International Journal of Gynecological Cancer最新文献

{"title":"Management of intravenous leiomyomatosis: a comprehensive review of surgical and perioperative considerations.","authors":"Emily Volfson, Michal Moshkovich, Johannes Koen, Robert Cusimano, Rachel Soyoun Kim","doi":"10.1016/j.ijgc.2025.102009","DOIUrl":"10.1016/j.ijgc.2025.102009","url":null,"abstract":"<p><p>Intravenous leiomyomatosis is a rare condition in which a smooth muscle tumor originates from the uterus and extends into the pelvic and systemic vasculature, frequently involving the inferior vena cava and the right atrium. Despite its benign histology, intravenous leiomyomatosis poses significant clinical challenges due to its potential to cause life-threatening complications. Conventional management involves a combined surgical approach: intracardiac tumor resection performed via sternotomy, with abdominal and pelvic tumor removal, including hysterectomy, conducted through laparotomy. Alternatively, an abdominal-only approach allows for complete tumor resection through inferior vena cava incision and hysterectomy without sternotomy. Surgical timing is an important consideration, with single-stage procedures addressing all tumor components in 1 operation, while 2-stage procedures separate cardiac and abdominal/pelvic resections into distinct surgeries to reduce risks in patients with extensive cardiac involvement or limited surgical tolerance. Post-operative management includes careful resumption of anti-coagulation for several months to prevent thromboembolic complications, particularly in patients with vascular involvement. Hormonal therapy, such as aromatase inhibitors, is considered for patients with residual disease. Advanced imaging techniques, including magnetic resonance imaging, computed tomography, and echocardiography, are essential in both preoperative planning and post-operative surveillance to ensure optimal surgical strategy and to help monitor for residual tumors. Multidisciplinary collaboration is crucial in the management of intravenous leiomyomatosis, ensuring a comprehensive approach that optimizes patient outcomes.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 10","pages":"102009"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760064","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":"Indocyanine green fluorescence angiography for bowel anastomosis assessment in ovarian cancer surgery.","authors":"Stephanie J Gill, Elise M Yates, Christian Braun, Kyra Fischer, Maria Clara Santia, Julia H Gelissen, Thomas Bartl, Manel Montesinos-Albert, Matteo Marchetti, Pedro T Ramirez","doi":"10.1016/j.ijgc.2025.102022","DOIUrl":"10.1016/j.ijgc.2025.102022","url":null,"abstract":"<p><p>Optimizing bowel anastomotic integrity is a key consideration in ovarian cancer cytoreductive surgery, as anastomotic complications can significantly impact postoperative recovery and delay systemic treatment. Conventional assessment techniques like visual inspection and palpation are inherently subjective and may not consistently predict the likelihood of anastomotic leakage. Due to the serious consequences of anastomotic failure and the impact of diverting ostomies, there is growing interest in fluorescence-based technologies to enhance the diagnostic accuracy of anastomoses and support more informed intraoperative decision-making. Indocyanine green fluorescence angiography (ICG-FA) has emerged as a promising tool for improving the accuracy of bowel perfusion at the time of surgery. While widely adopted in general surgery, its use in gynecologic oncology is still growing and has not yet been established as the standard of care. By allowing surgeons to assess perfusion intraoperatively, ICG-FA may help reduce anastomotic leaks and decrease the need for diverting ostomies, with the goal of improving patient outcomes and quality of life. While early evidence indicates that ICG-FA is a safe and feasible tool in ovarian cancer surgery, additional research is required to develop standardized protocols and evaluate its clinical significance and long-term benefits. This review provides a technical overview, examines the current evidence surrounding ICG-FA in gynecologic oncology, explores its potential advantages and limitations, and highlights future directions for research in fluorescence-guided bowel anastomosis assessment.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 10","pages":"102022"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953237","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":"Advanced epithelial ovarian cancer in older patients.","authors":"Victoria Cullimore, Kezia Gaitskell, Rebecca Newhouse, Kathryn Baxter, Nicholas Wood, Christina Fotopoulou, Jason Yap, Madeline MacDonald, Richard J Edmondson, Jo Morrison","doi":"10.1016/j.ijgc.2025.102017","DOIUrl":"10.1016/j.ijgc.2025.102017","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to analyze management and survival outcomes of older patients (≥75 years) with stage ≥II epithelial ovarian cancer across gynecological cancer centers in the United Kingdom.</p><p><strong>Methods: </strong>Retrospective cohort study performed using the IMPRESS project data set. Clinical information for patients diagnosed with epithelial ovarian cancer from 6 sites of varying size and population demographics was collated between January 2018 and December 2019. We compared treatment of patients aged ≥75 years with those <75, within and between centers, using multivariate analysis to understand effects on outcomes.</p><p><strong>Results: </strong>After exclusions, we assessed 721 patients for overall survival and 702 for progression-free survival. Patients aged ≥75 years had poorer performance status and more comorbidities. Older patients were less likely to receive combination treatment with surgery and chemotherapy (in either order) (overall = 392/721 (54.4%); <75 cohort = 320/495 (64.6%); ≥75 cohort = 72/226 (31.9%), p < .0001). Treatment varied between sites, with some having no active treatment rates of 49% for patients aged ≥75 years. Older patients had twice the relative risk of death (relative risk 1.98, 95% CI 1.63 to 2.39, p < .001). Adjustment for confounders individually caused only a relatively modest reduction in magnitude and strength of association. Adjustment for treatment led to this association essentially disappearing (relative risk 1.10, 95% CI 0.88 to 1.38, 99% reduction in χ²), though with significant variation in association between age and overall survival between treatment groups (p-heterogeneity = .0004).</p><p><strong>Conclusions: </strong>Older women may do as well as younger women in terms of survival if treated similarly, although this varies depending on treatment groups. Treatments varied between and within sites, with some sites treating older women differently than others.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 10","pages":"102017"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816567","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":"Reply to \"Methodological considerations on laparoscopic PIV in advanced ovarian cancer\".","authors":"Marco D'Indinosante, Denis Querleu, Diana Giannarelli, Anna Fagotti","doi":"10.1016/j.ijgc.2025.102126","DOIUrl":"10.1016/j.ijgc.2025.102126","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102126"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145053090","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":"Metastatic recurrence of a masked uterine PEComa.","authors":"Francesco Mezzapesa, Michael Deavers, Ryan Blair Kieser, Barret C Riddle, Anuj Suri","doi":"10.1016/j.ijgc.2025.102002","DOIUrl":"10.1016/j.ijgc.2025.102002","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102002"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760061","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":"Identification of a very-high risk subgroup of localized endometrial carcinoma before surgery using circulating tumor DNA: a proof-of-concept study.","authors":"Antoine Gaudet Chardonnet, Bruno Borghese, Jérôme Alexandre, Camille Richard, Marie Métairie, Adele Reilhac, Amel Kime, Simon Garinet, Beatrice Parfait, Audrey Didelot, Camille Bourreau, Claire Mulot, Justine Abdelli, Sixtine de Percin, Catherine Durdux, Charles Chapron, François Goldwasser, Pierre Laurent-Puig, Valérie Taly, Guillaume Beinse","doi":"10.1016/j.ijgc.2025.101941","DOIUrl":"10.1016/j.ijgc.2025.101941","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to study whether the detection of circulating tumor DNA (ctDNA) may predict the risk of early relapse for patients with localized endometrial carcinoma.</p><p><strong>Methods: </strong>Patients who underwent surgical resection at Cochin University Hospital (2021-2023) for International Federation of Gynecology and Obstetrics 2018 stage I to III endometrial carcinoma were prospectively included in a prospective biocollection cohort study. All patients had a plasma sample before surgery (EDTA collection tubes, 4-5 mL). After extraction and bisulfite-conversion of cell-free DNA, ctDNA was evaluated using a droplet-digital polymerase chain reaction assay targeting universally-hypermethylated positions in endometrial carcinoma (OXT, ZSCAN12 genes), and defined as significantly detected above the limit of detection. Patients were classified as high-risk based on 2022 European Society for Medical Oncology/European Society of Gynaecological Oncology/European Society of Pathology guidelines, or preoperative features (non-endometrioid histology, p53-abnormal tumors, or stage III). Events of interest were tumor progression or relapse (event-free survival). Adjusted-HR (aHR) was estimated using Cox regression.</p><p><strong>Results: </strong>Among 128 patients included with median follow-up of 26 months (interquartile range; 15-35), ctDNA was detected in 18 patients (14%). Patients with ctDNA had a 1-year event-free rate of 67% (95% CI [48% to 92%]), vs 91% [82% to 100%] among patients without ctDNA. The ctDNA was detected in 10 (29%) patients among those with preoperative high-risk features (N = 34, 1-year event-free rate = 60% [36%-100%]). ctDNA was associated with event-free survival independently of stage (aHR = 4.26 [1.68-10.8]), 2022 guidelines high-risk (aHR = 3.72 [1.57-8.87]), or preoperative high-risk features (aHR = 3.98 [1.65-9.60]).</p><p><strong>Conclusions: </strong>Elevated ctDNA before surgery identifies a very high-risk subgroup of newly diagnosed endometrial carcinoma, suggestive of occult metastasis. Further studies are warranted to validate this finding and investigate the window of opportunity for neoadjuvant approaches.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101941"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293747","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":"Beyond survival: reclaiming quality of life after cervical cancer treatment.","authors":"Daniele Assad Suzuki, Mariana Carvalho Gouveia, Marcela Bonalumi Dos Santos, Mariana Scaranti","doi":"10.1016/j.ijgc.2025.102026","DOIUrl":"10.1016/j.ijgc.2025.102026","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 10","pages":"102026"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873102","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":"No myoinvasion… no reassurance: recurrence risk in stage IA endometrial carcinosarcoma.","authors":"Diletta Fumagalli, Pedro T Ramirez","doi":"10.1016/j.ijgc.2025.102114","DOIUrl":"10.1016/j.ijgc.2025.102114","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 10","pages":"102114"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953214","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":"Maintenance therapy in homologous recombination proficiency ovarian cancer: a clinical and economic challenge.","authors":"Larissa Emanuella Costa, Loureno Cezana","doi":"10.1016/j.ijgc.2025.102125","DOIUrl":"10.1016/j.ijgc.2025.102125","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 10","pages":"102125"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145053107","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":"Body composition as a predictive factor for chemotherapy-induced peripheral neuropathy and dose-limiting toxicity in patients with endometrial cancer undergoing carboplatin and paclitaxel.","authors":"Masahiro Aichi, Ayaka Kozuka, Yukio Suzuki, Satoru Shinoda, Toshiyuki Itai, Natsuko Kamiya, Yumi Ishidera, Yuichi Imai, Etsuko Miyagi, Taichi Mizushima","doi":"10.1016/j.ijgc.2025.102108","DOIUrl":"10.1016/j.ijgc.2025.102108","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated whether lean body mass could predict the incidence of dose-limiting toxicity and chemotherapy-induced peripheral neuropathy in patients with endometrial cancer treated with carboplatin-paclitaxel.</p><p><strong>Methods: </strong>This retrospective study included patients with endometrial cancer who underwent carboplatin-paclitaxel after primary surgery. Lean body mass was calculated using an approximation formula based on abdominal computed tomography images. A multivariable analysis was conducted using a logistic regression model to explore the factors associated with the incidence of chemotherapy-induced peripheral neuropathy and dose-limiting toxicity, with age, body mass index, paclitaxel dose per lean body mass, and carboplatin dose per lean body mass as covariates. Subsequently, the cutoff value for the paclitaxel dose per lean body mass was determined based on the first quartile and receiver operating characteristic curve analysis, dividing the participants into high-dose and low-dose groups. Differences in the incidence of chemotherapy-induced peripheral neuropathy and dose-limiting toxicity between the 2 groups were examined.</p><p><strong>Results: </strong>The study included 98 patients, with 35 (35.7%) and 31 (31.6%) experiencing chemotherapy-induced peripheral neuropathy and dose-limiting toxicity, respectively. The multivariable analysis showed that paclitaxel dose per lean body mass was significantly associated with the incidence of chemotherapy-induced peripheral neuropathy (OR 2.58, 95% CI 1.08 to 6.19) but was not significantly associated with the incidence of dose-limiting toxicity. The cutoff value for the paclitaxel dose per lean body mass was determined to be 8.12 mg/kg. The high-dose group showed a significantly higher incidence of chemotherapy-induced peripheral neuropathy (high-dose group, 52.0%; low-dose group 30.1%, p = .049) and a higher incidence of dose-limiting toxicity (high-dose group, 52.0%; low-dose group, 24.7%, p = .011) than the low-dose group.</p><p><strong>Conclusions: </strong>Paclitaxel dose per lean body mass may predict the incidence of chemotherapy-induced peripheral neuropathy in patients with endometrial cancer undergoing carboplatin-paclitaxel and could be suitable for dosage modulation of paclitaxel.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 10","pages":"102108"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953213","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}