Lawrencia Bawuah Dsane, Heleen van Beekhuizen, Jogchum Beltman, Augustine Tawiah, Dennis Sunten
{"title":"FIGO 2023 classification of endometrial cancers: reflections from low- and middle-income countries.","authors":"Lawrencia Bawuah Dsane, Heleen van Beekhuizen, Jogchum Beltman, Augustine Tawiah, Dennis Sunten","doi":"10.1016/j.ijgc.2025.101910","DOIUrl":"10.1016/j.ijgc.2025.101910","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101910"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142261","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}
Xionge Mei, Seth-Frerich Fobian, Marloes IJff, Johannes Crezee, Gregor G W van Bochove, Luc R C W van Lonkhuijzen, Constantijne H Mom, Colette B M van den Broek, Jan Koster, Willem de Koning, Andrew P Stubbs, Renske D M Steenbergen, Timo L M Ten Hagen, Louis Vermeulen, Lukas J A Stalpers, Arlene L Oei
{"title":"High human papillomavirus viral load and local immune dysregulation are associated with poor clinical outcomes in patients with cervical cancer.","authors":"Xionge Mei, Seth-Frerich Fobian, Marloes IJff, Johannes Crezee, Gregor G W van Bochove, Luc R C W van Lonkhuijzen, Constantijne H Mom, Colette B M van den Broek, Jan Koster, Willem de Koning, Andrew P Stubbs, Renske D M Steenbergen, Timo L M Ten Hagen, Louis Vermeulen, Lukas J A Stalpers, Arlene L Oei","doi":"10.1016/j.ijgc.2025.101924","DOIUrl":"10.1016/j.ijgc.2025.101924","url":null,"abstract":"<p><strong>Objective: </strong>Human papillomavirus (HPV) infection is the primary cause of cervical cancer. Higher viral load, that is, a greater abundance of HPV DNA in a tumor, has been associated with poorer clinical outcomes, and may play a role in the more accurate prediction of (non-) responders to treatment. In this study, we investigated the correlation between HPV viral load, clinical outcomes, and immune parameters related to HPV infection.</p><p><strong>Methods: </strong>HPV viral load was quantified using quantitative polymerase chain reaction on biopsies from a prospective cohort of women diagnosed with cervical cancer. Patients were categorized into 2 HPV viral load groups based on the optimal fit of a non-linear piecewise regression model. Immunohistochemical staining was used to measure tumor cell characteristics (Ki67, p16<sup>INK4a</sup>, Pan-CK), as well as local tumor immune parameters (CD3, CD4, CD8, FOXP3) and immune checkpoint expression (PD-1, PD-L1). Kaplan-Meier curves were generated to compare recurrence-free and overall survival.</p><p><strong>Results: </strong>In the 44 women included in our study, high HPV viral load was significantly associated with shorter overall and recurrence-free survival (p = .045 and p = .046, respectively; 2-sided) and positively correlated with an increased risk of lymph node and distant metastasis. In addition, a high HPV viral load was linked to lower percentages of tumor-infiltrating lymphocytes and reduced expression levels of PD-1 and PD-L1.</p><p><strong>Conclusions: </strong>The viral load of HPV in cervical cancer correlates positively to metastasis and recurrence and negatively to survival rates, potentially because of local immune suppression. These results might indicate a lower response to immune checkpoint inhibition in the high viral load group and that other treatment options should still be explored.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101924"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191787","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}
Heather J Agnew, Holly Baker-Rand, Sarah J Kitson, Emma J Crosbie
{"title":"Leading causes of death after a diagnosis of endometrial cancer: a systematic review and meta-analysis.","authors":"Heather J Agnew, Holly Baker-Rand, Sarah J Kitson, Emma J Crosbie","doi":"10.1016/j.ijgc.2025.101926","DOIUrl":"10.1016/j.ijgc.2025.101926","url":null,"abstract":"<p><strong>Objective: </strong>Despite curative treatment, an endometrial cancer (EC) diagnosis is associated with an elevated risk of death compared with age-matched women in the general population. This study aimed to quantify their risk of death from EC, cardiovascular disease, and other causes.</p><p><strong>Methods: </strong>A systematic review of Medline, Embase, and CENTRAL databases was performed to February 2024. Studies reporting cause of death after a diagnosis of EC were included. Mortality rates and 95% CIs were calculated using a random-effects model. Heterogeneity was assessed through visual inspection of forest plots and the I<sup>2</sup> statistic. Risk of bias and evidence quality were appraised using the Newcastle-Ottawa scale and Grading of Recommendations Assessment, Development and Evaluation (GRADE), respectively. The effect of ethnicity, stage, grade, and time from diagnosis was examined.</p><p><strong>Results: </strong>In total, 22 studies including 323,551 participants were analyzed and 102,711 (31.7%) died within 20 years of diagnosis, 62.6% (n = 64,155) from non-EC causes. In the 12 studies that reported cardiovascular death, 24.6% of participants (n = 24,309) died from cardiovascular disease. Those with local disease at presentation were more likely to die from non-EC causes than those with advanced disease at presentation (48.9% vs 13.5%). A total of 2 studies reported cause of death by ethnicity; overall, Black individuals were more likely to die than individuals of White or Other ethnicities (40.8% vs 27.9% vs 18.9%). Deaths related to non-EC causes, including cardiovascular disease, overtook EC-specific deaths >5 years after diagnosis. Significant heterogeneity was noted, despite sub-group analyses, and the findings were based on very low certainty evidence.</p><p><strong>Conclusions: </strong>Individuals with a history of EC are at increased risk of death from other causes. Oncology follow-up appointments provide the ideal opportunity to optimize cardiovascular risk factors to reduce preventable deaths. Future research needs to reflect the global majority.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101926"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191788","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}
Joanna Kacperczyk-Bartnik, Houssein El Hajj, Icó Tóth, Nicolò Bizzarri, Richard Tóth, Zoia Razumova, Tibor Andrea Zwimpfer, Nadja Taumberger, Esra Bilir, Aleksandra Strojna, Martina Aida Angeles, Khayal Gasimli, Tanja Nikolova, Paweł Bartnik, Andrej Cokan, Sezin Yuce Sari, Ilker Kahramanoglu, Giuseppe Caruso, Elmar A Joura, Maria Kyrgiou, Vesna Kesic, Anna Fagotti, Marc Arbyn, Murat Gultekin
{"title":"Declaration on cervical cancer elimination: literature review and perspectives from early-career clinicians.","authors":"Joanna Kacperczyk-Bartnik, Houssein El Hajj, Icó Tóth, Nicolò Bizzarri, Richard Tóth, Zoia Razumova, Tibor Andrea Zwimpfer, Nadja Taumberger, Esra Bilir, Aleksandra Strojna, Martina Aida Angeles, Khayal Gasimli, Tanja Nikolova, Paweł Bartnik, Andrej Cokan, Sezin Yuce Sari, Ilker Kahramanoglu, Giuseppe Caruso, Elmar A Joura, Maria Kyrgiou, Vesna Kesic, Anna Fagotti, Marc Arbyn, Murat Gultekin","doi":"10.1016/j.ijgc.2025.101902","DOIUrl":"10.1016/j.ijgc.2025.101902","url":null,"abstract":"<p><p>Despite effective prevention methods, cervical cancer remains one of the most incident malignancies globally. This literature review and perspectives from early-career clinicians aim to propose actionable recommendations to reduce the global burden of cervical cancer. The authors, representing the early-career clinicians and researchers, patient representatives, epidemiologists, and gynecologic oncology experts, identified 5 key pillars for cervical cancer elimination based on literature reviews and interdisciplinary discussion: (1) raising awareness of human papillomavirus (HPV) and cervical cancer; (2) ensuring evidence-based HPV communication; (3) fostering collaboration with other specialties and organizations; (4) increasing HPV vaccination rates; and (5) improving cervical cancer screening. Achieving the World Health Organization's cervical cancer elimination target by 2030 requires a comprehensive, multi-faceted approach. Our recommendations emphasize the need for targeted awareness campaigns, evidence-based communication, collaboration with various stakeholders, promotion of best practices, and keeping evidence of innovative interventions up-to-date, with intensified efforts in low- and middle-income countries where the burden is the greatest.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101902"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173804","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}
Diletta Fumagalli, Emilia Palmieri, Giuseppe Caruso, Luigi A De Vitis, Ilaria Capasso, Benoit Guillot, Giulia Pappalettera, Tommaso Occhiali, Angela J Fought, Michaela E McGree, Carrie Langstraat, Evelyn Reynolds, Andrea Mariani, Gretchen E Glaser
{"title":"Rewinding the clock on positive peritoneal cytology in endometrial cancer: does it predict prognosis in low-risk disease?","authors":"Diletta Fumagalli, Emilia Palmieri, Giuseppe Caruso, Luigi A De Vitis, Ilaria Capasso, Benoit Guillot, Giulia Pappalettera, Tommaso Occhiali, Angela J Fought, Michaela E McGree, Carrie Langstraat, Evelyn Reynolds, Andrea Mariani, Gretchen E Glaser","doi":"10.1016/j.ijgc.2025.101814","DOIUrl":"10.1016/j.ijgc.2025.101814","url":null,"abstract":"<p><strong>Objective: </strong>Positive peritoneal cytology in endometrial cancer is a known risk factor for worse oncologic outcomes but is not used for staging purposes or to guide adjuvant treatment. Additionally, its prognostic impact on low-risk patients remains unclear. Therefore, we investigated the role of positive peritoneal cytology in patients with endometrial cancer and focused on low-risk disease.</p><p><strong>Methods: </strong>This is a retrospective cohort study including all consecutive patients undergoing primary surgery for endometrial cancer at Mayo Clinic from 1999 to 2021. The role of positive peritoneal cytology was investigated in the entire cohort and in 2 subgroups: the National Comprehensive Cancer Network (NCCN) low-risk group, including low-risk patients according to NCCN guidelines (endometrioid, grade 1-2, stage IA) and the European Society of Gynecologic Oncology/European Society of Radiotherapy and Oncology/European Society of Pathology (ESGO/ESTRO/ESP) low-risk group, including low-risk patients according to ESGO/ESTRO/ESP guidelines (as NCCN, plus no lymphovascular space invasion). Univariate and multivariable analyses were used to evaluate the association of positive peritoneal cytology with recurrence within 5 years after surgery, and Kaplan-Meier survival analyses were performed in all groups.</p><p><strong>Results: </strong>A total of 3517 patients were included, 1911 in the NCCN low-risk group and 1832 in the ESGO/ESTRO/ESP low-risk group. Positive peritoneal cytology was found in 15.9% of the entire cohort (559/3517), 8.1% of the NCCN low-risk group (154/1911), and 7.9% of the ESGO/ESTRO/ESP low-risk group (145/1832). In both low-risk groups, 5-year recurrence-free survival was worse in patients with positive peritoneal cytology (p < .01 and p = .03, respectively), but there was no difference in overall survival. On univariate analysis, age, tumor grade, and positive peritoneal cytology were significant predictors of recurrence in both subgroups. After multivariable analysis, positive peritoneal cytology remained independently associated with recurrence (p < .01 and p = .03, respectively).</p><p><strong>Conclusions: </strong>Positive peritoneal cytology was an independent predictor of recurrence and was associated with worse recurrence-free survival in patients with low-risk endometrial cancer. However, overall survival was not impacted.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101814"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019801","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}
Alejandro Gallego, Ainhoa Madariaga, Purificación Estévez-García, Facundo Albertí, Anna Carbó, Isabel Palacio, Cristina Churruca, Fernando Gálvez, María Eugenia Ortega, Paola Murata, Aránzazu Manzano, María Masvidal, Cristina Martín-Lorente, Blanca Hernando, Inmaculada Lozano, Juan F Cueva, David García-Illescas, Ester Gost, Marta Mendiola, Andrés Redondo
{"title":"An ambispective, real-world multi-center study of DOstarlimab in patients with Recurrent or Advanced DNA mismatch repair deficient/microsatellite instability-high endometrial cancer (GEICO 120-R/DORA study).","authors":"Alejandro Gallego, Ainhoa Madariaga, Purificación Estévez-García, Facundo Albertí, Anna Carbó, Isabel Palacio, Cristina Churruca, Fernando Gálvez, María Eugenia Ortega, Paola Murata, Aránzazu Manzano, María Masvidal, Cristina Martín-Lorente, Blanca Hernando, Inmaculada Lozano, Juan F Cueva, David García-Illescas, Ester Gost, Marta Mendiola, Andrés Redondo","doi":"10.1016/j.ijgc.2025.101903","DOIUrl":"10.1016/j.ijgc.2025.101903","url":null,"abstract":"<p><strong>Objective: </strong>Patients with advanced or recurrent endometrial cancer who experience progression following platinum-based chemotherapy have limited treatment options. The phase I GARNET trial showed the high efficacy of dostarlimab in treating mismatch repair deficient (dMMR) and/or microsatellite instability-high (MSI-H) endometrial cancer.</p><p><strong>Methods: </strong>DORA is a multi-center, ambispective, observational real-world study evaluating the efficacy and safety of dostarlimab. The study included patients with dMMR/MSI-H endometrial cancer who had experienced tumor progression on or after a platinum-based treatment and had received at least 1 cycle of dostarlimab within the Spanish Expanded Access Program. The primary endpoints were objective response rate and duration of response.</p><p><strong>Results: </strong>A total of 129 patients from 57 of the Spanish Research Group for Gynaecological Cancer (GEICO) affiliated hospitals were enrolled, with 125 evaluable for radiological response. The median duration of dostarlimab administration was 8.8 months (interquartile range; 13.2), and 73 patients (57%) remained on therapy at the data cutoff. With a median follow-up of 11.6 months (range; 0.8-30.1), the objective response rate was 53.6% (95% CI 44.4 to 62.5). Complete response was observed in 27 patients (21.6%), and partial response in 40 (32%), with a median time to response of 2.9 months (95% CI 2.6 to 3.6). The median duration of response was not reached. The probability of maintaining the response at 12 and 24 months was 84.98% (95% CI 70.8 to 92.5) and 73.39% (95% CI 50.5 to 86.9), respectively. Treatment was discontinued due to toxicity in 4.7% of patients.</p><p><strong>Conclusions: </strong>Dostarlimab monotherapy in dMMR/MSI-H endometrial cancer patients shows similar efficacy in real-world practice to that observed in the GARNET trial.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101903"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093878","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}
Robert L Coleman, Zulikhat Segunmaru, Elizabeth A Szamreta, Kathryn Krupsky, Kathleen Beusterien, M Janelle Cambron-Mellott, Michael F Barry, Nicole Kashine, Emily Mulvihill, Daniel Simmons
{"title":"Oncologist perceptions of \"cure\" and long-term management in advanced ovarian cancer in the United States: results from a cross-sectional survey.","authors":"Robert L Coleman, Zulikhat Segunmaru, Elizabeth A Szamreta, Kathryn Krupsky, Kathleen Beusterien, M Janelle Cambron-Mellott, Michael F Barry, Nicole Kashine, Emily Mulvihill, Daniel Simmons","doi":"10.1016/j.ijgc.2025.101919","DOIUrl":"10.1016/j.ijgc.2025.101919","url":null,"abstract":"<p><strong>Objectives: </strong>Treatment advancements have improved survival outcomes for patients with advanced ovarian cancer. In advanced ovarian cancer, some physicians believe discussing \"cure\" as a potential treatment goal may be premature. In contrast, others note that the durable responses observed among some patients may suggest that long-term remission or \"cure\" are legitimate outcomes to strive for. Despite this, the term 'cure' has no accepted definition in this setting, and whether physicians are willing to use this language is unknown.</p><p><strong>Methods: </strong>A cross-sectional, internet-based survey was conducted to evaluate United States oncologists' attitudes and beliefs related to \"cure\" in the context of treating patients with newly diagnosed advanced ovarian cancer. The survey included questions on attitudes and beliefs toward patient prognosis with newly diagnosed advanced ovarian cancer, oncologists' perceptions of clinical outcomes, oncologist characteristics, and clinical practice details.</p><p><strong>Results: </strong>Among 150 oncologists, when addressing the topic of disease prognosis or treatment goals in patients newly diagnosed with stage III-IV ovarian cancer, the terms endorsed by more than half of oncologists were \"achieve long-term remission\" and \"achieve long-term response.\" Terms including \"cure\" or \"curable\" were endorsed by less than 35% of oncologists. Among several patient characteristics evaluated, no evidence of disease for 5 to 10 years was most indicative of cure. In the context of primary disease, the proportion of oncologists who would tell a patient with advanced ovarian cancer they were cured, even if they believe it to be true, decreased with the stage (II = 73.8%; III = 60.8%; IV = 50.5%).</p><p><strong>Conclusions: </strong>The current study found that while oncologists may believe a cure is possible across early stages of ovarian cancer, many remain hesitant to discuss the potential of \"cure\" with patients, particularly those with stage IV disease.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101919"},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119655","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}