi":"10.1016/j.ijgc.2025.102648","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102648","url":null,"abstract":"<p><p>Sustainability in health care is an increasingly urgent priority, and gynecologic oncology (as a resource-intensive surgical specialty) offers opportunities to reduce environmental impact without compromising patient care. This review provides actionable, evidence-based strategies that individual clinicians, departments, and institutions can readily implement into routine practice. Practical anesthetic strategies, such as total intravenous anesthesia, regional anesthesia, and low-flow techniques, substantially decrease greenhouse gas emissions. Transitioning from disposable to reusable surgical instruments, drapes, and gowns significantly curbs waste. Energy-efficient solutions in the operating room, including optimized heating, ventilation, air conditioning systems, as well as light emitting diode lighting, minimize unnecessary energy use. Optimizing diagnostic imaging through clinical justification and powering down equipment when feasible further decreases energy consumption. Pharmaceutical-related strategies, including accurate chemotherapy dosing, safe medication disposal through drug take-back programs, and environmentally conscious procurement, mitigate harmful emissions and pharmaceutical waste. Surgical techniques such as sentinel lymph node biopsy, rather than extensive lymphadenectomy, also support sustainability goals by reducing resource consumption and procedural waste. Digital innovations, notably telemedicine, demonstrate clear environmental advantages by minimizing patient travel, particularly for routine follow-up and the collection of patient-reported outcomes. Enhanced Recovery After Surgery protocols, promoting shorter hospital stays and digital preoperative assessments, represent additional avenues for improvement. Preventive interventions, such as human papillomavirus vaccination programs and early cancer screening, are vital long-term sustainability investments, reducing resource-intensive treatments associated with advanced disease. By highlighting practical examples from recent studies and clinical experience, this review aims to encourage widespread adoption of sustainable practices in gynecologic oncology, aligning clinical excellence with global environmental goals.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 11","pages":"102648"},"PeriodicalIF":4.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206429","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":"Long-term survival analysis of a randomized phase II study of front-line chemo-immunothe-rapy with carboplatin-paclitaxel using oreg-ovomab indirect immunization in advanced ovarian cancer (QPT-ORE-002).","authors":"Corrado Terranova, Vanda Salutari, Francesco Plotti, Caterina Ricci, Anna Fagotti, Francesco Raspagliesi, Violante Di Donato, Paolo Scollo, Sunil Gupta, Jada Srinivasa Rao, Giovanni Scambia, Roberto Angioli","doi":"10.1016/j.ijgc.2025.102649","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102649","url":null,"abstract":"<p><strong>Objective: </strong>Oregovomab is a murine monoclonal antibody directed to the tumor-associated antigen CA125 that stimulates host cellular and humoral immune response against tumor cells expressing CA125. A single-arm phase II study in; treatment of patients with epithelial ovarian cancer, simultaneous day infusion of; oregovomab with paclitaxel and carboplatin dramatically enhanced the magnitude of; induced immunity relative to a 1-week delayed schedule and other schedules; historically evaluated. This randomized phase II study tested the hypothesis that; schedule-dependent chemotherapy with oregovomab may improve progression-free survival in optimally resected, stage III/IV ovarian cancer.</p><p><strong>Methods: </strong>Stage III/IV epithelial ovarian cancer patients optimally debulked to <1 cm residual disease with CA125 >50 U/mL were randomized to carboplatin-paclitaxel + oregovomab; cycle 1,3,5,C5 +12 weeks versus carboplatin-paclitaxel and followed for clinical outcomes and immune response. Secondary endpoints were clinical evaluations and safety.</p><p><strong>Results: </strong>A total of 97 patients were randomized to the protocol, 47 to carboplatin-paclitaxel-oregovomab and 50 to carboplatin-paclitaxel. Progression-free survival analysis revealed a median progression-free survival of 41.8 months (95% CI 21.8-not estimable [NE]) for carboplatin-paclitaxel-oregovomab and 12.2 months (10.4-18.6) for carboplatin-paclitaxel (HR 0.46, CI 0.28 to 0.7, p = .0027). An updated long-term overall survival analysis was performed with a median follow-up of 109.4 months which demonstrated that in the intent-to treat population the median overall survival for carboplatin-paclitaxel-oregovomab was 121.3 months (95% CI 106.2 to NE) and 64.7 months (95% CI 38.2 to NE) for carboplatin-paclitaxel (HR 0.47, 95% CI 0.26 to 0.86, p = .0116).</p><p><strong>Conclusions: </strong>This study suggests that simultaneous administration of oregovomab on alternate cycles during front-line carboplatin and paclitaxel could enhance progression-free survival and long-term overall survival. This increase in median overall survival after 9 years of follow-up is meaningful in patients with optimally debulked epithelial ovarian cancer.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102649"},"PeriodicalIF":4.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181980","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":"Redefining surgical goals: beyond R0 for long-term survival in advanced ovarian cancer.","authors":"Fatma Ferda Verit","doi":"10.1016/j.ijgc.2025.102652","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102652","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 11","pages":"102652"},"PeriodicalIF":4.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181882","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":"Long-term oral contraceptive use as a risk factor for high-grade cervical lesions in women with high-risk human papillomavirus: a retrospective cohort analysis.","authors":"Farah Farzaneh, Fatemeh Dastyar, Marzieh Mohammadi, Maryam Sadat Hosseini, Amir Soltani","doi":"10.1016/j.ijgc.2025.102650","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102650","url":null,"abstract":"<p><strong>Objective: </strong>While high-risk human papillomavirus (HPV) is the established cause of cervical intraepithelial neoplasia (CIN), cofactors influencing progression to high-grade disease remain poorly defined. This study aimed to investigate the association between long-term oral contraceptive use and the risk of high-grade CIN (grade 2/3) in a high-risk referral population.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the records of 684 women screened at a specialized gynecologic oncology clinic (2019-2024). Data on oral contraceptive use (≥5 years), high-risk HPV status, age, and smoking history were extracted. The primary outcome was CIN grade. To mitigate bias from sparse data, Firth-penalized logistic regression was used to calculate adjusted ORs (aOR) for the association between long-term oral contraceptive use and CIN grade.</p><p><strong>Results: </strong>Long-term oral contraceptive use was reported by 5.6% of the cohort. After adjusting for confounders, long-term oral contraceptive use was strongly associated with a 16.8-fold increased odds of high-grade CIN (aOR 16.79, 95% CI 3.82 to 73.70, p < .001). However, the wide CI indicates significant statistical uncertainty in the magnitude of the effect. Conversely, oral contraceptive use was associated with significantly lower odds of low-grade CIN (aOR 0.04, 95% CI 0.01 to 0.15, p < .001).</p><p><strong>Conclusions: </strong>In this high-risk population, long-term oral contraceptive use is a significant independent risk factor for high-grade cervical lesions, while paradoxically being associated with a lower risk of low-grade disease. This suggests an important role for hormonal factors in the progression of cervical neoplasia. Clinicians should consider long-term oral contraceptive use a key risk indicator in HPV-positive women and incorporate this modifiable factor into patient counseling.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 11","pages":"102650"},"PeriodicalIF":4.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206484","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":"Psychophysical and social impact of risk-reducing salpingo-oophorectomy in China: a cross-sectional study.","authors":"Xinyu Ha, Zheng Feng, Jing Xia, Ziqi Liu, Jiajia Wang, Zuo Ke, Yu Lin, Yaqiong Chen, Hao Wen, Xiaohua Wu","doi":"10.1016/j.ijgc.2025.102135","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102135","url":null,"abstract":"<p><strong>Objective: </strong>Risk-reducing salpingo-oophorectomy has been adopted in China as an effective preventive measure against ovarian cancer, particularly for individuals with breast cancer gene (BRCA) mutations. While the procedure's efficacy in reducing ovarian cancer risk is well established, the associated psychophysical and social impacts have received limited attention. Understanding these impacts is critical for enhancing patient care and improving quality of life.</p><p><strong>Methods: </strong>This retrospective study included 154 BRCA mutation carriers who underwent risk-reducing salpingo-oophorectomy at Fudan University Shanghai Cancer Center between October 2016 and March 2024. A total of 136 patients were successfully followed up for quality-of-life assessment. Data were collected using the Self-Rating Anxiety Scale, Menopause Rating Scale, Decision Regret Scale, Decision Conflict Scale, and self-reported evaluations. Descriptive statistics were employed to summarize the data, and subgroup analyses were conducted to identify potential influencing factors.</p><p><strong>Results: </strong>The median age of participants was 46 years. Personal histories of breast cancer were reported in 63.97% (87/136) of the patients, and 8.82% (12/136) were diagnosed with occult ovarian cancer or precancerous lesions post-surgery. Among the cohort, 71.32% (97/136) were postmenopausal. Of the premenopausal patients, only 6 attempted hormone replacement therapy. Anxiety levels and menopausal symptoms were not significantly associated with clinical or demographic variables. Most patients reported low decision regret, with 89.71% (122/136) expressing complete satisfaction with the surgery and only 5.88% (8/136) reporting persistent stress. However, sexual dysfunction was reported by 46.32% (63/136).</p><p><strong>Conclusion: </strong>Risk-reducing salpingo-oophorectomy is associated with significant challenges, particularly concerning sexual dysfunction. These findings underscore the need for comprehensive preoperative counseling that distinctly addresses biomedical, physiological, and psychosocial considerations, alongside postoperative support to manage the quality-of-life impacts of risk-reducing salpingo-oophorectomy.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102135"},"PeriodicalIF":4.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181963","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":"Intermediate-risk endometrial carcinoma: is the evidence ripe for this strength of recommendation?","authors":"Francesco Olivero, Anna Maria Merlotti, Stefania Martini, Paola Critelli, Jacopo Di Muzio","doi":"10.1016/j.ijgc.2025.102132","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102132","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 11","pages":"102132"},"PeriodicalIF":4.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148990","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":"Surgery plus post-operative radiotherapy versus definitive chemoradiotherapy in locally advanced endocervical adenocarcinoma.","authors":"Jong Yun Baek, Won Park, Won Kyung Cho, Hyun-Soo Kim, Byoung-Gie Kim, Jeong-Won Lee, Chel Hun Choi, Tae-Joong Kim, Yoo-Young Lee","doi":"10.1016/j.ijgc.2025.102013","DOIUrl":"10.1016/j.ijgc.2025.102013","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated whether treatment outcomes for endocervical adenocarcinoma differ according to treatment modality (surgery plus post-operative radiotherapy versus definitive chemoradiotherapy) and human papillomavirus (HPV) status.</p><p><strong>Methods: </strong>We retrospectively analyzed 105 patients with clinical stage IIB to IIIC endocervical adenocarcinoma, classified according to the 2018 International Federation of Gynecology and Obstetrics staging system, who were treated with surgery plus post-operative radiotherapy or definitive chemoradiotherapy at a single institution between 2011 and 2022. HPV status was determined based on the 2020 World Health Organization classification. Among the 105 patients, 61 had HPV-associated tumors and 44 had HPV-independent tumors. Patients were categorized into 4 groups: HPV-associated surgery plus post-operative radiotherapy (n = 46), HPV-associated definitive chemoradiotherapy (n = 15), HPV-independent surgery plus post-operative radiotherapy (n = 27), and HPV-independent definitive chemoradiotherapy (n = 17). Progression-free survival, locoregional recurrence-free survival, and overall survival were evaluated.</p><p><strong>Results: </strong>Baseline characteristics differed significantly among the 4 groups, particularly in clinical stage, tumor size, and parametrial invasion. The 3-year progression-free, locoregional recurrence-free, and overall survival rates were 47.4%, 54.7%, and 69.8%, respectively. By group, survival rates were 55.4%, 66.4%, and 76.9% for HPV-associated surgery plus post-operative radiotherapy; 52.5%, 52.5%, and 93.3% for HPV-associated definitive chemoradiotherapy; and 54.3%, 56.8%, and 67.5% for HPV-independent surgery plus post-operative radiotherapy, compared with significantly poorer rates of 11.8%, 20.6%, and 33.1% for HPV-independent definitive chemoradiotherapy (p < .05). These differences remained significant after multivariate adjustment, while no significant survival differences were observed between other groups. In a sub-group analysis of HPV-independent patients with clinical T2 to T3 disease, definitive chemoradiotherapy remained associated with worse outcomes than surgery plus post-operative radiotherapy.</p><p><strong>Conclusions: </strong>Definitive chemoradiotherapy showed outcomes comparable to surgery plus post-operative radiotherapy in HPV-associated adenocarcinoma, but was associated with significantly worse survival in HPV-independent cases. Further studies are warranted to confirm these findings.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 9","pages":"102013"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768642","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}