International Journal of Gynecological Cancer最新文献

{"title":"APOLLO: neo-adjuvant pembrolizumab for primary vulvar squamous cell carcinoma-a multicenter, single-arm, phase II, clinical proof-of-concept study.","authors":"M I E van Poelgeest, Kim E Kortekaas, Helena C van Doorn, Maaike Oonk, Hans W Nijman, Ingrid Boere, Anneke L Eerkens, Anna K L Reyners, Patricia C Ewing-Graham, Joost Bart, Tjalling Bosse, Marij J P Welters, Judith R Kroep, Sjoerd H van der Burg","doi":"10.1136/ijgc-2024-005523","DOIUrl":"10.1136/ijgc-2024-005523","url":null,"abstract":"<p><strong>Background: </strong>Vulvar squamous cell carcinoma (VSCC) is a rare cancer for which the cornerstone of treatment is surgery with high complication rates. The unmet need is a less radical and more effective treatment for VSCC.</p><p><strong>Primary objectives: </strong>To investigate the impact of mono-immunotherapy pembrolizumab as neoadjuvant treatment for primary resectable VSCC patients.</p><p><strong>Study hypothesis: </strong>Some primary VSCC patients display a specific immune profile which is associated with better survival. In other tumors, this profile is associated with a better response to programmed cell death protein 1 (PD-1) checkpoint blockade which may reinvigorate tumor specific T cells. This potentially results in a reduced tumor load and less radical surgery and/or adjuvant treatment in patients with this immune profile.</p><p><strong>Trial design: </strong>This is an investigator-initiated, prospective, single arm, multicenter, phase II clinical trial.</p><p><strong>Inclusion criteria: </strong>Patients with VSCC clinical stage International Federation of Gynecology and Obstetrics (FIGO) I-III (2021) eligible for primary surgery, with at least one measurable lesion of at least one dimension ≥10 mm in the largest diameter, are included in this study.</p><p><strong>Main exclusion criteria: </strong>Patients not suitable for surgery and/or previously treated with immunomodulatory agents, and/or who suffer from comorbidities that may interfere with PD-1 blockade, are excluded from the study.</p><p><strong>Endpoints: </strong>The clinical efficacy of neoadjuvant pembrolizumab in VSCC is measured by an objective change in tumor size according to the Response Evaluation Criteria In Solid Tumors version 1.1 (RECIST 1.1) and documented by calipers using standardized digital photography with a reference ruler. In addition, the activation, proliferation, and migration of T cells in the tumor will be studied. The secondary endpoints are pathological complete responses at the time of surgery, feasibility, and safety.</p><p><strong>Sample size: </strong>40 patients with FIGO I-III (2021) primary VSCC will be enrolled.</p><p><strong>Estimated dates for completing accrual and presenting results: </strong>The intervention phase started in July 2023 and will continue until July 2025. The expected completion of the entire study is July 2026.</p><p><strong>Trial registration number: </strong>NCT05761132.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101831"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442592","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":"Six cycles of neoadjuvant chemotherapy followed by cytoreduction in high-grade serous ovarian cancer: prognostic implications of the chemotherapy response score, CA-125, and tumor-infiltrating lymphocytes.","authors":"Andre Lopes, Marilia Albanezi Bertolazzi, Samantha Cabral Severino da Costa, Valesca Bizinoto, Rossana Veronica Mendoza Lopez, Maria Luiza Nogueira Dias Genta, Jesus Paula Carvalho, Filomena Marino Carvalho","doi":"10.1016/j.ijgc.2025.102027","DOIUrl":"10.1016/j.ijgc.2025.102027","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the prognostic value of the chemotherapy response score, a histopathologic grading system for tumor regression following neoadjuvant chemotherapy, along with post-treatment serum CA-125 levels and tumor-infiltrating lymphocyte density, in patients with high-grade serous ovarian carcinoma treated with 6 cycles of neoadjuvant chemotherapy followed by surgery.</p><p><strong>Methods: </strong>This retrospective cohort study included patients with histologically confirmed high-grade serous ovarian carcinoma treated at a single institution between 2008 and 2021. All patients completed 6 cycles of carboplatin- and paclitaxel-based neoadjuvant chemotherapy. The chemotherapy response score was assessed in omental and adnexal specimens and categorized as 1, 2, or 3. Tumor-infiltrating lymphocyte density in pre- and post-treatment samples was classified as low (<10%) or high (≥10%). Associations among the chemotherapy response score, CA-125 levels, tumor-infiltrating lymphocytes, and survival outcomes-including overall survival and disease-free survival-were analyzed using Kaplan-Meier estimates and Cox proportional hazards models.</p><p><strong>Results: </strong>Of 294 patients screened, 110 met the inclusion criteria. In the omentum, 35.6% had a Chemotherapy Response Score of 3, with a median overall survival of 56.7 months (HR 0.34, 95% CI 0.19 to 0.61). In the adnexa, 43.8% had a score of 2, 41.7% had a score of 1, and 14.6% had a score of 3. Median overall survival for adnexal score 2 was 50.6 months, compared to 33.8 months for score 1. Post-treatment CA-125 levels ≤35 U/mL were associated with higher chemotherapy response score categories and improved survival (HR 0.45, 95% CI 0.28 to 0.73). Tumor-infiltrating lymphocyte density ≥10% was more frequent in adnexal score 2 cases (88.5%, p = .006), but tumor-infiltrating lymphocyte levels-both pre- and post-treatment-were not independently associated with overall survival or disease-free survival.</p><p><strong>Conclusions: </strong>The chemotherapy response score and post-treatment CA-125 levels are independent prognostic indicators following 6 cycles of neoadjuvant chemotherapy. Tumor-infiltrating lymphocyte density showed site-specific patterns but lacked independent prognostic significance for survival outcomes.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 10","pages":"102027"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953211","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":"Experiences and expectations of advance directives in gynecological cancer patients (the NOGGO-expression X study).","authors":"Melisa Guelhan Inci, Ebru Ilter, Eva Roser, Desislava Dimitrova, Reema Kofiah, Cindy Stoklossa, Murat Karaman, Ute Goerling, Helmut Plett, Bahriye Aktas, Mandy Mangler, Malgorzata Lanowska, Guelten Oskay-Oezcelik, Jana Barinoff, Pauline Wimberger, Adak Pirmorady-Sehouli, Barbara Schmalfeldt, Doris Mayr, Anne Letsch, Nicolai Maass, Philipp Harter, Sven Mahner, Volker Hanf, Annette Hasenburg, Jalid Sehouli","doi":"10.1016/j.ijgc.2025.102008","DOIUrl":"10.1016/j.ijgc.2025.102008","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the experiences and expectations regarding advance directives among patients with gynecological cancer, with an additional focus on patients with migration backgrounds.</p><p><strong>Methods: </strong>An anonymous, self-administered questionnaire comprising 38 multiple-choice questions on advance directives was distributed online and in paper form from May 2019 to April 2021 across Germany. Participants included women diagnosed with various gynecological tumors. The survey was available in German, Turkish, Arabic, and Russian to capture culture-specific differences.</p><p><strong>Results: </strong>Out of 718 participants, 355 (49.4%) reported having an advance directive. Patients with an advance directive were significantly older (64.5 years) compared to those without (56.0 years, p < .0001). Advanced tumor stage (Fédération Internationale de Gynécologie et d'Obstétrique III and IV) was not significantly associated with having an advance directive (OR 0.82, 95% CI 0.49 to 1.35, p = .43). Compared to women with ovarian/fallopian tube/peritoneal cancer, those with cervical cancer (OR 0.7, 95% CI 0.35 to 1.39, p = .31), endometrial cancer (OR 0.43, 95% CI 0.16 to 1.12, p = .09), and vulvar cancer (OR 0.58, 95% CI 0.16 to 2.04, p = .39) were less likely to have an advance directive. A total of 56.8% of patients believed their family doctor should initiate end-of-life care discussions. Among the 18.2% of women with migration backgrounds, there was a lower likelihood of having an advance directive (OR 0.61, 95% CI 0.35 to 1.03, p = .07) and a significantly higher desire for information and documentation about advance directives in their native language (p = .0001). A total of 330 (48.4%) patients reported that a conversation with their physician would be the most important way to receive information about end-of-life care and advanced directives.</p><p><strong>Conclusions: </strong>This study highlights a substantial need for enhanced information and proactive discussions about end-of-life care among patients with gynecological malignancies, particularly emphasizing the pivotal role of family doctors in these conversations. Notably, women with migration backgrounds are disproportionately disadvantaged in accessing and understanding advance directives, underscoring the urgent need for information and documents about advance directives in their native language. It is therefore recommended that the medical team routinely and proactively address these relevant topics in discussions with their patients and that clinical guidelines should also reflect this.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102008"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144845876","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":"Assessing ovarian cancer via laparoscopic video: inter-rater and intra-rater reliability.","authors":"Kjestine Emilie Møller, Catrine Carlstein, Mikkel Rosendahl, Anders Tolver, Teodor Grantcharov, Jette Led Sørensen, Jeanett Strandbygaard","doi":"10.1016/j.ijgc.2025.102681","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102681","url":null,"abstract":"<p><strong>Objective: </strong>Ovarian Cancer is often diagnosed at an advanced stage. Central to treatment is a correct initial assessment and the probability of complete resection of visible cancer. The predictive index value (PIV) is a validated tool for laparoscopic procedures, assessing the chance of complete resection by evaluating 7 intra-abdominal areas. The final PIV determines the type of treatment to which women with ovarian cancer are referred. Gynecologic oncologists perform the procedure and assessment, and agreement and correct staging are essential. This study examines the agreement among gynecologists when assessing videos using the PIV.</p><p><strong>Methods: </strong>Laparoscopic videos were collected from October 2021 to January 2024, comprising 20 videos, of which 5 were duplicated. Each video was edited by a gynecologic oncologist, representing the seven intra-abdominal areas according to the PIV model. Eight gynecologic oncologists, eight gynecologists specialized in benign conditions, and eight residents in gynecology were invited to assess the videos using the PIV. The ratings from the participants were examined according to laparoscopic real-time scores. Inter-rater and intra-rater agreement were quantified using kappa statistics.</p><p><strong>Results: </strong>Twenty-one individuals participated in the study. Correct assessment of intra-abdominal areas, that is, agreement with laparoscopic real-time scores, ranged from 58.4% to 81.7%. The probability of correct scores among groups of gynecologists ranged from 34% (95% CI 14.9 to 60.2) to 98.9% (95% CI 95.9 to 99.7), with the highest scores among gynecologic oncologists. The inter-rater agreement of all participants ranged from moderate to substantial agreement (Light κ = 0.436-0.624). For specific intra-abdominal sites, it ranged from fair to perfect agreement (Light κ = 0.181-0.829).</p><p><strong>Conclusions: </strong>Assessing ovarian cancer based on videoclips was challenging, even for specialists in gynecologic oncology, indicating that edited videos reduce accuracy in evaluating disease burden. Gynecologic oncologists achieved the highest scores among all groups, suggesting that specialized training and knowledge improve consistency and that the assessment should remain an expert task.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 12","pages":"102681"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312812","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":"Endometrial carcinosarcoma without myoinvasion.","authors":"Giuseppe Cucinella, William A Zammarrelli, Dimitrios Nasioudis, Sofia Gabrilovich, Ilaria Capasso, Roberto Berretta, Paolo Scollo, Francesco Raspagliesi, Glauco Baiocchi, Giuseppe Barresi, Basilio Pecorino, Giorgio Bogani, Katherine C Kurnit, Louise De Brot, Antonio Lembo, Shahi Maryam, Angela J Fought, Michaela E McGree, Vito Chiantera, Jesus Gonzalez Bosquet, Francesco Fanfani, Giovanni Scambia, Nadeem R Abu-Rustum, Andrea Mariani, Robert Giuntoli, Gretchen Glaser, Mario M Leitao","doi":"10.1016/j.ijgc.2025.101971","DOIUrl":"10.1016/j.ijgc.2025.101971","url":null,"abstract":"<p><strong>Objective: </strong>Uterine carcinosarcoma without myoinvasion, limited to the endometrial lining/polyp or with no residual uterine disease at the time of hysterectomy, is extremely uncommon, with unknown oncologic outcomes. Thus, this study aimed to evaluate the long-term outcomes of patients with carcinosarcoma without myoinvasion.</p><p><strong>Methods: </strong>Patients with International Federation of Gynecology and Obstetrics 2009 stage IA carcinosarcoma without myoinvasion who underwent surgery from December 1998 to January 2023 were identified from 11 centers worldwide. Patients were classified by tumor status (limited to the endometrium, limited to polyp, no residual disease in the hysterectomy specimen) and by type of adjuvant therapy (chemotherapy vs no chemotherapy). Survival analysis follow-up was limited to the first 5 years after surgery.</p><p><strong>Results: </strong>Of 97 patients included, 28 (28.9%) had disease confined to a polyp, 55 (56.7%) to the endometrium, and 14 (14.4%) had no residual disease in the hysterectomy specimen. Patients received observation only (n=16, 16.5%), vaginal brachytherapy alone (n=14, 14.4%), external beam radiation therapy ± vaginal brachytherapy (n=5, 5.2%), chemotherapy ± vaginal brachytherapy (n=51, 52.6%), and chemotherapy and external beam radiation therapy ± vaginal brachytherapy (n=7, 7.2%), whereas adjuvant therapy was unknown in 4 patients (4.1%). A total of 29 patients (29.9%) recurred, mostly with a distant pattern of relapse. The 5-year recurrence-free survival was 63.5% (95% CI 53.4% to 75.4%) and the overall survival was 72.0% (95% CI 62.6% to 82.9%). The median follow-up for patients without recurrence was 56.9 months (interquartile range; 21.8-72.9). No significant differences were observed in recurrence-free survival and overall survival based on status of the tumor (p=.99 and p=.43, respectively). The difference in recurrence-free survival and overall survival was not statistically significant based on the receipt of chemotherapy (p=.08 and p=.07, respectively).</p><p><strong>Conclusions: </strong>Patients with carcinosarcoma without myoinvasion have a poor prognosis, with a high recurrence rate with distant pattern. The use of chemotherapy did not achieve statistical significance but may be limited by our small series.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101971"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742094","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":"Fertility-sparing approach in endometrioid grade II endometrial cancer: the role of molecular classification.","authors":"Giorgio Bogani, Luigi De Vitis, Andrea Mariani, Francesco Multinu, Giuseppe Vizzielli, Fabio Ghezzi, Caterina Borso, Lilliana Galli, Carlotta Caia, Filippo Ferrari, Andrea Giannini, Enrico Vizza, Giuseppe Cucinella, Vito Chiantera, Violante Di Donato, Francesca Falcone, Mario Malzoni, Salvatore Lopez, Gennaro Cormio, Francesco Raspagliesi, Jvan Casarin","doi":"10.1016/j.ijgc.2025.102035","DOIUrl":"10.1016/j.ijgc.2025.102035","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether molecular classification could support individualized selection of patients with grade II endometrioid endometrial cancer for fertility-sparing approaches.</p><p><strong>Methods: </strong>This is a retrospective multi-institutional study. Data of patients undergoing fertility-sparing treatment with a levonorgestrel intrauterine device (with or without oral hormonal therapy) were retrieved. Surrogate molecular classification was used to categorize patients into 4 classes: (1) POLE-mutated, (2) mismatch repair deficient/microsatellite instability high, (3) p53 abnormal, and (4) no specific molecular profile.</p><p><strong>Results: </strong>Overall, data from 23 patients with grade II endometrioid endometrial cancer starting a fertility-sparing attempt were retrieved. The median patient age was 36 (range; 30-41) years. All patients underwent hysteroscopic-guided endometrial biopsies. Hysteroscopic resection of the tumor was performed in 9 (39.1%) patients. According to surrogate molecular classification, 1 (4.3%), 2 (8.7%), 3 (13.1%), and 17 (73.9%) patients were classified as POLE-mutated, p53 abnormal, mismatch repair deficient/microsatellite instability high, and no specific molecular profile, respectively. Molecular classification was not associated with 6-month response rates (p = .080) nor with best response rates (p = .366). Overall, 7 women attempted to achieve a pregnancy; 3 underwent in vitro fertilization. Three patients achieved a pregnancy (1 first-trimester miscarriage and 2 term live births). A total of 10 (43.4%) patients were diagnosed with progressive disease during hysteroscopic surveillance. Overall, 19 (82.6%) patients required hysterectomy. Three (13%) patients required adjuvant therapy for the presence of locally advanced disease (1 stage II, and 2 stage III). Over a median (range) follow-up of 28.7(8.2-91.1) months, no recurrence or disease-related death occurred.</p><p><strong>Conclusions: </strong>Less than 10% of women with grade II endometrioid endometrial cancer starting a fertility-sparing attempt achieve a term pregnancy. In our series, molecular classification did not influence response rate. Further collaborative registers are needed.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 10","pages":"102035"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953208","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":"Survival outcomes in patients with recurrent mixed sex cord-stromal tumors of the ovary.","authors":"Elio Tahan, Allison L Brodsky, Naomi R Gonzales, Alexandra Bercow, Anil K Sood, Lois M Ramondetta, David M Gershenson, R Tyler Hillman","doi":"10.1016/j.ijgc.2025.102018","DOIUrl":"10.1016/j.ijgc.2025.102018","url":null,"abstract":"<p><strong>Objective: </strong>Mixed sex cord-stromal tumors of the ovary contain combinations of granulosa cell tumor components-either adult or juvenile subtypes-and/or Sertoli-Leydig cell tumor elements. The objective of this study is to evaluate survival outcomes in recurrent mixed sex cord-stromal tumors.</p><p><strong>Methods: </strong>This is a retrospective cohort study of recurrent mixed ovarian sex cord-stromal tumors identified through the MD Anderson Rare Gynecologic Malignancy Registry between 2000 and 2025. Comparative cohorts with recurrent, histologically uniform adult granulosa cell tumors, juvenile granulosa cell tumors, and Sertoli-Leydig cell tumors were included. Demographic and clinical characteristics were compared using descriptive statistics. Progression-free survival after first recurrence and overall survival from first recurrence were assessed using Kaplan-Meier methods and compared using log-rank tests.</p><p><strong>Results: </strong>Sixteen patients with recurrent mixed ovarian sex cord-stromal tumors were identified: 6 (37.5%) with adult granulosa cell plus Sertoli-Leydig cell tumors, 4 (25%) with juvenile granulosa cell plus Sertoli-Leydig cell tumors, and 6 (37.5%) with adult plus juvenile granulosa cell tumors. When comparing adult granulosa cell tumors to adult plus juvenile granulosa cell tumors, significant differences in median progression-free survival-2 (21.2 vs 8.7 months, p = .03) and overall survival (181.9 vs 83.8 months, p = .001) were observed. No significant differences in progression-free survival-2 (p = .7) or overall survival (p = .8) were noted between juvenile granulosa cell tumors and adult plus juvenile granulosa cell tumors. Among tumors with molecular testing results, 25% (1 of 4) of adult plus juvenile granulosa cell tumors, 25% (1 of 4) of adult granulosa cell plus Sertoli-Leydig cell tumors, and 33% (1 of 3) of juvenile granulosa cell plus Sertoli-Leydig cell tumors were positive for the c.C402G FOXL2 mutation.</p><p><strong>Conclusions: </strong>Recurrent adult plus juvenile granulosa cell tumors may exhibit more aggressive clinical behavior than uniform adult granulosa cell tumors, aligning more closely with juvenile granulosa cell tumors in recurrence outcomes.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 10","pages":"102018"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859164","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 patient characteristics on primary treatment approach of endometrial cancer: a population-based study in the Netherlands.","authors":"Heidi Rütten, Hans H B Wenzel, Mieke Ten Eikelder, Michiel Simons, Maaike A van der Aa, Johan Bussink, Johanna M A Pijnenborg","doi":"10.1016/j.ijgc.2025.102034","DOIUrl":"10.1016/j.ijgc.2025.102034","url":null,"abstract":"<p><strong>Objective: </strong>The incidence of endometrial cancer is rising worldwide, with increasing numbers of elderly patients with substantial comorbidity. We aimed to provide insight into the primary treatment strategies, trends, and outcomes for patients with endometrial cancer in the Netherlands across different periods, and to evaluate the influence of patient characteristics on treatment approaches within these periods.</p><p><strong>Methods: </strong>All patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage I to III endometrial cancer between 1995 and 2022 were identified in the Netherlands Cancer Registry. Data on histology, FIGO stage, primary treatment, Charlson comorbidity index, body mass index, and outcome were collected and analyzed. Patients were evaluated in 6 5-year cohorts to observe possible trends in treatment choices and outcomes over time, based on patient and tumor characteristics.</p><p><strong>Results: </strong>A total of 43,443 patients were included. Most patients were diagnosed with endometrioid histology (89%, n = 38,751) and early-stage disease (FIGO I-II, 87%, n = 38,077). An increase in endometrial cancer incidence and survival was observed over time, along with a shift toward more non-endometrioid endometrial cases. A primary surgical approach was performed in 95% (n = 41,107) of patients. Among those receiving non-surgical management, curative treatment was reported in only 4% (n = 88). Most patients unfit for surgery either received no treatment (n = 1053, 2%) or were treated with hormonal therapy (n = 840, 2%). Over time, we observed increased use of hormonal therapy as a non-surgical treatment. Patients who did not undergo surgery were older, more often had a body mass index >30 kg/m², and more often had a Charlson comorbidity index ≥2.</p><p><strong>Conclusions: </strong>Incidence and survival in patients with endometrial cancer increased between 1999 and 2022. Patients unfit for surgery most often received no treatment or palliative hormonal therapy. Curative radiotherapy is not often used in patients unfit for surgery and should be considered for this group of patients.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 10","pages":"102034"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953260","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":"When the blood speaks first: circulating tumor DNA as a biomarker in locally advanced cervical cancer.","authors":"Julia Chain Martins, Mariana Carvalho Gouveia, Renata Colombo Bonadio, Mariana Scaranti","doi":"10.1016/j.ijgc.2025.102020","DOIUrl":"10.1016/j.ijgc.2025.102020","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 10","pages":"102020"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953301","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":"Omitting adjuvant therapy in POLE-mutated endometrial carcinoma with cervical stromal invasion: are we moving too fast?","authors":"Anna Merlotti, Francesco Olivero, Stefania Martini, Paola Critelli, Elvio Russi","doi":"10.1016/j.ijgc.2025.102113","DOIUrl":"10.1016/j.ijgc.2025.102113","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 10","pages":"102113"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015112","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}