International Journal of Gynecological Cancer最新文献

{"title":"Updated pocket guide for integrated risk stratification in endometrial carcinoma: a practical tool based on European Society of Gynecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology 2025 guidelines.","authors":"Reyes Oliver-Perez, Manon Daix, Jorge García-Ibañez, Alejandra Martinez, Martina Aida Angeles","doi":"10.1016/j.ijgc.2026.104785","DOIUrl":"10.1016/j.ijgc.2026.104785","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"36 9","pages":"104785"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360623","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":"Age-related distribution of homologous recombination deficiency in advanced ovarian carcinoma: a large real-world French cohort.","authors":"Witold Gertych, Alexis Trecourt, Faustine Morineau, Pauline Beacco, Astrid Brasselet, Marion Carnet, Angélique Chevriaux, Sandy Chevrier, Morgane Dupasquier, Anne Gibeaud, Juliette Albuisson, Anthony Comte, Valentin Derangère, Vincent Goussot, Laurent Arnould, Anthony Bergeron, Françoise Beltjens, Céline Charon-Barra, Charles Vinson, Romain Boidot","doi":"10.1016/j.ijgc.2026.104821","DOIUrl":"10.1016/j.ijgc.2026.104821","url":null,"abstract":"<p><strong>Objective: </strong>Tumor genetic testing for BRCA and homologous recombination repair is essential for guiding maintenance therapy in high-grade non-mucinous ovarian carcinomas. While clinical trials (PAOLA-1, PRIMA, ATHENA-MONO, PRIME) have reported homologous recombination deficiency rates of 44% to 67% in cohorts with a median age of 61, real-world data suggest age-related variations. We aimed to evaluate homologous recombination deficiency prevalence in a large French population and hypothesized a distribution pattern similar to the recent German findings published in 2022, in which older age correlated with lower homologous recombination deficiency rates.</p><p><strong>Methods: </strong>We retrospectively analyzed advanced ovarian carcinoma cases referred to the Dijon Cancer Center from 191 care centers between 2022 and 2024 for Myriad MyChoice homologous recombination deficiency testing. Data collected included age, histologic type, homologous recombination deficiency status, homologous recombination proficiency status, and genomic instability scores. We compared the distribution of homologous recombination deficiency and HRP tumors in women <60 and ≥60 years using the χ² test.</p><p><strong>Results: </strong>In 1322 advanced ovarian carcinoma cases with a median age of 70.1 years, the overall rates were 35.3% homologous recombination deficiency and 64.7% homologous recombination proficiency. A sub-analysis of 1226 high-grade cases (median age 70.4; including high-grade serous carcinoma, clear-cell carcinoma, undifferentiated carcinomas, and carcinosarcoma) showed 36.5% homologous recombination deficiency and 63.5% homologous recombination proficiency. Notably, patients aged ≥60 years had a significantly higher likelihood of presenting with a homologous recombination proficiency tumor compared with those aged <60 years (65.8% vs 53.2%, p < .001). Among 42 clear-cell carcinoma cases, 97.6% exhibited homologous recombination proficiency status.</p><p><strong>Conclusions: </strong>In this large real-world cohort of advanced ovarian carcinoma, we observed a notably higher prevalence of homologous recombination proficiency tumors compared to the 4 clinical trials reported in the literature, with homologous recombination proficiency incidence increasing significantly with age. Given that older patients predominantly present with homologous recombination proficiency tumors, which are associated with poorer survival, treatment strategies should be adjusted to better address the specific needs of this demographic.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"36 9","pages":"104821"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470536","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":"From vaginal morbidity to sexual health: rethinking sexual rehabilitation after gynecological cancer through a survivor-informed patient expert perspective.","authors":"Icó Tóth, Richárd Tóth, Kathrin Kirchheiner","doi":"10.1016/j.ijgc.2026.104833","DOIUrl":"10.1016/j.ijgc.2026.104833","url":null,"abstract":"<p><p>Sexual health is a core component of quality of life in gynecologic cancer survivorship, yet it remains not fully integrated into routine oncologic care. Advances in treatment have improved survival, shifting attention toward long-term outcomes, including sexual function, identity, and relational well-being. Vaginal morbidity represents a common and clinically accessible entry point for interventions. However, the relationship between tissue changes and sexual experience is non-linear, as psychological, behavioral, and relational factors critically modulate outcomes. Evidence from cognitive-behavioral models suggests that repeated pain experiences may reinforce maladaptive avoidance patterns, whereas positive experiential learning and gradual exposure may restore adaptive sexual functioning. Current clinical guidelines appropriately emphasize prevention and management of vaginal morbidity through lubricants, local estrogen therapy, and vaginal dilation. Nonetheless, these approaches often implicitly prioritize penetrative intercourse as the primary marker of sexual health, potentially overlooking broader dimensions of sexuality. Alternative tools, such as vibrators, may provide comparable mechanical benefits to dilators while additionally enhancing arousal, reducing pelvic floor tension, and supporting patient agency. Furthermore, re-centering sexual pleasure as a legitimate therapeutic goal and addressing relational dynamics are essential for meaningful recovery. Ultimately, successful sexual rehabilitation should not be defined by anatomical restoration alone but by alignment with individual preferences, restoration of bodily trust, and the capacity for intimacy and pleasure. Integrating multidisciplinary, patient-centered sexual health care into survivorship pathways is critical to achieving comprehensive oncologic outcomes.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"36 9","pages":"104833"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602670","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":"Adnexectomy without intraoperative capsule rupture for early ovarian cancer: survival comparison between minimally invasive and open surgery.","authors":"Koji Matsuo, Mariya Kobayashi, Aoi Yamaguchi, Shinya Matsuzaki, Michiko Kodama, Rohan D Luhar, Matthew W Lee, Emmeline L Friedman, X Mona Guo, Lynda D Roman","doi":"10.1016/j.ijgc.2026.104871","DOIUrl":"10.1016/j.ijgc.2026.104871","url":null,"abstract":"<p><p>This comparative effectiveness study of 15,572 patients with stage IA ovarian cancer who underwent primary anti-cancer surgery with adnexectomy from 2012 to 2022, identified in the Commission-on-Cancer's National Cancer Database, compared the overall survival of 5867 patients who underwent minimally invasive surgery with that of 9705 patients who underwent open surgery. In the propensity score inverse probability of treatment weighting cohort for node-staged cases, the 5-year overall survival rates were 92.4% (95% confidence interval 91.1% to 93.7%) for the minimally invasive surgery group and 92.0% (95% confidence interval 91.2% to 92.7%) for the open surgery group. Controlling for postoperative chemotherapy use, the adjusted hazard ratio for minimally invasive surgery compared with open surgery was 0.94 (95% confidence interval 0.80 to 1.11). This survival association was consistent when including node-unstaged cases or for histology subgroups, including type I epithelial ovarian cancer, type II epithelial ovarian cancer, sex cord-stromal tumors, and malignant germ cell tumors. Associations were also similar when the modality of minimally invasive surgery was assessed as robot-assisted or conventional laparoscopic surgery. In conclusion, the results of this comparative effectiveness study suggest that minimally invasive surgery may not negatively influence overall survival for stage IA ovarian cancer when adnexectomy is performed without ovarian capsule rupture during surgery.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"36 9","pages":"104871"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148619908","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":"European Society of Gynecological Oncology Consensus Statement on the prevention of surgical complications in gynecologic oncology.","authors":"Dimitrios Haidopoulos, Ignacio Zapardiel, Francois Planchamp, Nikolaos Thomakos, Maria Kyrgiou, Mihaela Grigore, Vasilis Pergialiotis, Vesna Kesic, Charalampos Theofanakis, Nicolò Bizzarri, Houssein El Hajj, Vasilis Theodoulidis, Laura Burney Ellis, Sarah Bowden, Deepali Raina, Niccolò Gallio, Nilanchali Singh, Belen Lopez, Murat Gultekin","doi":"10.1016/j.ijgc.2026.104862","DOIUrl":"10.1016/j.ijgc.2026.104862","url":null,"abstract":"<p><strong>Objective: </strong>Surgical intervention remains the cornerstone of treatment for gynecologic malignancies. However, the complex nature of these procedures leads to a significant risk of perioperative and post-operative complications. The European Society of Gynecological Oncology recognized the need for standardized, evidence-based consensus statements with the aim to minimize surgical morbidity and mortality and decrease surgical complications.</p><p><strong>Methods: </strong>A literature review was conducted by the methodologist of the group, using the MEDLINE database, based on 5 patient, intervention or exposure, comparison or control, outcome frameworks. Literature published between January 1, 2014, and June 1, 2025, was reviewed and critically appraised. The literature search was limited to publications in English. Priority was given to high-quality systematic reviews, meta-analyses, and randomized controlled trials, but studies with less evidence, such as prospective cohort studies and retrospective registry-based analyses, were also evaluated. Statements were subsequently drafted collaboratively based on the review of the literature and adapted in an iterative process in conference call meetings including anonymous voting for each statement.</p><p><strong>Results: </strong>The group achieved consensus on 26 statements categorized into six primary surgical domains: Energy Devices and Surgical Environment, Minimally Invasive Entry Techniques, Use of Uterine Manipulators, Lymphedema Prevention and Management, Vulvar Surgery and Wound Management, and Inguinal Lymphadenectomy.</p><p><strong>Conclusions: </strong>This Consensus Statement presents comprehensive guidelines for the prevention of surgical complications in gynecologic oncology. These recommendations are expected to standardize surgical care, reduce perioperative morbidity and lead to improvement of post-operative recovery and ultimately quality of life of patients with gynecologic malignancies.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"36 9","pages":"104862"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602623","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":"Best original research presented at the 27th European Congress on Gynaecological Oncology: best of ESGO 2026.","authors":"Houssein El Hajj, Alexander Shushkevich, Joanna Kacperczyk-Bartnik, Andrej Cokan, Ilker Kahramanoglu, Tibor Andrea Zwimpfer, Richard Tóth, Aleksandra Strojna, David Viveros-Carreño, Nicolò Bizzarri, Martina Aida Angeles, Khayal Gasimli, Ilker Selcuk, Giuseppe Caruso, Jonathan Ledermann, Viola Heinzelmann-Schwarz","doi":"10.1016/j.ijgc.2026.104875","DOIUrl":"10.1016/j.ijgc.2026.104875","url":null,"abstract":"<p><p>The Best of the European Society of Gynaecological Oncology 2026 review highlights a selection of the best original research presented at the 27th Congress of the European Society of Gynaecological Oncology, held February 26 to 28, 2026, in Copenhagen, Denmark. Of the 1585 abstracts submitted, the ESGO Scientific Programme Committee chairs and authors from the European Network of Young Gynae Oncologists selected 31 high-impact studies for inclusion in this compilation. This included 10 Best Oral Sessions abstracts, 10 Mini Oral Sessions abstracts, 9 Young Investigator Session abstracts, and 2 Best 3-Minute Presentations abstracts. Key research themes this year included implementation of updated European Society of Gynaecological Oncology ovarian and endometrial cancer guidelines, refinement of surgical strategies in advanced and recurrent ovarian cancer, advances in immunotherapy and non-chemotherapy combinations, biomarker testing and personalized surgery as part of precision oncology, human epidermal growth factor receptor 2-directed therapies and antibody-drug conjugates, management of rare tumors, and innovations in prevention, diagnosis, and cervical cancer care. Through this initiative, European Society of Gynaecological Oncology and European Network of Young Gynae Oncologists aim to showcase the most impactful developments in gynaecologic oncology research and to facilitate their dissemination to clinicians, researchers, patients, advocacy groups, and allied professionals across Europe and internationally.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"36 9","pages":"104875"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653874","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 PROMISE-EC Study: prognostic role of molecular classification and sentinel lymph node status in early-stage endometrial cancer.","authors":"Francesco Fanfani, Ilaria Capasso, Jessica Mauro, Emanuele Perrone, Michael Mueller, Valentina Bruno, Robert Fruscio, Sara Imboden, Virginia Garcia-Pineda, Salih Taskin, Elisa Tripodi, Stefano Restaino, Tommaso Grassi, Diego Raimondo, Roberto Berretta, Andrea Papadia, Franziska Siegenthaler, Jvan Casarin, Vito Chiantera, Enrico Vizza, Ignacio Zapardiel, Giuseppe Vizzielli, Cagatay Taskiran, Mete Gungor, Alessandro Buda","doi":"10.1016/j.ijgc.2026.104796","DOIUrl":"10.1016/j.ijgc.2026.104796","url":null,"abstract":"<p><strong>Objective: </strong>The updated European Society of Gynaecological Oncology guidelines recommend routine molecular classification to refine risk assessment and guide adjuvant treatment. However, the prognostic impact of sentinel lymph node involvement and molecular classification in apparent early-stage endometrial cancer remains incompletely defined.</p><p><strong>Methods: </strong>PROMISE-EC is a multi-center retrospective study including patients with apparently uterine-confined endometrial cancer who underwent surgical staging with sentinel lymph node biopsy at 16 European institutions (January 2014-February 2024). Clinicopathologic characteristics, sentinel lymph node status, and Cancer Genome Atlas-based molecular classification were collected and analyzed. The primary endpoint was progression-free survival.</p><p><strong>Results: </strong>Among 2732 records, 2003 patients met inclusion criteria. International Federation of Gynecology and Obstetrics 2009 stage I was observed in 1585 patients (79.4%). Sentinel lymph node involvement was present in 282 patients (14.1%). p53-abnormal tumors were associated with poorer progression-free survival (p <.0001), whereas patients with POLE-mutated tumors showed excellent outcomes, with no significant difference compared with non-specific molecular profile (p =.103). Patients with deficient mismatch repair tumors showed intermediate outcomes (p =.484). In unadjusted Kaplan-Meier analysis, progression-free survival worsened with increasing sentinel lymph node tumor burden (p =.047). In multi-variable analysis, high-grade disease (p =.003) and p53 abnormal status (p <.001) remained independent predictors of recurrence. The association between sentinel lymph node tumor burden and recurrence was attenuated, with only macrometastatic involvement retaining independent prognostic significance. In multi-variable logistic regression, lymphovascular space invasion was the strongest predictor of sentinel lymph node metastases (p <.00001), while patients with POLE-mutated tumors were less likely to harbor clinically relevant nodal involvement (p =.032).</p><p><strong>Conclusions: </strong>Our study supports the prognostic relevance of both sentinel lymph node assessment and molecular classification in early-stage endometrial cancer, with potential implications for post-operative risk stratification and management.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"36 9","pages":"104796"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360715","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 endometrial cancer phenotypes in the era of molecular classification and sentinel lymph node mapping: results from a multicenter Italian study.","authors":"Elisa Scarpelli, Vito Andrea Capozzi, Emanuele Perrone, Emilia Palmieri, Giorgio Bogani, Pierandrea De Iaco, Anna Myriam Perrone, Vito Chiantera, Giuseppe Cucinella, Michela Gaiano, Marco Carnelli, Andrea Puppo, Stefano Uccella, Marcello Ceccaroni, Stefano Restaino, Giuseppe Vizzielli, Francesco Fanfani, Roberto Berretta","doi":"10.1016/j.ijgc.2026.104502","DOIUrl":"10.1016/j.ijgc.2026.104502","url":null,"abstract":"<p><strong>Objective: </strong>To describe the clinicopathologic phenotypes of endometrial cancer across molecular sub-types and to identify independent predictors of nodal metastasis and sentinel lymph node (SLN) mapping failure.</p><p><strong>Methods: </strong>This multicenter retrospective study included 2592 endometrial cancer patients with defined molecular classification and SLN mapping. Continuous variables are reported as medians. Tumors were classified as POLE-mutated, mismatch repair-deficient, p53-abnormal, or no specific molecular profile. When hormone receptor status was available, no specific molecular profile tumors were further sub-classified according to European Society of Gynaecological Oncology/European Society for Therapeutic Radiology and Oncology/European Society of Pathology 2025 criteria.</p><p><strong>Results: </strong>Molecular sub-types exhibited distinct phenotypes: POLE-mutated tumors occurred in younger patients (median 56 years), with the lowest body mass index (27.0 kg/m²), smallest tumor size (26 mm), and the lowest nodal metastasis rate (8.0%); p53-abnormal tumors affected older patients (67 years), with the largest tumors (35 mm), frequent non-endometrioid histology (78.4%), and the highest nodal metastasis rate (26.1%); mismatch repair-deficient tumors showed intermediate age (63 years), body mass index (28.5), predominantly endometrioid histology (90.4%), substantial lymphovascular space invasion (28.3%), and a 19.4% nodal metastasis rate; no specific molecular profile tumors, the most common group (55.6%), had the highest body mass index (29.0 kg/m²), were low-grade in 84.2% of cases and endometrioid in 92.5%, and exhibited a low metastasis rate (11.0%). Among no specific molecular profile tumors with available hormone receptor status, a high-risk-like sub-group (22%), characterized by hormone receptor negativity and/or high-grade histology, displayed aggressive features macro-metastases (18.2%), SLN mapping failure (24.3%), substantial lymphovascular space invasion (33.2%), deep myometrial invasion (54.3%), and cervical stromal involvement (23.1%) (resembling a \"p53-abnormal-like\" phenotype despite their molecular profile). At multivariate analysis, molecular sub-type was not an independent predictor of nodal involvement (p=.20) or SLN mapping failure (p=.75).</p><p><strong>Conclusions: </strong>Molecular sub-types in endometrial cancer reflect distinct and reproducible phenotypes. However, classic histopathologic features remain the strongest predictors of nodal spread and SLN detection failure.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"104502"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157069","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 \" 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\" by Farzaneh et al.","authors":"Polat Dursun, Bilge Pinar Keskinsoy, Damla Özdemir","doi":"10.1016/j.ijgc.2025.104461","DOIUrl":"10.1016/j.ijgc.2025.104461","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"104461"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097089","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":"In-transit lymph node metastases in the ovarian pedicle in early-stage ovarian cancer: myth or reality?","authors":"Stoyan Kostov, Rafał Watrowski, Berta Díaz Feijoo, Nicolò Bizzarri, Denis Querleu","doi":"10.1016/j.ijgc.2026.104800","DOIUrl":"10.1016/j.ijgc.2026.104800","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"36 9","pages":"104800"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360640","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}