International Journal of Gynecological Cancer最新文献

{"title":"Cervical cancer elimination in low-resource countries: low-cost strategy.","authors":"Reda Hemida, Rafik Barakat, Hanan Nabil, Mohammed Hasan, Adel Helal, Ahmed Ragab","doi":"10.1016/j.ijgc.2025.101828","DOIUrl":"10.1016/j.ijgc.2025.101828","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101828"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999646","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":"Uterine mass to sarcoma: navigating diagnostic ambiguity and fertility-sparing considerations.","authors":"Pauline Prost, Sophie Bringer-Deutsch, Stéphanie Nougaret, Cristina Leaha, Sébastien Carrère","doi":"10.1016/j.ijgc.2025.101944","DOIUrl":"10.1016/j.ijgc.2025.101944","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101944"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247710","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":"Preclinical activity of sacituzumab govitecan in TROP2-positive low-grade serous ovarian cancer patient-derived xenograft models.","authors":"Victoria M Ettorre, Cem Demirkiran, Stefania Bellone, Na Niu, Natalia Buza, Namrata Sethi, Tobias Max Philipp Hartwich, Luca Palmieri, Alessandro D Santin","doi":"10.1016/j.ijgc.2025.101988","DOIUrl":"10.1016/j.ijgc.2025.101988","url":null,"abstract":"<p><strong>Objective: </strong>Low-grade serous ovarian cancer is a rare epithelial ovarian cancer subtype characterized by high resistance to chemotherapy and an indolent disease course. The development of novel, effective, targeted treatments for recurrent, chemotherapy-resistant low-grade serous ovarian cancer remains an unmet medical need. We evaluated trophoblast cell-surface antigen 2 (TROP2) expression in a cohort of patients with low-grade serous ovarian cancer and assessed the preclinical activity of sacituzumab govitecan, an antibody-drug conjugate targeting TROP2, in vivo using a patient-derived xenograft (PDX) model.</p><p><strong>Methods: </strong>TROP2 expression was evaluated in 26 patients with low-grade serous ovarian cancer using immunohistochemistry. The efficacy of sacituzumab govitecan was assessed in vivo in severe combined immunodeficiency mice using a TROP2-positive low-grade serous ovarian cancer PDX model established from a patient with disease resistant to chemotherapy, aromatase inhibitors, and MEK inhibitors.</p><p><strong>Results: </strong>TROP2 expression was observed in all low-grade serous ovarian cancer cases, with 21 of 26 (81%) samples demonstrating moderate to strong expression. In vivo studies in mice demonstrated that sacituzumab govitecan significantly inhibited tumor growth in a chemotherapy-, aromatase inhibitor-, and MEK inhibitor-resistant low-grade serous ovarian cancer PDX model compared to control animals treated with vehicle/saline (p < .0001). Median survival for control mice was 25 days, while it was not reached by the end of the experiment (day 50) in animals treated with sacituzumab govitecan.</p><p><strong>Conclusion: </strong>TROP2 is a novel biomarker highly expressed in low-grade serous ovarian cancer. Sacituzumab govitecan may represent a potentially effective new treatment option for patients with low-grade serous ovarian cancer progressing after standard treatment modalities. Further clinical trials in low-grade serous ovarian cancer treated with sacituzumab govitecan are warranted.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 9","pages":"101988"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667615","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":"Uterine leiomyosarcoma.","authors":"Giorgio Bogani, Giuseppe Caruso, Isabelle Ray-Coquard, Pedro T Ramirez, Nicole Concin, Natalie Yl Ngoi, Robert L Coleman, Andrea Mariani, William Cliby, Mario M Leitao, Nadeem Abu Rustum, Paolo G Casali, Alessandro Gronchi, Ignace Vergote, Judith Kroep, Takayuki Enomoto, Kazuhiro Takehara, Hannelore Denys, Masashi Takano, Diane Provencher, Pauline Wimberger, Se Ik Kim, Jae-Weon Kim, Gian Franco Zannoni, David Sp Tan, Jvan Casarin, Biagio Paolini, Valentina Chiappa, Francesco Raspagliesi, Ilaria Cuccu, Violante Di Donato, David M O'Malley, David Mutch, Jubilee Brown, Fernanda Herrera, Nicoletta Colombo, Sandro Pignata, Giovanni Scambia, Brian M Slomovitz, Bradley J Monk","doi":"10.1016/j.ijgc.2025.101992","DOIUrl":"10.1016/j.ijgc.2025.101992","url":null,"abstract":"<p><p>Uterine leiomyosarcoma is a rare and heterogeneous gynecological malignancy that poses a significant clinical challenge due to its aggressive nature and limited treatment options. Its multifactorial etiopathogenesis involves complex cytogenetic and molecular aberrations, including TP53, RB1, and chromothripsis-associated gene alterations. The non-specific clinical presentation, resembling other benign conditions, complicates early and accurate diagnosis, alongside intricate radiological and pathological patterns. Advanced imaging techniques, such as magnetic resonance imaging and computed tomography, are employed to differentiate uterine leiomyosarcoma from benign conditions, but no single test is definitive. For FIGO (International Federation of Gynecology and Obstetrics) stage I uterine leiomyosarcoma, treatment consists of en bloc total hysterectomy ± bilateral salpingo-oophorectomy. Patients with stage II to IV disease amenable to complete resection can undergo surgery followed by adjuvant systemic therapy and/or radiotherapy. Lymphadenectomy is unnecessary in patients lacking bulky nodes. Unresectable or unsuitable cases warrant primary systemic therapy and/or radiotherapy. Managing recurrent disease requires a multimodal approach tailored to factors such as the site and number of metastases, prior radiotherapy, and resectability. Multidisciplinary management and centralization in referral centers are crucial for individualized decision-making. Ongoing research explores the intricate cytogenetic and molecular aberrations of uterine leiomyosarcoma, paving the way for personalized treatment strategies. This review, developed following the European Society of Gynaecological Oncology/Gynecologic Cancer InterGroup/European Reference Network on Rare Adult Solid Cancers guidelines, explores the clinical presentation, diagnostic challenges, and evolving therapeutic strategies for uterine leiomyosarcoma, while also highlighting variations in clinical practice worldwide.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 9","pages":"101992"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760063","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":"A message from the Editor-in-Chief: call for applications for the next International Journal of Gynecological Cancer Editor-in-Chief.","authors":"Pedro T Ramirez","doi":"10.1016/j.ijgc.2025.102014","DOIUrl":"10.1016/j.ijgc.2025.102014","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 9","pages":"102014"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775364","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":"Impact of surgery and molecular classification in stage IV endometrial cancer.","authors":"Matteo Loverro, Emanuele Perrone, Vincenzo Tarantino, Giovanni Esposito, Camilla Culcasi, Fulvia Pirrelli, Raffaella Sardo Infirri, Eleonora Palluzzi, Virginia Vargiu, Veronica Celli, Francesco Fanfani","doi":"10.1016/j.ijgc.2025.102015","DOIUrl":"10.1016/j.ijgc.2025.102015","url":null,"abstract":"<p><strong>Objective: </strong>Evidence supporting the role of surgery after neoadjuvant chemotherapy in advanced endometrial cancer remains limited. Additionally, the prognostic relevance of molecular classification in this setting is poorly defined. We aimed to evaluate overall survival in patients with peritoneal and/or extra-abdominal spread, focusing on surgical approach and molecular sub-type.</p><p><strong>Methods: </strong>We retrospectively analyzed all patients with Fédération Internationale de Gynécologie et d'Obstétrique 2009 stage IVB (Fédération Internationale de Gynécologie et d'Obstétrique 2023 IIIB2, IVB, IVC) endometrial cancer treated between January 2012 and September 2023. Patients were stratified according to immunohistochemistry-based molecular classification, intra-abdominal disease extension, and treatment strategy. Kaplan-Meier and Cox regression analyses were used to assess overall survival. Differences across groups were evaluated using appropriate nonparametric and categorical statistical tests.</p><p><strong>Results: </strong>Among 363 eligible patients, 229 (63.1%) underwent primary cytoreduction, 52 (14.3%) had interval debulking surgery, 55 (15.2%) received chemotherapy alone, and 27 (7.4%) were untreated. Patients receiving neoadjuvant or exclusive chemotherapy more frequently had extra-abdominal (p < .001) and upper abdominal disease (p < .001). In patients with extra-pelvic disease, overall survival was comparable between primary and interval surgery (p = .82). Among those treated with neoadjuvant treatment, surgical cytoreduction was strongly associated with improved overall survival (p < .001). Mismatch repair-deficient patients had better overall survival than those with p53 abnormal tumors (34 vs 21 months, p = .026). No specific molecular profile-estrogen receptor positive tumors showed longer overall survival than both p53 abnormal and no specific molecular profile-estrogen receptor negative sub-types (60 vs 34 and 21 months, p = .018 and p = .041, respectively). In multivariate analysis, extra-pelvic disease (p = .042) and exclusive chemotherapy (p < .0001) were independent negative prognostic factors.</p><p><strong>Conclusions: </strong>In advanced endometrial cancer, surgery remains a key component of management. Our findings suggest a potential survival advantage for patients who undergo surgery-either as primary treatment or following neoadjuvant chemotherapy-compared to those treated with chemotherapy alone. Molecular classification may offer prognostic insight even in stage IV disease, although further validation is required. These findings provide a benchmark for future studies in the evolving landscape of immunotherapy and personalized treatment.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 9","pages":"102015"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812043","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":"Clinical and pathological characteristics and outcomes of small cell neuroendocrine carcinoma of the uterine cervix.","authors":"Mariya Kobayashi, Satoshi Nakagawa, Tatsuo Masuda, Mamoru Kakuda, Kosuke Hiramatsu, Tadashi Iwamiya, Shinya Matsuzaki, Kae Hashimoto, Yutaka Ueda, Michiko Kodama, Munetaka Takekuma, Maximilian Klar, Lynda D Roman, Jason D Wright, Koji Matsuo","doi":"10.1016/j.ijgc.2025.102011","DOIUrl":"10.1016/j.ijgc.2025.102011","url":null,"abstract":"<p><strong>Objective: </strong>To describe the clinical and pathological characteristics and outcomes of small cell neuroendocrine carcinoma of the uterine cervix at the population level in the United States.</p><p><strong>Methods: </strong>The National Cancer Institute's Surveillance, Epidemiology, and End Results Program was retrospectively queried. The study population included 54,987 patients with cervical cancer from 2004 to 2021. Descriptive analysis was performed based on histology.</p><p><strong>Results: </strong>Histology types included squamous cell carcinoma (n = 38,145, 69.4%), adenocarcinoma (n = 14,333, 26.1%), adenosquamous carcinoma (n = 1,970, 3.6%), and small cell neuroendocrine carcinoma (n = 539, 1.0%). Over the 18-year study period, the incidence rate of small cell neuroendocrine carcinoma increased by 3.2% per year (95% CI 1.2 to 5.7, p = .003). Based on this trajectory, the incidence of small cell neuroendocrine carcinoma is estimated to reach 2.0% by 2035. Small cell neuroendocrine carcinoma was associated with larger cervical tumors (60 mm versus 27-40 mm), a higher lymph node metastasis ratio (25.0% versus 14.3%-15.4%), higher distant metastasis rate even in small tumor (10 mm, 10.3% versus 0.5-2.6%; and 20 mm, 14.8% versus 3.9-5.3%), and stage IV disease (40.1% versus 11.9%-15.2%) than other histologies (p < .001). Among distant metastasis cases, small cell neuroendocrine carcinoma was more likely to spread to the liver (36.1% versus 14.3%-15.4%) or bone (28.8% versus 17.3%-19.1%) and to involve multiple distant organ metastases (≥2 organs: 37.3% vs 27.8%-30.2%; and ≥3 organs: 18.1% vs 9.2%-10.1%) compared with other histologies (p < .001). Across stages I to IV, small cell neuroendocrine carcinoma had lower 5-year overall survival rates than other histologies: stage I, 58.0% versus 82.5% to 91.3%; stage II, 38.4% versus 60.7% to 64.6%; stage III, 31.3% versus 49.5% to 51.4%; and stage IV, 8.1% versus 18.2% (p < .05). Early-death rates within two months from diagnosis of small cell neuroendocrine carcinoma were substantially higher than other histologies (9.0% vs 2.2%, p < .001).</p><p><strong>Conclusions: </strong>This population-based assessment suggests that, although rare, the incidence of small cell neuroendocrine carcinoma of the uterine cervix is gradually increasing in the United States. Multiple distant organ metastases, especially to the liver and bone, and poor survival outcomes characterize small cell neuroendocrine carcinoma of the uterine cervix.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 9","pages":"102011"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835020","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":"Sarcopenia shortens overall survival of patients with platinum-resistant recurrent ovarian cancer: inverse probability of treatment-weighting analysis.","authors":"Masahiro Aichi, Sho Hasegawa, Satoru Shinoda, Yukio Suzuki, Natsuko Kamiya, Yumi Ishidera, Yuichi Imai, Etsuko Miyagi, Taichi Mizushima","doi":"10.1136/ijgc-2024-005323","DOIUrl":"10.1136/ijgc-2024-005323","url":null,"abstract":"<p><strong>Objective: </strong>The association between sarcopenia and prognosis in patients with platinum-resistant recurrent ovarian cancer remains unclear. This study investigated whether sarcopenia is a prognostic factor in patients with platinum-resistant recurrent ovarian cancer.</p><p><strong>Methods: </strong>A total of 52 patients diagnosed with platinum-resistant recurrent ovarian cancer who had undergone non-platinum chemotherapy at our institution formed our study population. Body composition and clinicopathological data of these patients were collected retrospectively. Abdominal computed tomography (CT) scans obtained at the time of platinum-resistant recurrent ovarian cancer diagnosis were used to measure the cross-sectional area of skeletal muscles at L3 level. These values were corrected for height to calculate the skeletal muscle index, and accordingly sarcopenia was defined. Overall survival was defined as the primary outcome of the study. The impact of sarcopenia on overall survival was assessed using Cox proportional hazards regression models with inverse probability weighting of treatment based on propensity scores and log-rank tests.</p><p><strong>Results: </strong>The median patient age was 63 years (IQR: 53-71). The most common International Federation of Gynecology and Obstetrics (FIGO) 2018 stage was stage III (50%) and the most common histology was serous or adenocarcinoma (67.3%). The optimal cut-off value of skeletal muscle index was 35.6 cm²/m², which was calculated using the data of 21 patients with sarcopenia and 31 without sarcopenia. Sarcopenia was significantly associated with shorter overall survival (HR 1.93; 95% CI 1.06-3.49; p=0.03). Subgroup analysis based on patient attributes and prognostic factors suggested a consistent prognostic impact of sarcopenia. Sarcopenia was identified as a significant risk factor, particularly in patients who had higher CA125 levels (HR, 2.47; 95% CI, 1.07 to 5.69; p=0.034) and a higher neutrophil-to-lymphocyte ratio (HR, 2.92; 95% CI, 1.02 to 8.31; p=0.045).</p><p><strong>Conclusion: </strong>Sarcopenia significantly shortened the overall survival of patients with platinum-resistant recurrent ovarian cancer.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101849"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897419","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":"A multicenter retrospective study to assess feasibility, safety and efficacy of first-line carboplatin-paclitaxel versus carboplatin monotherapy in a frail, elderly epithelial ovarian cancer population^☆.","authors":"Eve Merry, Ronas Taner Kesmez, Tamara Yu, Michael Flynn, Jonathan Ledermann, Michelle Lockley, Nicola Macdonald, Mary McCormack, Shibani Nicum, Shanthini Crusz, Rowan Miller","doi":"10.1136/ijgc-2024-005394","DOIUrl":"10.1136/ijgc-2024-005394","url":null,"abstract":"<p><strong>Objective: </strong>Underrepresentation of elderly ovarian cancer patients in clinical trials has led to lack of clarity regarding optimal first-line chemotherapy in this cohort. The Elderly Women with Ovarian Cancer (EWOC)-1 trial demonstrated that 3-weekly carboplatin (3wC) resulted in worse survival and feasibility compared with standard 3-weekly carboplatin-paclitaxel (3wCP) in frail, elderly ovarian cancer patients. Our retrospective study compares feasibility, safety, and efficacy of first-line 3wCP and 3wC in a frail ovarian cancer cohort.</p><p><strong>Methods: </strong>Clinical data were retrospectively analyzed for newly-diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV, ≥70-year-old epithelial ovarian cancer patients, treated by clinician choice with 3wC or 3wCP at two London cancer centers over a 2 year period. Charlson Comorbidity Index (CCI) and Eastern Cooperative Oncology Group (ECOG) performance status provided surrogate markers of frailty. Common Terminology Criteria for Adverse Events v5.0 graded toxicity.</p><p><strong>Results: </strong>A total of 107 patients were treated with 3wC (n=30) and 3wCP (n=77). Age, performance status, and CCI were significantly different between cohorts, with 3wC patients older (84 vs 75 years, p<0.001), with more comorbidities (median CCI 4 vs 3, p<0.001) and worse performance status (47% vs 17% PS ≥2, p=0.015). Surgical outcomes differed significantly between cohorts, with 20 (67%) 3wC patients not undergoing surgery, compared with 22 (29%) 3wCP patients (p<0.001). Median follow-up was 45.8 months (IQR 38.7-56.3 months). While we observed improved progression-free (HR 0.55, 95% CI 0.33 to 0.90, p=0.017) and overall survival (HR 0.44, 95% CI 0.27 to 0.73, p=0.001, log-rank test) in a univariate cox proportional hazards comparison between 3wCP and 3wC, this was not significant on multivariate analysis. Completion of six planned chemotherapy cycles was achieved by the majority, with similar discontinuation rates between groups (13% 3wC vs 8% 3wCP, p>0.05). Overall grade ≥3 hematological toxicity rates were similar between regimens (33% 3wC vs 44% 3wCP, p=0.37) with grade ≥3 neutropenia (p=0.019) and grade ≥3 thrombocytopenia (p=0.006) more common with 3wCP and 3wC, respectively. No treatment-related deaths occurred.</p><p><strong>Conclusion: </strong>Our data demonstrates that standard 3wCP is a well-tolerated, feasible first-line treatment for frail, elderly ovarian cancer patients. Improved survival with 3wCP was not significant when corrected for established clinical prognostic factors.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101853"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132682","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":"Clinical characteristics and prognosis of rhabdomyosarcoma in the female reproductive system: a population-based analysis using SEER data.","authors":"Xinyan Gao, Yan Kong, Ying Ning, Zhumei Cui, Ke Lei, Tian Tian","doi":"10.1016/j.ijgc.2025.101989","DOIUrl":"10.1016/j.ijgc.2025.101989","url":null,"abstract":"<p><strong>Objective: </strong>Rhabdomyosarcoma of the female reproductive system is rare, and as a result, management strategies are unclear. In this study, we categorized rhabdomyosarcoma based on location (cervical, uterine, vulvovaginal) and analyzed prognostic factors to guide individualized treatment.</p><p><strong>Methods: </strong>Data from the Surveillance, Epidemiology, and End Results database (2000-2021) were used to identify patients with cervical, uterine, and vulvovaginal rhabdomyosarcoma. Multivariate Cox regression identified prognostic factors, and Kaplan-Meier analysis assessed overall survival and disease-specific survival.</p><p><strong>Results: </strong>For cervical rhabdomyosarcoma (n = 76), radical surgery improved disease-specific survival (91.9% vs 62.8%, p = .005), but conservative surgery was sufficient for patients aged <49 years, with a tumor diameter <4 cm, or with the embryonal subtype. In uterine rhabdomyosarcoma (n = 253), the embryonal subtype showed better overall survival (62.3% vs 23%, p < .0001) and disease-specific survival (65.9% vs 31%, p < .0001), especially for tumors ≤14 cm. For vulvovaginal rhabdomyosarcoma (n = 60), no survival differences were observed between local and radical surgery in patients aged <16 years or with tumors <8 cm. Adjuvant chemotherapy in cervical rhabdomyosarcoma has been shown to enhance the overall survival rate of patients undergoing radical surgery; however, radiotherapy appears to diminish their overall survival outcomes. In the case of uterine rhabdomyosarcoma of the embryonic subtype, chemotherapy concurrently improves both overall and disease-specific survival rates, while radiotherapy does not demonstrate a significant impact. For vulvovaginal rhabdomyosarcoma, chemotherapy is effective in improving the overall survival rate among non-surgical patients, whereas radiotherapy shows no effect on the survival outcomes across all subgroups.</p><p><strong>Conclusions: </strong>Conservative treatment is suitable for young patients with cervical rhabdomyosarcoma who have small tumors or the embryonal subtype, while radical surgery benefits the overall population. Embryonal uterine rhabdomyosarcoma has better outcomes, and young patients with vulvovaginal rhabdomyosarcoma of the embryonal subtype can undergo local surgery. For these 3 sites, chemotherapy is indispensable, while radiotherapy should be administered with caution.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 9","pages":"101989"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667613","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}