International Journal of Gynecological Cancer最新文献

{"title":"External validation of the annual recurrence risk model for tailored surveillance strategy in patients with cervical cancer.","authors":"Luigi A De Vitis, Gabriella Schivardi, Aurora Gaeta, Giuseppe Caruso, Marina Rosanu, Lucia Ribero, Diletta Fumagalli, Jvan Casarin, Ilaria Betella, Giorgio Bogani, Carrie L Langstraat, Giovanni D Aletti, Nicoletta Colombo, Vanna Zanagnolo, Sara Gandini, Francesco Multinu","doi":"10.1016/j.ijgc.2025.101756","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101756","url":null,"abstract":"<p><strong>Objective: </strong>The annual recurrence risk model (ARRM), developed by the Surveillance in Cervical Cancer consortium and endorsed by the European Society of Gynecological Oncology, predicts the annual risk of cervical cancer recurrence. However, it lacks an external validation, which we aimed to address in the current retrospective study.</p><p><strong>Methods: </strong>We included patients with pathology confirmed T1a to T2b cervical cancers who underwent radical surgery at the European Institute of Oncology, Milan from January 2010 to December 2022. Using the ARRM risk calculator, patients were assigned a score from 0 to 100 points, which allowed classification into 5 risk groups (0, 1-25, 26-50, 51-75, and 76-100 points). Differences in 5-year disease-free survival were evaluated through log-rank tests with pairwise comparisons. Annual risk of recurrence was calculated using conditional survival analysis.</p><p><strong>Results: </strong>Overall, 411 patients with cervical cancers were included: 0 (0.0%) scored 0 points, 149 (36.3%) scored 1 to 25 points, 224 (54.5%) scored 26 to 50 points, 37 (9.0%) scored 51 to 75 points, and 1 (0.2%) scored 76 to 100 points. The patient from 76 to 100 points was excluded from further analyses. The 5-year disease-free survival rates were 96.3% (95% CI 90.0 to 98.6), 85.7% (95% CI 80.1% to 89.9%), and 66.6% (95% CI 47.3% to 80.2%) in groups 1 to 25, 26 to 50, and 51 to 75 points, respectively (p < .01). Compared with 26 to 50 and 51 to 75 points, the annual risk of recurrence was lower in the 1 to 25 points group, at around 1% from year 1 to 5.</p><p><strong>Conclusions: </strong>The ARRM tool confirmed its validity in stratifying cervical cancer into groups with significantly different disease-free survival rates in an independent large population from a tertiary center. The annual risk of recurrence should be carefully considered when tailoring follow-up, always taking into account the patient's perspective.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101756"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718825","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":"Controversies in the management of rare gynecologic cancers.","authors":"David M Gershenson, Jonathan Ledermann, Isabelle Ray-Coquard","doi":"10.1016/j.ijgc.2025.101677","DOIUrl":"10.1016/j.ijgc.2025.101677","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 3","pages":"101677"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472457","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":"Laparoscopic para-uterine lymphovascular tissue sentinel lymph node biopsy with indocyanine green in cervical cancer.","authors":"Nicolò Bizzarri, Giacomo Guidi, Matteo Pavone, Luigi Pedone Anchora, Agnieszka Rychlik, Marta Goglia, Francesco Fanfani, Giovanni Scambia, Denis Querleu","doi":"10.1016/j.ijgc.2025.101744","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101744","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101744"},"PeriodicalIF":4.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605052","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":"https://doi.org/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":"2025-02-22","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":"Value of frozen section to tailor surgical staging in apparent early-stage epithelial ovarian cancer.","authors":"Stefano Di Berardino, Nicolò Bizzarri, Marianna Ciancia, Francesca Moro, Belen Padial Urtueta, Claudia Marchetti, Gian Franco Zannoni, Giovanni Scambia, Anna Fagotti","doi":"10.1016/j.ijgc.2025.101746","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101746","url":null,"abstract":"<p><strong>Objective: </strong>Frozen section (FS) has been shown to have high accuracy in determining ovarian malignancy. However, its utility in guiding surgical approaches, particularly, lymph node staging, for early-stage epithelial ovarian cancer remains unclear. This study aimed to evaluate the post-test positive probability of FSs in identifying cases requiring lymph node or peritoneal staging. The secondary aims were sensitivity, specificity, and accuracy assessments.</p><p><strong>Methods: </strong>This retrospective study analyzed patients undergoing surgery for early-stage epithelial ovarian cancer with FS performed on ovarian masses between July 2007 and March 2023 at a tertiary center. The FS results were compared with the final histology (gold standard paraffin sections). The FS cases were categorized based on further actions as follows: lymph node staging (type A), peritoneal staging only (type B), or no additional procedures (type C). The patients were divided into group 1 (requiring lymph node and peritoneal staging) and group 2 (requiring only peritoneal staging). A comparison between specialized and general pathology diagnoses was also performed. Incorrect FS assessments were classified as under-diagnosed or over-diagnosed.</p><p><strong>Results: </strong>Of the 715 patients, group 1 had appropriate staging in 425 of 447 cases, with 4.9% over-treatment. In group 2, staging was correct in 109 of 195 cases, with 44.1% under-treatment. For type A FSs, the post-test positive probability was 95% (95% CI 93% to 97%), with sensitivity, specificity, and accuracy rates of 76.4%, 86.1%, and 78.6%, respectively. For type B FSs, the post-test positive probability was 56% (95% CI 50% to 61%), with sensitivity, specificity, and accuracy rates of 68.6%, 84.5%, and 81%, respectively. There was no significant difference in the agreement between the specialized and general pathology groups (p = 0.92).</p><p><strong>Conclusions: </strong>Frozen sections suggestive of a cancer diagnosis requiring peritoneal and lymph node staging in a population with apparent early-stage epithelial ovarian cancer are highly reliable. In the case of FSs suggesting only peritoneal staging, malignancy is frequently underestimated.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101746"},"PeriodicalIF":4.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692047","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":"Horseshoe kidney.","authors":"Daniel Vázquez-Vicente, Lidia Sancho, Luis Chiva","doi":"10.1016/j.ijgc.2025.101694","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101694","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101694"},"PeriodicalIF":4.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567001","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":"Health care organization for gynecologic oncology patients fleeing Ukraine: Insights from the European Network of Young Gyne Oncologists survey during the first six months of the military conflict.","authors":"Joanna Kacperczyk-Bartnik, Olha Khoptiana, Klaudia Żak, Alicja Rajtak, Alexander Shushkevich, Andrei Pletnev, Zoia Razumova, Aleksandra Strojna, Esra Bilir, Houssein El Hajj, Tibor Andrea Zwimpfer, Charalampos Theofanakis, Kamil Zalewski, Nicolò Bizzarri, Marcin Bobiński","doi":"10.1016/j.ijgc.2025.101719","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101719","url":null,"abstract":"<p><strong>Objective: </strong>The Russian invasion of Ukraine in February 2022 caused a mass displacement of over 6 million people, including many women requiring urgent medical care, such as those with gynecologic malignancies. The disruption of cancer treatment in conflict zones poses critical challenges because timely oncologic care is vital for patient survival. This study, conducted by the European Network of Young Gynecologic Oncologists, aimed to assess the health care responses provided to Ukrainian gynecologic oncology patients across European countries during the first 6 months of the conflict.</p><p><strong>Methods: </strong>A cross-sectional survey was distributed to European Network of Young Gynecologic Oncologists members between July and August 2022, gathering insights from health care providers about their experiences in managing Ukrainian gynecologic oncology patients. The survey explored the medical needs of displaced patients, challenges encountered, and the resources available. Descriptive statistics were used for data analysis.</p><p><strong>Results: </strong>During the study period, approximately 400 gynecologic oncology patients fleeing Ukraine received care in 38 European health care centers represented by the respondents (N = 50). Surgical interventions (54%), chemotherapy (40%), and specialist consultations (32%) were identified as the most common medical needs. The key barriers to care included language difficulties (44%), lack of previous medical documentation (40%), and inconsistencies in treatment protocols between centers. Psychological support was notably insufficient, with 36% of respondents reporting a lack of adequate resources for addressing mental health needs.</p><p><strong>Conclusions: </strong>The study identifies critical barriers to the continuity of gynecologic oncology care for displaced patients during humanitarian crises. Addressing language barriers, ensuring access to patient medical histories, and providing psychological support are essential to improve care for refugees. The findings underscore the importance for international collaboration and the development of robust frameworks for delivering oncologic care during crises.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101719"},"PeriodicalIF":4.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542002","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":"Role of lymphadenectomy in advanced ovarian cancer-a subgroup analysis of the patients excluded from the LION trial (the Charité cohort).","authors":"Robert Armbrust, Christina Fotopoulou, Dario Zocholl, Radoslav Chekerov, Mustafa Zelal Muallem, Iona Braicu, Klaus Pietzner, Philipp Harter, Jalid Sehouli","doi":"10.1016/j.ijgc.2025.101683","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101683","url":null,"abstract":"<p><strong>Objective: </strong>The phase III LION trial found no therapeutic benefit from systematic lymphadenectomy in patients with advanced ovarian cancer with optimal upfront cytoreduction and normal-appearing lymph nodes. Patients were randomized intra-operatively, excluding those who could not be operated on when they were tumor-free or had suspicious/bulky lymph nodes upon inspection or palpation. This analysis focused on the outcomes of the group excluded because of bulky lymph nodes alone.</p><p><strong>Methods: </strong>This was a monocentric, retrospective subgroup analysis of a randomized controlled trial conducted at Charité University Hospital. We evaluated the same patients as in the LION trial. Tumor-free patients with presumed bulky/suspicious lymph nodes underwent full systematic lymphadenectomy after exclusion. Patients were analyzed according to the same endpoints as the LION trial and compared with those of the original study.</p><p><strong>Results: </strong>Overall, 202 patients with a median age of 61 years (range; 37-74) were included; 83.6% had stage III/IV disease (n = 122) and predominantly high-grade serous histology (72%, n = 145). The rate of complete tumor resection was significantly lower in intra-operatively excluded patients (45%, n = 55) than in those included (92%, n = 112), with a significant negative impact on overall and progression-free survival (p = .042). Only 60% (n = 33) of the originally excluded patients had histologically positive lymph nodes, although 38.8% (n = 21) were presumed to be bulky by the surgeon. There was no significant difference in progression-free survival or overall survival between the patients who underwent optimal surgery and were excluded from the original LION study versus those included, regardless of their histological lymph node status and whether a lymphadenectomy was performed (p = .4, 95% CI 24.8 to 39).</p><p><strong>Conclusion: </strong>Patients with ovarian cancer, when operated on upfront without macroscopic residual disease, have the same survival regardless of whether they have bulky nodes as long as any bulky lymph nodes are removed. Moreover, we demonstrated that intra-operative lymph node evaluation by a surgeon is subjective and often inaccurate.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101683"},"PeriodicalIF":4.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585609","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":"Improving pre-operative binary grading: relevance of p53 and PR expression in grade 2 endometrioid endometrial carcinoma.","authors":"Puk Meijs-Hermanns, Henrica M J Werner, Loes Kooreman, Petra Bretová, Vit Weinberger, Stephanie Vrede, Luthy S M Alcala, Frédéric Amant, Jasmin Asberger, Markéta Bednaříková, Dorry Boll, Carolien M Bronkhorst, Johan Bulten, Antonio Gil-Moreno, Ingfrid S Haldorsen, Jitka Hausnerová, Jutta Huvila, Martin Koskas, Camilla Krakstad, Heidi Küsters-Vandevelde, Gemma Mancebo Moreno, Xavier Matias-Guiu, Huy Ngo, Brenda M Pijlman, Maria Santacana, Marieke Smink, Jone Trovik, Viola M J Verhoef, Koen Van de Vijver, Dennis van Hamont, Anneke A M van der Wurff, Johanna M A Pijnenborg, Nicole C M Visser","doi":"10.1016/j.ijgc.2025.101682","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101682","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the association between pre-operative progesterone receptor (PR) and p53 expression and prognosis in pre-operative grade 2 endometrioid endometrial carcinoma compared with grade 1 and grade 3 carcinomas.</p><p><strong>Methods: </strong>Three European endometrial carcinoma cohort studies were included. Patients with pre-operative grade 2 endometrioid carcinoma and known pre-operative PR and p53 status were included (n = 400), as were patients with pre-operative grade 1 (n = 602) or grade 3 (n = 148) endometrioid carcinomas. Kaplan-Meier and Cox regression analyses were performed to analyze disease-specific and disease-free survival.</p><p><strong>Results: </strong>Patients with pre-operative grade 2 endometrial carcinoma and wild-type p53 plus PR-positive expression showed a similar 7-year disease-specific survival to grade 1 endometrial carcinoma patients (95.8% vs 97.5%, p = .13), while the 7-year disease-specific survival of patients with grade 2 endometrial carcinoma with p53 aberrant and/or negative PR expression (83.5%) was significantly lower (p < .001). The combination of these markers was an independent prognostic factor in multivariate Cox regression analyses.</p><p><strong>Conclusions: </strong>The prognostic impact of pre-operative p53 and PR expression in patients with grade 2 endometrioid endometrial carcinoma supports a modified binary grading system in which grade 2 patients should be pre-operatively classified as low- or high-grade depending on p53 and PR expression.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101682"},"PeriodicalIF":4.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515554","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":"Selective systematic nerve-sparing type C2 radical hysterectomy.","authors":"Ilker Selcuk, Hakan Rasit Yalcin","doi":"10.1016/j.ijgc.2025.101691","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101691","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101691"},"PeriodicalIF":4.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556660","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}