International Journal of Gynecological Cancer最新文献

{"title":"Clinician perceptions of asynchronous care for patients with ovarian cancer on PARP inhibitor therapy.","authors":"Melissa Kozak, Ainhoa Madariaga, Yuliya Gavrylyuk, Genevieve Bouchard-Fortier, Valerie Bowering, Nazlin Jivraj, Tran Truong, Mike Lovas, Kelly Lane, Soyoun R Kim, Adam Badzynski, Jennifer Catton, Stephanie Lheureux, Alejandro Berlin","doi":"10.1016/j.ijgc.2025.101788","DOIUrl":"10.1016/j.ijgc.2025.101788","url":null,"abstract":"<p><p>Asynchronous care is an alternative model of care involving information transmission without a simultaneous interaction between people. This study aimed to understand clinician perspectives about providing asynchronous care to patients with ovarian cancer who are clinically stable and receiving poly(adenosine diphosphate-ribose) polymerase inhibitor (PARPi) maintenance therapy at a large academic teaching hospital. The Theoretical Domains Framework (TDF) was used to undertake this study. Interviews were conducted with oncologists, physician assistants, and nurses who actively manage this patient population. Data were analyzed according to TDF domains to generate themes and understand supports, barriers, and buy-in related to this model of care. Overall, 73% of the 15 clinicians (50% of the oncologists) participating in this study were willing to provide asynchronous care to patients on PARPi who were clinically stable. Several themes emerged representing considerations for moving forward with this model of care, including selecting the ideal patients, streamlined access to information, safe and effective escalations, perceived acceptability of the asynchronous model by clinicians, reimbursement, and an opportunity and willingness to innovate. Participants recognized the potential benefits of an asynchronous care model for patients on PARPi therapy who are clinically stable and the opportunity to innovate while optimizing the use of limited clinic resources. Continued work toward discovery and implementation of an asynchronous care model should account for findings uncovered by application of the TDF.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 5","pages":"101788"},"PeriodicalIF":4.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811165","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":"De-escalation of surgery: is trachelectomy becoming obsolete?","authors":"Kenro Chikazawa, Shigenori Hayashi, Ken Imai, Tomoyuki Kuwata","doi":"10.1016/j.ijgc.2025.101772","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101772","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 5","pages":"101772"},"PeriodicalIF":4.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001115","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 detection rate of metastatic lymph nodes comparing sentinel lymph node biopsy and lymphadenectomy for staging of intermediate- and high-risk endometrial carcinoma.","authors":"Pernille Bjerre Trent, Nils Leitzinger, Yun Wang, Gunn Fallås Dahl, Brynhildur Eyjólfsdóttir, Jørgen Fallås Dahl, Kjersti Vassmo Lund, Anne Cathrine Staff, Ragnhild S Falk, Ane Gerda Z Eriksson","doi":"10.1016/j.ijgc.2025.101810","DOIUrl":"10.1016/j.ijgc.2025.101810","url":null,"abstract":"<p><strong>Objective: </strong>The primary aim of this study was to compare the detection rates of nodal metastases between lymphadenectomy (LND) and sentinel lymph node (SLN) in intermediate- and high-risk patients with assumed uterine-confined disease.</p><p><strong>Methods: </strong>This was a single-center observational study of patients from a tertiary referral center (2006-2023). Intermediate risk was defined as endometrioid adenocarcinoma grade 1/2 with ≥50% myoinvasion or grade 3 with <50% myoinvasion. High risk was defined as endometrioid adenocarcinoma grade 3 with ≥50% myoinvasion, non-endometrioid histologies regardless of myoinvasion or cervical involvement of any histology, and myoinvasion. All SLNs underwent pathologic ultra-staging. Nodal metastases were defined as the presence of macro- or micro-metastases. The comparison of metastatic lymph node rates by nodal assessment method was performed using the χ² test and multivariable logistic regression analysis.</p><p><strong>Results: </strong>A total of 996 patients were included (333 in the intermediate-risk group and 663 in the high-risk group). In the intermediate-risk group 192/333 (58%) patients underwent LND and 141/333 (42%) underwent SLN. Nodal metastases were detected in 11% and 9% of the LND and SLN cohorts (p = .46). Increasing proportions of staged patients were observed after SLN implementation (57% vs 78%) (p < .001). In the high-risk group, 412/663 (62%) patients underwent LND, and 251/663 (38%) underwent SLN. Nodal metastases were detected in 19% and 14% of the LND and SLN cohorts, respectively (p = .11). The majority of isolated tumor cells were observed in endometrioid histologies compared to non-endometrioid histologies (71% vs 29%, p = .01). Increasing proportions of staged patients were observed after SLN implementation (82% vs 88%) (p = .02). In the multivariable analysis, no association was observed between the nodal assessment method and the detection rates of nodal metastases in either risk group.</p><p><strong>Conclusions: </strong>In this predominantly high-risk population, the implementation of an SLN algorithm did not compromise the detection of nodal metastases. As more patients are comprehensively staged after SLN implementation, we expect more accurate surgical staging and adjuvant therapy allocation in this specific patient group in the future.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 5","pages":"101810"},"PeriodicalIF":4.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964604","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":"Genomic alterations, molecularly targeted therapy, and survival: a real-world Endometrial Cancer Molecularly Targeted Therapy Consortium cohort study.","authors":"Angeles Alvarez Secord, Victoria Bae-Jump, Floor Backes, Premal Thaker, Paola A Gehrig, Rebecca A Previs, Lindsay Borden, Samantha M Thomas, Amanda Jackson, Gottfried E Konecny, Linda R Duska, Rebecca Arend, Jason Wright, Bradley Corr, G Larry Maxwell, Casey M Cosgrove, Maggie M Mullen, Christina Washington, Thomas J Herzog, Joshua Cohen, June Hou, Stephanie Gaillard, Amanda Nickles Fader, Andrew Berchuck, Bhavana Pothuri","doi":"10.1016/j.ijgc.2025.101758","DOIUrl":"10.1016/j.ijgc.2025.101758","url":null,"abstract":"<p><strong>Objective: </strong>Next-generation sequencing and tumor testing to direct therapy in advanced/recurrent endometrial cancer are frequently used, but the impact of this approach is unclear. We sought to confirm the proportion of patients with at least 1 actionable alteration and whether the use of molecularly targeted therapy was associated with improved survival in metastatic endometrial cancer.</p><p><strong>Methods: </strong>A multidisciplinary consortium was formed to study tumor testing and treatment with targeted therapies in advanced/recurrent endometrial cancer. Tumor testing and therapeutic decisions were physician's recommendations. The abstracted data included age, stage, grade, histology, race, ethnicity, treatment, genomic alterations, protein expression for Her2, p53, mismatch repair, estrogen and progesterone receptors, and survival. Statistical analyses were performed using SAS v9.4.</p><p><strong>Results: </strong>A total of 967 patients from 12 centers were included. The median age was 64 years (range; 22-93 years). Of the participants, 68.5% were White, 24.0% were Black, 2.0% were Asian, and 92.7% were non-Hispanic. A total of 656 (67.8%) patients had recurrent/persistent disease and received a median of two (range; 0-9) therapies. 902 (93.3%) underwent tumor testing. Overall, 576 (94.0%) patients with next-generation sequencing testing had at least 1 genomic alteration in 11 pre-specified genes. The most frequent alterations were PI3K (35.8%), TP53 (34.7%), and PTEN (26.5%) mutations, respectively. A subset of 233 patients received 292 matched biologic therapies, and the median follow-up was 29.7 months, while the median progression-free survival and overall survival were 6.9 and 20.5 months, respectively.</p><p><strong>Conclusions: </strong>The consortium facilitated the development of real-world data on the patterns of genomic testing and molecularly targeted therapy used in a racially and geographically diverse patient cohort with advanced/recurrent endometrial cancer. Survival improved for those receiving matched biologic therapies compared to chemotherapy.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 5","pages":"101758"},"PeriodicalIF":4.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019742","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":"Response to \"Correspondence on \"Laparoscopic bariatric surgery with hysterectomy for endometrial cancer to improve long-term outcomes: a review article\" by Mezzapesa et al.\"","authors":"Emma Goddard, Joannie Neveu","doi":"10.1016/j.ijgc.2025.101804","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101804","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 5","pages":"101804"},"PeriodicalIF":4.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005577","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":"Whole-uterine versus individualized-uterine radiotherapy in locally advanced cervical cancer: clinical outcome and toxicity.","authors":"Jie Lee, Jhen-Bin Lin, Chao-Hsing Wang, Wen-Hsuan Lin, Chih-Long Chang, Yu-Jen Chen","doi":"10.1016/j.ijgc.2025.101817","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101817","url":null,"abstract":"<p><strong>Objective: </strong>Emerging evidence has suggested the safety and efficacy of individualized-uterine radiotherapy in locally advanced cervical cancer. This study aimed to compare the clinical outcomes and gastrointestinal toxicity of whole-uterine and individualized-uterine radiotherapy in women with locally advanced cervical cancer.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 220 patients with stage IB3 to IVA cervical cancer, treated with definitive chemoradiotherapy between 2014 and 2021 at 2 tertiary centers. The clinical target volume included the entire uterus (whole-uterine group) or an individualized-uterine volume based on the gross tumor with a 15 mm margin (individualized-uterine group). Local recurrence rate, overall survival, and progression-free survival were evaluated using the Kaplan-Meier method. The Patient-Reported Outcome version of the Common Terminology Criteria for Adverse Events was used to assess acute gastrointestinal toxicity, and a score of ≥3 indicated severe toxicity.</p><p><strong>Results: </strong>Overall, 128 (58.2%) and 92 (41.8%) patients received whole- and individualized-uterine radiotherapy with a median follow-up of 63.0 (interquartile range; 39.4-93.2) months and 64.8 (interquartile range; 47.3-85.6) months, respectively. Compared to the whole-uterine group, the individualized-uterine group had significantly lower volumes of small bowel, rectum, and sigmoid colon exposed to 45 Gy or 30 Gy (all p < .05). The 5-year local recurrence rate, overall survival, and progression-free survival in the whole- and individualized-uterine groups were 4.1% vs 0.0% (p = .054), 84.9% vs 87.6% (p = .48), and 74.7% vs 84.8% (p = .07), respectively. Fewer patients in the individualized group reported severe acute gastrointestinal toxicity (5.4% vs 23.4%, p < .001). The 5-year rates of severe late gastrointestinal toxicity were 7.4% and 0.0% in the whole- and individualized-uterine groups, respectively (p = .009).</p><p><strong>Conclusions: </strong>Individualized-uterine radiotherapy resulted in favorable clinical outcomes and reduced acute or late gastrointestinal toxicity compared to whole-uterine radiotherapy. This approach may offer an optimized balance between outcomes and toxicity in patients with locally advanced cervical cancer.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 5","pages":"101817"},"PeriodicalIF":4.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015617","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":"Intraluminal small bowel metastasis: an atypical presentation of bowel obstruction in recurrent ovarian cancer.","authors":"Montassar Ghalleb, Mehdi Mbarek","doi":"10.1136/ijgc-2024-006074","DOIUrl":"https://doi.org/10.1136/ijgc-2024-006074","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 5","pages":"101891"},"PeriodicalIF":4.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964775","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":"Patterns of pembrolizumab use for recurrent cervical cancer.","authors":"Yongmei Huang, Katherine Yoh, Elizabeth A Szamreta, Xiao Xu, Dawn L Hershman, Jason D Wright","doi":"10.1016/j.ijgc.2025.101802","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101802","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the real-world use of pembrolizumab for recurrent cervical cancer as part of first-line or recurrence treatment, and its associated health care utilization.</p><p><strong>Methods: </strong>The Merative MarketScan Research Databases were used to identify newly diagnosed patients with cervical cancer who underwent primary hysterectomy or radiation from 2017 to 2022. Systemic therapy utilization, including pembrolizumab, was assessed at first recurrence. Health care utilization (hospitalization, emergency department visits, and costs) during first-line treatments for recurrence was described for patients treated with and without pembrolizumab. Multivariable regression models explored factors associated with pembrolizumab adoption and differences in health care utilization.</p><p><strong>Results: </strong>A total of 2727 patients were identified, including 1259 (46.2%) who underwent primary hysterectomy and 1468 (53.8%) who received primary radiotherapy. Chemotherapy for recurrence was initiated in 339 patients (12.4%). Recurrence treatment was noted in 9.7% of patients initially treated with hysterectomy and in 14.8% of those receiving primary radiotherapy. Among patients treated for recurrence, 24.8% received platinum alone, 52.5% a platinum-based combination therapy, and 22.7% non-platinum regimens. Forty-one patients (12.1%) received pembrolizumab. The median duration of first-line chemotherapy for recurrence was 2.3 months (interquartile range; 1.0-5.8) overall, and 4.3 months (interquartile range; 2.4-9.8) for patients treated with pembrolizumab. Pembrolizumab utilization was associated with more recent years of recurrence, advanced age, and prior chemotherapy. While pembrolizumab use was not associated with increased inpatient stays or emergency department visits, it was associated with significantly higher total costs and chemotherapy-related expenses.</p><p><strong>Conclusions: </strong>Platinum-based chemotherapy is the predominant treatment for recurrent cervical cancer. Pembrolizumab utilization, although increasing, remains limited, highlighting a significant opportunity to optimize guideline-recommended therapies with proven efficacy in clinical trials.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 5","pages":"101802"},"PeriodicalIF":4.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986287","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":"Molecular subtypes and genomic landscape of undifferentiated and dedifferentiated endometrial cancer.","authors":"Christian Dagher, Pier Selenica, Amir Momeni-Boroujeni, Lora H Ellenson, Jennifer J Mueller, Nadeem R Abu-Rustum, M Herman Chui, Britta Weigelt","doi":"10.1016/j.ijgc.2025.101815","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101815","url":null,"abstract":"<p><strong>Objective: </strong>Undifferentiated and dedifferentiated endometrial carcinomas are rare and clinically aggressive variants of the disease. We sought to define the molecular subtypes and genetic alterations affecting cancer-related genes of these rare histologic endometrial cancer types.</p><p><strong>Methods: </strong>Patients with undifferentiated/dedifferentiated endometrial cancer subjected to clinical tumor-normal panel sequencing between January 1, 2014, to June 1, 2023, were retrospectively identified, and relevant demographic and clinicopathologic data were extracted from medical records. All cases underwent central pathology review. Endometrial carcinomas with mixed histology and synchronous tumors were excluded. Genomic data including somatic mutations, copy number alterations, and microsatellite instability (MSI), in addition to immunohistochemistry results, were extracted and utilized for molecular subtyping.</p><p><strong>Results: </strong>A total of 35 patients met inclusion criteria, with a median age at diagnosis of 60 years (range, 36 to 85). Of these, 16 (46%) were undifferentiated and 19 (54%) dedifferentiated, with undifferentiated being more frequently of International Federation of Obstetrics and Gynecology (FIGO) 2009 stage IV at diagnosis than dedifferentiated (7/16, 40% vs 3/19, 17%, p = .05). All 4 molecular subtypes were present, with the majority being MSI-high/mismatch repair-deficient (n = 25, 71%); the remaining cases were of POLE molecular subtype (n = 2, 6%), copy number (CN)-high/TP53abnormal (n = 3, 9%), and CN-low/no specific molecular profile (n = 5, 14%). The most recurrent genetic alterations were found in PTEN (26/35, 74%), ARID1A (26/35, 74%), PIK3CA (21/35, 60%) ARID1B (14/35, 40%), and SMARCA4 (9/35, 26%). Pathogenic mutations in chromatin remodeling genes, including ARID1A and ARID1B, were absent in endometrial cancers of CN-high/TP53abnormal subtype.</p><p><strong>Conclusions: </strong>Undifferentiated/dedifferentiated endometrial cancers are heterogeneous at the molecular level; however, the majority are MSI-high/mismatch repair-deficient, which may have therapeutic implications. Loss-of-function alterations in chromatin remodeling genes were present in all molecular subtypes except CN-high/TP53 abnormal undifferentiated/dedifferentiated endometrial cancers.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 5","pages":"101815"},"PeriodicalIF":4.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987007","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":"Primary mixed carcinoid tumor arising in a mature ovarian teratoma.","authors":"Jessica Mauro, Federica Filipello, Chiara Borghi, Giuseppe Di Guardia, Alessandro Buda","doi":"10.1016/j.ijgc.2025.101806","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101806","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 5","pages":"101806"},"PeriodicalIF":4.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999406","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}