International Journal of Gynecological Cancer最新文献

{"title":"Minimally invasive simple hysterectomy in low-risk cervical cancer: a single-arm trial with stopping rules (ENGOT-cx23/MITO/LASH trial).","authors":"Nicolò Bizzarri, Denis Querleu, Pedro T Ramirez, Marie Plante, Diana Giannarelli, Henrik Falconer, Nadeem R Abu-Rustum, David Cibula, Alejandra Martinez, Enora Laas, Christina Fotopoulou, Luis Chiva, Matteo Pavone, Luigi Pedone Anchora, Francesco Fanfani, Anna Fagotti, Giovanni Scambia","doi":"10.1016/j.ijgc.2025.101818","DOIUrl":"10.1016/j.ijgc.2025.101818","url":null,"abstract":"<p><strong>Background: </strong>The oncologic safety of minimally invasive simple hysterectomy in low-risk cervical cancer has not been explored by an adequately powered clinical trial.</p><p><strong>Primary objective: </strong>This study aims to evaluate whether minimally invasive simple hysterectomy affects disease-free survival in low-risk early-stage cervical cancer.</p><p><strong>Study hypothesis: </strong>Minimally invasive simple hysterectomy represents an oncologically safe approach in selected patients with low-risk cervical cancer.</p><p><strong>Trial design: </strong>This is a single-arm trial with stopping rules. All patients must undergo cervical conization. Patients with clear conization margins or absence of residual macroscopic disease at imaging after conization (re-conization is mandatory if these criteria are not met) are submitted to minimally invasive (laparoscopy or robot-assisted laparoscopy) simple hysterectomy with sentinel lymph node biopsy algorithm. Adjuvant therapy is given in case of tumor-involved surgical margins, and/or metastatic lymph nodes, and/or substantial lymphovascular space invasion with depth of stromal infiltration >2/3 (or tumor-free distance ≤3 mm).</p><p><strong>Major inclusion/exclusion criteria: </strong>The major inclusion criteria are: squamous cell carcinoma, human papillomavirus-related adenocarcinoma, adenosquamous carcinoma of the uterine cervix; International Federation of Gynecology and Obstetrics 2018 stage IA2-IB1 (≤2 cm) with depth of infiltration ≤10 mm on conization specimen; International Federation of Gynecology and Obstetrics 2018 stage IA2-IB1 (≤2 cm) with depth of infiltration ≤50% at pre-conization magnetic resonance imaging scan or \"expert\" ultrasound scan. Women are not eligible if they have evidence of metastatic disease, contra-indications to surgery and/or lymph node assessment, or fertility sparing desire.</p><p><strong>Primary endpoint: </strong>The primary end point is 3-year disease-free survival of patients who undergo minimally invasive simple hysterectomy.</p><p><strong>Sample size: </strong>A sample size of 974 patients will give a power of 80% at a significance level of 2.5% (1-sided) to reject the null hypothesis of a 3-year recurrence rate of 2.4%, assuming a 3-year recurrence rate of 1.2%. A maximum of 14 recurrences at 3 years should be observed to reject the null hypothesis. A stopping rule based on the number of recurrences observed at different timepoints will be implemented to avoid a higher recurrence rate with the study procedure. The trial will also be stopped if no recurrences are observed in the first 400 patients followed up for 2 years.</p><p><strong>Estimated dates for completing accrual and presenting results: </strong>The enrolment will last 60 months. After the surgery, the follow-up time will be ≥3 years.</p><p><strong>Trial registration: </strong>The trial is registered at ClinicalTrials.gov (NCT06416748) and as ENGOT/MITO trial (ENGOT-cx23).</p","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 6","pages":"101818"},"PeriodicalIF":4.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021157","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 and stratification of placenta percreta with gynecologic oncologist management.","authors":"Jessian Louis Munoz, Logan Michelle Blankenship, Kayla Evonne Ireland, Patrick Shannon Ramsey, Georgia A McCann","doi":"10.1136/ijgc-2024-005850","DOIUrl":"10.1136/ijgc-2024-005850","url":null,"abstract":"<p><strong>Objective: </strong>Gynecologic oncologist involvement in the surgical team of patients with placenta percreta has shown improved patient outcomes. Yet, stratification of cases is dependent on identification of placenta percreta by ultrasonography which has a poor detection rate. To allow patients to receive optimal team management by pre-operative stratification our objective was to identify the pre-operative characteristics of patients with previously underdiagnosed placenta percreta.</p><p><strong>Methods: </strong>A retrospective single institution case-control study was performed from January 2010 to December 2022 of singleton, non-anomalous pregnancies with suspicion for placenta accreta spectrum (PAS). Ultrasonography was used as the primary method of detection. Final inclusion was dependent on histology confirmation of PAS and degree of invasion. We explored the role of concurrent antenatal magnetic resonance imaging (MRI) on patients with previously unrecognized placenta percreta.</p><p><strong>Results: </strong>During the 13 year study period, 140 cases of histologically confirmed PAS were managed by our team and met inclusion criteria. A total of 72 (51.4%) cases were for placenta percreta and 27 (37.5%) of these were diagnosed pre-operatively while 45 (62.5%) were only diagnosed post-operatively. Comparison between these two groups revealed patient body mass index (BMI) >30 kg/m² was independently associated with unrecognized placenta percreta (p=0.006). No findings by MRI were associated with mischaracterization of placenta percreta. Yet, concurrent MRI assessment of patients with BMI >30 kg/m² (n=18), increased placenta percreta detection by 11 cases (61%).</p><p><strong>Conclusion: </strong>The ability to determine pre-operatively which patients are more likely to have placenta percreta allows for gynecologic oncologists to be involved in the most complex cases in a planned manner. This study shows that women at risk for placenta accreta spectrum, who are obese (BMI >30 kg/m²), may benefit from further assessment with pre-operative MRI to facilitate appropriate staffing and team availability for cases of placenta percreta.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101859"},"PeriodicalIF":4.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346244","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 Laparoscopic bariatric surgery with hysterectomy for endometrial cancer to improve long-term outcomes: A review article by Goddard et al.","authors":"Francesco Mezzapesa, Pierandrea De Iaco, Anna Myriam Perrone","doi":"10.1016/j.ijgc.2025.101763","DOIUrl":"10.1016/j.ijgc.2025.101763","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101763"},"PeriodicalIF":4.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709690","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":"Sentinel lymph node detection in early ovarian cancer: the role of indocyanine green as a single tracer.","authors":"Víctor Lago, Iria Rey, Marta Arnáez, Pablo Padilla-Iserte, Luis Matute, Marta Gurrea, Susana López, Beatriz Montero, Teresa Dawid De Vera, Santiago Domingo","doi":"10.1016/j.ijgc.2025.101826","DOIUrl":"10.1016/j.ijgc.2025.101826","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the usefulness of indocyanine green (ICG) as a single tracer for sentinel lymph node (SLN) biopsy in apparent early-stage ovarian cancer and analyze the role of ultra-staging for metastasis detection.</p><p><strong>Methods: </strong>A retrospective, observational study was performed including patients with confirmed early-stage ovarian cancer. A total of 0.2 to 0.5 mL of ICG (1.25 mg/mL) was injected at the utero-ovarian ligament stump versus the cervix for pelvic SLN detection and at the infundibulopelvic ligament stump for para-aortic SLN detection, followed by systematic surgical staging. SLNs and non-SLNs were processed with a standard protocol, and then ultra-staging analysis was performed for the SLNs. The primary outcomes included detection rate and diagnostic accuracy (sensitivity and negative predictive value) of ICG for SLN's detection in pelvic and para-aortic fields. The secondary outcome was to determine the detection rate of SLN ultra-staging for metastasis detection.</p><p><strong>Results: </strong>A total of 31 patients were included. The intra-operative SLN detection rates were 72% (95% CI 54.4% to 89.6%) for the pelvic field and 87.1% (95% CI 75.3% to 98.9%) for the para-aortic field. However, empty packets reduced the true detection rates to 52% (95% CI 32.4% to 71.6%) and 81% (95% CI 66.7% to 94.6%), respectively. For pelvic SLN, the negative predictive value was 100% (95% CI 82.4% to 100%), whereas the diagnostic accuracy and sensitivity could not be calculated because of the absence of metastasis. For para-aortic SLN, the diagnostic accuracy, sensitivity, and negative predictive value were 96.3% (95% CI 88% to 100%), 50% (95% CI 9.5% to 90.5%), and 96.2% (95% CI 81.1% to 99.3%), respectively. The only patient with a positive SLN (3.3%) was detected by micro-metastasis thanks to ultra-staging analysis (100%).</p><p><strong>Conclusions: </strong>The low volume of ICG (range; 0.2-0.5 mL) as a single tracer for SLN mapping in early-stage ovarian cancer shows a high negative predictive value but limited sensitivity and lead to empty packets detection. Ultra-staging allows low-volume metastasis detection, but its prognostic significance requires further evaluation.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 6","pages":"101826"},"PeriodicalIF":4.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982824","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":"Efficacy of PD-(L)1 inhibition in the treatment of endometrial cancer across molecular classes: a systematic review and meta-analysis.","authors":"Merve Kaya, Matthieu C A Schaddelee, Carien L Creutzberg, Judith R Kroep, Nanda Horeweg","doi":"10.1016/j.ijgc.2025.101759","DOIUrl":"10.1016/j.ijgc.2025.101759","url":null,"abstract":"<p><strong>Objective: </strong>PD-(L)1 inhibitors have shown benefit in mismatch repair-deficient (MMRd) endometrial cancer. However, their efficacy in mismatch repair-proficient endometrial cancer (comprising POLE-mutated (POLEmut), p53-abnormal (p53abn), and no-specific-molecular-profile (NSMP) molecular classes) remains unclear. This systematic review and meta-analysis evaluated the efficacy of PD-(L)1 inhibitors, as monotherapy or combined with chemotherapy, across the 4 molecular classes.</p><p><strong>Methods: </strong>Systematic searches were conducted across Embase, PubMed, Cochrane, and Web of Science, with manual searches of reference lists and conference websites. A total of 7 reports on 5 clinical trials were identified, with 3 included in the meta-analysis. Overall survival and progression-free survival were assessed.</p><p><strong>Results: </strong>In patients with primary advanced or recurrent MMRd endometrial cancer (n=215), adding a PD-(L)1 inhibitor to platinum-based chemotherapy significantly improved overall (HR 0.36, 95% CI 0.21 to 0.62) and progression-free survival (HR 0.35, 95% CI 0.23 to 0.53). In patients with p53abn endometrial cancer, no significant benefits in overall (HR 0.91, 95% CI 0.26 to 3.22; n=135) or progression-free survival (HR 0.84, 95% CI 0.41 to 1.70; n=326) were observed, but both were affected by significant heterogeneity. In patients with NSMP endometrial cancer, a significant benefit was observed for progression-free survival (HR 0.73, 95% CI 0.57 to 0.95; n=373), but no overall survival benefit (HR 0.93, 95% CI 0.63 to 1.39; n=242). Insufficient data were available for patients with POLEmut endometrial cancer (n=12), with no events reported in 2 of 3 clinical trials comprising the majority of patients (n=11).</p><p><strong>Conclusions: </strong>PD-(L)1 inhibition demonstrated significant efficacy in patients with advanced or recurrent MMRd endometrial cancer. In NSMP endometrial cancer, adding a PD-(L)1 inhibitor to platinum-based chemotherapy showed potential benefit, whereas in p53abn endometrial cancer, such benefit was not found. POLEmut endometrial cancer, although rare in recurrent or metastatic settings, was associated with a favorable prognosis, regardless of treatment. These findings underscore the relevance of the molecular classification of endometrial cancer and highlight the importance of prioritizing molecular analyses in clinical trials to guide personalized PD-(L)1 inhibition strategies.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101759"},"PeriodicalIF":4.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810740","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":"Frailty and gynecologic cancer: a cross-sectional analysis of the Canadian Longitudinal Study on Aging.","authors":"Melissa Lavecchia, Maura Marcucci, Parminder Raina, Waldo Jimenez, Julie M V Nguyen","doi":"10.1016/j.ijgc.2025.101642","DOIUrl":"10.1016/j.ijgc.2025.101642","url":null,"abstract":"<p><strong>Objective: </strong>There is significant heterogeneity in the recovery of individuals after gynecological cancer treatment. The Canadian Longitudinal Study on Aging provided a distinct opportunity to evaluate the associations between psychosocial and functional factors and long-term health outcomes. We sought to examine the prevalence of frailty and utilization of social and community support among community-dwelling older adults with a history of gynecologic cancer.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of female participants in the Canadian Longitudinal Study on Aging, a population-based cohort comprising over 50,000 individuals aged 45 to 85 years old. Frailty was operationalized using the deficit accumulation model (frailty defined as Frailty Index >0.21). Associations were evaluated using multivariable regression analyses adjusted for sociodemographic, lifestyle, economic, and social support factors.</p><p><strong>Results: </strong>Data points to measure frailty were available for 15,149 of the 15,320 (98.8%) female participants. The prevalence of frailty was 19.9% in those with a history of gynecologic cancer compared to 9.1% in those without (p < .001; adjusted OR 2.2, 95% CI 1.6 to 2.9). For all female participants, regardless of a history of gynecologic cancer, history of smoking, alcohol use, lower income, lower educational level, never having been married, living alone, and less social support availability were significantly associated with frailty in univariate analysis. Those with a history of gynecologic cancer classified as frail were more likely to require assistance from family members (OR 3.4, 95% CI 2.0 to 5.7) and professional community supports (OR 7.9, 95% CI 4.1 to 15.0) than those who were not frail.</p><p><strong>Conclusions: </strong>In this large national cohort study, a history of gynecological cancer was independently associated with frailty. We identified the factors of social vulnerability that may affect health outcomes. These novel findings can be instrumental in advocating for resource allocation and designing proactive strategies.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101642"},"PeriodicalIF":4.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965558","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 'Primary versus interval cytoreductive surgery in patients with rare epithelial or non-epithelial ovarian cancer' [International Journal of Gynecological Cancer Volume 35 Issue 3 (2025) 101664].","authors":"Diletta Fumagalli, Aarthi Jayraj, Elena Olearo, Ilaria Capasso, Heng-Cheng Hsu, Yossi Tzur, Sabrina Piedimonte, Bella Jugeli, Beatriz Navarro Santana, Luigi Antonio De Vitis, Giuseppe Caruso, Giovanni Aletti, Nicoletta Colombo, Pedro T Ramirez","doi":"10.1016/j.ijgc.2025.101952","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101952","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101952"},"PeriodicalIF":4.1,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199012","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 vulvar cancer: revisiting the margin of error' [International Journal of Gynecological Cancer Volume 35 Issue 3 (2025) 101678].","authors":"Maureen E Byrne, Mario M Leitao, Nadeem R Abu-Rustum","doi":"10.1016/j.ijgc.2025.101955","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101955","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101955"},"PeriodicalIF":4.1,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199011","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":"https://doi.org/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":"2025-05-30","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":"Simple perinephric adipose tissue measurement for prediction of failed sentinel lymph node mapping in endometrial cancer.","authors":"Lina Salman, Paulina Cybulska, Ryley Fowler, Manjula Maganti, Ur Metser, Sarah E Ferguson","doi":"10.1016/j.ijgc.2025.101949","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101949","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to evaluate whether pre-operative average perinephric fat is associated with sentinel lymph node (SLN) mapping, peri-operative complications, and survival in endometrial cancer.</p><p><strong>Methods: </strong>This was a retrospective cohort study of endometrial cancer patients who underwent surgical staging with SLN mapping between 2015 and 2021. Average perinephric fat was measured on axial sections of pre-operative computed tomography scans. Baseline characteristics and average perinephric fat measurements were compared between patients with successful mapping and those with bilateral failed mapping. We also compared peri-operative complications between patients with high and low average perinephric fat.</p><p><strong>Results: </strong>Of the 297 participants included, 274 (92%) had at least unilateral successful SLN mapping, while 23 (8%) had bilateral failed SLN mapping. Median body mass index (34.7 vs 29.8 kg/m², p = .01) and average perinephric fat (1.5 vs 1.0 cm, p = .02) were significantly higher among patients with failed mapping. In univariate logistic regression, body mass index (OR 1.07, 95% CI 1.03 to 1.12, p = .001) and average perinephric fat (OR 1.43, 95% CI 1.13 to 1.80, p = .003) were associated with failed mapping. Using receiver operating characteristic curve analysis, a cut-off of 2.2 cm for average perinephric fat was a significant predictor of failed mapping (OR 7.62, 95% CI 2.85 to 20.3, p < .001). There was no significant difference in intra-operative (4% vs 3%) or post-operative complications (19% vs 14%) between those with average perinephric fat ≥ 2.2 cm and <2.2 cm (p > .05).</p><p><strong>Conclusions: </strong>Increased average perinephric fat is associated with a higher risk of failed SLN mapping in endometrial cancer, without an associated increase in peri-operative complications. Incorporating this simple measurement into clinical practice may add value in identifying and counseling individuals at higher risk for failed mapping.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101949"},"PeriodicalIF":4.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266176","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}