International Journal of Gynecological Cancer最新文献

{"title":"Prognostic value of tertiary lymphoid structures in molecular subgroups of endometrial carcinoma.","authors":"Manohar Pradhan, Wanja Kildal, Ljiljana Vlatkovic, Kari Anne R Tobin, Kristina Lindemann, Gunnar B Kristensen, Andreas Kleppe, Hanne A Askautrud","doi":"10.1016/j.ijgc.2025.101915","DOIUrl":"10.1016/j.ijgc.2025.101915","url":null,"abstract":"<p><p>Tertiary lymphoid structures, lymphoid cell clusters formed in response to cancer or chronic disease, serve as a prognostic marker in multiple cancer types, including endometrial carcinoma. We assessed the prognostic significance of tertiary lymphoid structures, using the surrogate marker L1 cell adhesion molecule (L1CAM), in 1208 endometrial carcinoma patients in all stages, histological subtypes, and risk groups. Immunohistochemical evaluation of L1CAM in 1 tissue section from each patient revealed tertiary lymphoid structure-positivity in 287 of 1208 (23.8%) cases. In univariable analyses, patients with tertiary lymphoid structure-positive tumors had significantly longer time to recurrence (HR 0.61, p < .001) and cancer-specific survival (HR 0.53, p < .001) compared to patients with tumors without tertiary lymphoid structures. In multivariable analyses with standard clinical and pathological markers as well as modern molecular classification, the presence of tertiary lymphoid structures was an independent prognostic marker for time to recurrence (HR 0.63, p < .001) and cancer-specific survival (HR 0.54, p < .001). The presence of tertiary lymphoid structures was more frequent in POLE-mutated (59.4%) and mismatch repair deficient (32.3%) compared to p53-abnormal (15.8%) and no specific molecular profile (14.7%) tumors. In patients with p53-abnormal tumors, the presence of tertiary lymphoid structures was significantly associated with better outcomes for both time to recurrence (HR 0.51, p = .014) and cancer-specific survival (HR 0.52, p = .021) in multivariable analyses. These findings suggest that the evaluation of tertiary lymphoid structures by L1CAM may enhance prognostic precision in endometrial carcinoma.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101915"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132385","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":"Oncological outcomes, surgical margins, and adjuvant treatment delays in vulvar cancer patients with or without reconstruction during primary surgery.","authors":"Milla K Mörsky, Reita H Nyberg, Maarit H Vuento, Synnöve Staff, Ilkka S Kaartinen","doi":"10.1016/j.ijgc.2025.101942","DOIUrl":"10.1016/j.ijgc.2025.101942","url":null,"abstract":"<p><strong>Objective: </strong>As vulvar reconstruction has been proposed to improve surgical margins and could affect the timing of adjuvant therapy in patients with vulvar cancer, we aimed to compare oncological outcomes, surgical margins, and adjuvant treatment delays of patients with or without a vulvar reconstruction in their primary vulvar cancer surgery.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center study comprising patients who underwent surgery due to primary vulvar squamous cell carcinoma in Tampere University Hospital, Finland, in 2005-2018. The primary outcome was the number of vulvar recurrences. Secondary outcomes were time to vulvar recurrence, disease-free and overall survival, surgical margins, and adjuvant treatment delays.</p><p><strong>Results: </strong>Overall, 126 patients were included (reconstruction n = 37, direct closure n = 89). Median follow-up time was 46.0 (interquartile range [IQR] 15.5-102.0) vs 55.0 months (IQR 17.0-102.0) in the reconstruction and direct closure groups, respectively. Vulvar recurrences occurred in 18.9% vs 20.2% of patients, respectively (p = 0.87). Time to vulvar recurrence, disease-free survival, or overall survival were comparable between the groups despite an overrepresentation of large [40.0 mm (IQR 25.5-55.0) vs 20.0 mm (IQR 13.0-35.0), p < 0.001], medial (81.1% vs 56.2%, p = .008), multifocal (29.7% vs 7.9%, p = .001), deeply invasive tumors [8.0 mm (IQR; 4.5-14.5) vs 3.5 mm (IQR 2.0-8.0), p < .001] presenting with perineural (32.3% vs 13.6%, p = .035) and lymphovascular space invasion (42.9% vs 15.6%, p = .003) in the reconstruction group. Surgical margins did not differ between the groups despite differences in pathological characteristics. Adjuvant therapy was not delayed in the reconstruction group compared to direct closure group [median delay 59.0 (IQR 52.0-73.8) vs 61.0 days (IQR 50.0-66.0), p = .59], and there was no statistically significant difference in the need for adjuvant therapy.</p><p><strong>Conclusions: </strong>Vulvar reconstruction was associated with non-inferior oncological outcomes compared to the direct closure group, though this conclusion is limited by the retrospective nature of the study. Frequent co-operation between gynecologic oncologists and plastic surgeons is encouraged.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101942"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234037","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":"Centralization and advanced endometrial cancer.","authors":"Anna Myriam Perrone, Stefano Restaino, Pierandrea De Iaco, Giovanni Scambia, Giuseppe Vizzielli","doi":"10.1016/j.ijgc.2025.101750","DOIUrl":"10.1016/j.ijgc.2025.101750","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101750"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692013","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":"Erratum to 'Controversies in the management of ovarian granulosa cell and Sertoli-Leydig cell tumors' [International Journal of Gynecological Cancer Volume 35 Issue 3 (2025) 101668].","authors":"Michael L Friedlander, Lyndal Anderson, Yeh Chen Lee","doi":"10.1016/j.ijgc.2025.101953","DOIUrl":"10.1016/j.ijgc.2025.101953","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101953"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191786","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":"Node-positive carcinoma of the vulva treated with curative-intent radiotherapy.","authors":"Julianne O'Shea, Emma Link, Pearly Khaw, David Chang, Krystel Tran, Andrew Lim, Ming Yin Lin","doi":"10.1016/j.ijgc.2025.101916","DOIUrl":"10.1016/j.ijgc.2025.101916","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the outcomes of patients with node-positive vulvar carcinoma treated with radiotherapy, with or without chemotherapy, administered with curative intent, focusing on patterns of first failure, locoregional control, and overall survival.</p><p><strong>Methods: </strong>Patients were eligible if they had a histologic diagnosis of node-positive vulvar cancer and were referred for curative-intent radiotherapy, with or without chemotherapy, either as the primary treatment or in the adjuvant setting following definitive surgery between January 2000 and December 2019 at our institution. Eligible patients were selected from the prospective database of the gynecology oncology unit, where clinical, histopathologic, treatment, and follow-up data were systematically collected for analysis.</p><p><strong>Results: </strong>Out of 256 patients with vulvar cancer, 88 (34.4%) patients met the inclusion criteria. The median age was 65 years (range; 33-90). Sixty-two patients underwent surgery and adjuvant radiotherapy, of whom 57 (92%) received concomitant chemotherapy. Twenty-four patients received definitive chemoradiotherapy and 2 received definitive radiotherapy alone. The median total dose to the primary site was 54 Gy in the definitive setting and 45 Gy in the adjuvant setting. The median dose was 54 Gy (range; 45-60) to gross inguinal nodes (n = 48) and 54 Gy (range; 34-64) to gross primary disease (n = 26). The median follow-up was 5.3 years (range; 0.1-21.8). Five-year overall survival was 62% in the adjuvant group and 50% in the definitive group. Of 88 patients, 46 (52%) relapsed; 16 of 46 (35%) had failure at the primary site alone. Disease control at the primary site and nodes was 64% (95% CI; 48%-75%) in the adjuvant group and 49% (26%-68%) in the definitive group at 5 years.</p><p><strong>Conclusions: </strong>Locoregional control and overall survival were highest in patients treated with surgery followed by radiotherapy. Definitive chemoradiotherapy provided moderate disease control and survival outcomes in patients unfit for surgery, supporting its use as an alternative treatment strategy.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101916"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term impact of surgical route and tumor size on risk of recurrence among early-stage cervical cancer patients in a managed care population.","authors":"Rosa A Guerra, Lue-Yen Tucker, Ramey Littell, Allison H Kay","doi":"10.1016/j.ijgc.2025.101928","DOIUrl":"10.1016/j.ijgc.2025.101928","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare survival outcomes between minimally invasive surgery (MIS) and open surgery for early-stage cervical cancer in a managed care community patient population.</p><p><strong>Methods: </strong>This retrospective study included adult patients who underwent a hysterectomy or trachelectomy for a pre-operative clinical-pathologic diagnosis of stage IA1 to IIA1 cervical cancer as defined by the International Federation of Gynecology and Obstetrics 2018 cervical cancer staging. Patients were diagnosed with cervical cancer between January 2005 and December 2018 at a Kaiser Permanente Northern California hospital. We compared outcomes between patients with stage IA2 to IIA1 cervical cancer who underwent a radical MIS and those who underwent open surgery. We separately analyzed patients with stage IA1 disease.</p><p><strong>Results: </strong>A total of 227 patients (55%) with stage IA2 to IIA1 disease underwent MIS and were compared with 187 patients (45%) in the open cohort. In most cases, MIS involved robotic-assisted surgery (77%). The median length of follow-up was 82.6 months (interquartile range; 53.8-106.4) for MIS and 156.6 months (interquartile range; 139.1-168.7) for the open group. There were 27 recurrences in the MIS group (12%) and 8 recurrences in the open group (4%) (p < .01). The 10-year recurrence-free survival was significantly lower in the MIS group (87%, 95% CI 81.0% to 90.7%) than in the open group (97%, 95% CI 92.4% to 98.4%, p < .01). Among patients with tumor size <2 cm, the 10-year recurrence-free survival was significantly lower with MIS (89%, 95% CI 82.7% to 93.5%) than with open surgery (98%, 95% CI 92.3% to 99.5%, p < .01). The 10-year disease-specific survival was also inferior for MIS (96%, 95% CI 92.0% to 98.2%) than for open surgery (100%, 95% CI 100% to 100%, p < .01). None of the 133 patients with stage IA1 disease experienced a cancer recurrence, regardless of surgical approach. Prior cone biopsy was associated with a lower risk of recurrence (adjusted HR 0.48, 95% CI 0.22 to 1.03).</p><p><strong>Conclusions: </strong>Patients with stage IA2 to IIA1 cervical cancer, including those with tumors <2 cm, had inferior survival outcomes following MIS compared with open surgery. Patients with stage IA1 cervical cancer have a very low risk of recurrence regardless of surgical approach.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101928"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274810","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":"Is cone length a risk factor for internal margin positivity in high-grade squamous intraepithelial lesions based on age?","authors":"Lu Zhang, Shuang Shang, Peiqing Quan, Long Sui, Qing Cong","doi":"10.1016/j.ijgc.2025.101825","DOIUrl":"10.1016/j.ijgc.2025.101825","url":null,"abstract":"<p><strong>Objective: </strong>To determine the association between cone length and internal margin positivity in high-grade squamous intraepithelial lesion (HSIL) patients, stratified by age, and provide personalized treatment recommendations.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 1188 HSIL patients treated with Loop Electrosurgical Excision Procedure at the Obstetrics and Gynecology Hospital of Fudan University in 2021. The study evaluated human papillomavirus genotyping, cytology, colposcopy findings, and characteristics of cone excision. Logistic regression analysis was performed to identify independent risk factors associated with internal margin positivity.</p><p><strong>Results: </strong>The overall rate of positive internal margins was 11%. Age (OR 1.03, 95% CI 1.00 to 1.05, p = .021), high-risk cytology (OR 1.69, 95% CI 1.12 to 2.52, p = .012), human papillomavirus 16 infection (OR 1.78, 95% CI 1.18 to 2.66, p = .006), and endocervical HSIL lesion (OR 5.05, 95% CI 3.15 to 8.08, p < .001) were independent risk factors for internal margin positivity. Notably, among women >50, a negative correlation between cone length and positive internal margins was observed. A cone length exceeding 20 mm reduced the positive internal margin rate to 7%. In cases of cervical atrophy, excising at least 50% of the pre-operative cervical length significantly reduced the positive internal margin rate to 12.5%.</p><p><strong>Conclusions: </strong>The length of the excision cone is a significant risk factor for positive internal margin, particularly among women >50. This highlights the importance of age-specific, optimized cervical excision lengths and supports personalized treatment strategies.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101825"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316801","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 \"the prognostic value of tertiary lymphoid structures in molecular subgroups of endometrial carcinoma\" by Pradhan et al.","authors":"Gabriel Levin, Basile Tessier-Cloutier, Xing Zeng","doi":"10.1016/j.ijgc.2025.101943","DOIUrl":"10.1016/j.ijgc.2025.101943","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101943"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199010","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":"Back to the past: should positive peritoneal cytology influence patient management in low-risk endometrial cancer?","authors":"Félix Boria, Enrique Chacón","doi":"10.1016/j.ijgc.2025.101969","DOIUrl":"10.1016/j.ijgc.2025.101969","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101969"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540083","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":"Community-based interventions to reduce cervical cancer in low- and middle-income countries: a call to action.","authors":"Laila Afroze, Md Sazedur Rahman","doi":"10.1136/ijgc-2024-006188","DOIUrl":"10.1136/ijgc-2024-006188","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101838"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464673","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}