International Journal of Gynecological Cancer最新文献

{"title":"Exploratory evaluation of the somatic and immunologic landscape of primary and metastatic cervical cancer to better inform future clinical trial development.","authors":"Victoria Cerda, Bobbie J Rimel, Jacob Mercer, Michael A Thompson, Denise Shieh, Emma L Barber, Summer Dewdney, Ritu Salani, Ana I Tergas, Katherine Tucker, Mitchell Kamrava","doi":"10.1016/j.ijgc.2025.102677","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102677","url":null,"abstract":"<p><strong>Objective: </strong>To explore the somatic and immunologic landscape of cervical primary versus metastatic tumors for differential sensitivity of metastatic cervical sites and potential therapeutic implications.</p><p><strong>Methods: </strong>Patients with sequenced squamous cell cervical cancer were selected from the Tempus Database (2016-2023). The cohort included 136 unmatched samples (73 primary, 63 metastatic sites). Pathogenic somatic mutations and gene expression patterns of immune cells were evaluated for relative intratumor abundance. Immune cell percentages, tumor mutational burden, and tumor neoantigen burden (tumor mutational burden) were compared across tumor sites. χ²/Fisher exact tests or Kruskal-Wallis tests were used to assess statistical significance.</p><p><strong>Results: </strong>The median cohort age was 52 years (interquartile range; 42-60). High tumor mutational burden (≥ 10 mut/Mb) was seen in 9.6% (9% primary, 0% lung, 17% liver, 17% lymph node, p = .7) of patients. High microsatellite instability (MSI) was noted in 1.5% (p = .7) of patients. PD-L1 status was positive in 78% (76% primary, 88% lung, 71% liver, and 80% lymph node, p = .8) of patients. Median tumor neoantigen burden was 1.71 (interquartile range; 0.98-3.20). Liver lesions had the lowest percentage of B cells (p = .001) and a higher percentage of macrophages (p = .053) compared with other sites. There was a trend toward lower percentages of CD4 cells (p = .053) and natural killer cells (p = .090) in lymph nodes compared with other sites. PIK3CA was the most common pathogenic somatic alteration but not statistically different across sites (q = 0.9).</p><p><strong>Conclusions: </strong>Molecular and immune profiling of primary and metastatic lesions indicated that liver lesions had a less immunogenic microenvironment. Further interrogation of the molecular landscape across paired samples is needed to better inform the development and use of novel therapies.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 12","pages":"102677"},"PeriodicalIF":4.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370300","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":"Prediction models for gynecological cancers: an assessment from a statistical perspective.","authors":"Run Huang, Yue Lu, Shuai Yin, Zhe Yang, Jiaqi Xu, Haotian Yang, Xinyi Liu, Hairong Xiang, Zaixiang Tang, Jingfang Liu","doi":"10.1016/j.ijgc.2025.102685","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102685","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the methodological quality and statistical rigor of recent prediction model studies (2020-2025) for ovarian, cervical, and endometrial cancers.</p><p><strong>Methods: </strong>We performed a systematic assessment of PubMed literature (January 2020-April 2025), including studies developing, validating, or updating diagnostic/prognostic models for these cancers. Methodological quality and risk of bias were assessed using the Prediction Model Risk Of Bias Assessment Tool across 4 domains (participant selection, predictors, outcome, and analysis). Sub-group analyses compared studies by publication period and Journal Citation Report quartile.</p><p><strong>Results: </strong>Among 192 included studies, Prediction Model Risk Of Bias Assessment Tool assessment revealed a high overall risk of bias in 96.9% (n = 189). Key issues included a high risk of bias in the analysis domain (89.1%, n = 171) and participant selection (85.9%, n = 165), primarily due to flawed methods and use of unsuitable cohorts (eg, public databases). External validation was critically lacking (62.5% performed none, only 6.8% performed ≥3), and statistician involvement was minimal (2.6%). While baseline reporting improved significantly from 2020-2022 (39.6%) to 2023-2025 (59.7%, p = .02), deficiencies in sample size, outcome definition, analytical methods, and validation practices showed no significant improvement.</p><p><strong>Conclusions: </strong>Current gynecological cancer prediction models exhibit widespread methodological shortcomings and a high risk of bias, severely limiting clinical utility. Urgent adherence to Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis standards, prioritized multi-center external validation, integration of statisticians, and reduced reliance on single public data sets are essential for developing reliable and applicable models.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102685"},"PeriodicalIF":4.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329047","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":"Cytoreductive surgery for recurrent platinum-sensitive low-grade ovarian carcinoma: a retrospective single institution experience.","authors":"Maximilian Pruss, Mareike Bommert, Sarah Ehmann, Filiz Temizel-Kanbur, Julia Welz, Sabrina Kaiser, Timo Westermann, Edin Karabeg, Kristina Zdanyte, Aleksandra Strojna, Alexander Traut, Florian Heitz, Philipp Harter, Malak Moubarak","doi":"10.1016/j.ijgc.2025.102672","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102672","url":null,"abstract":"<p><strong>Objective: </strong>Cytoreductive surgery with complete gross resection improves survival in selected patients with recurrent platinum-sensitive epithelial ovarian cancer. Limited data are available on sub-groups with rare histological sub-types undergoing cytoreductive surgery for recurrent disease. We analyzed the outcomes of patients with low-grade histologies undergoing surgery for recurrent disease.</p><p><strong>Methods: </strong>We performed a retrospective exploratory database analysis of patients undergoing cytoreductive surgery for recurrent platinum-sensitive low-grade epithelial ovarian cancer at a tertiary cancer center in Germany between 1999 and 2024.</p><p><strong>Results: </strong>In total, 74 patients were included. The majority had low-grade serous histology (53 of 74 [72%]). Median progression-free survival to first recurrence was 34.1 months. The most common surgical procedures were peritonectomy (72%), lymphadenectomy (34%), and large-bowel resection (30%). The stoma rate was 11%. Complete gross resection was achieved in 51 of 74 patients (69%), and 7 patients (9.5%) had residual disease of 1 to 10 mm. The rate of severe complications (Clavien-Dindo grade ≥3) was 12%. In total, 84% of patients received chemotherapy and 11% received endocrine therapy after surgery. Median progression-free survival and overall survival after cytoreductive surgery for recurrence were 26.5 months and 93 months, respectively. On multi-variate analysis, complete gross resection versus residual disease > 10 mm (p = .002) was the only significant factor for overall survival.</p><p><strong>Conclusions: </strong>Cytoreductive surgery for patients with recurrent platinum-sensitive low-grade ovarian cancer appears feasible and may be associated with clinical benefit. Given the surgical risks and an 11% stoma rate, careful patient selection is essential. Complete gross resection was associated with improved progression-free and overall survival. Additional research is needed to clarify whether a survival benefit exists in cases with residual disease of 1 to 10 mm.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 12","pages":"102672"},"PeriodicalIF":4.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318284","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":"The utility of the novel biomarker HE4 for monitoring epithelial ovarian cancer during PARP inhibitor treatment.","authors":"Alexandra Morell, Anne Stoklosa, Alexandra Blackman, Youngeun Armbuster, Rachael Rowswell-Turner, M Craig Miller, Richard G Moore","doi":"10.1016/j.ijgc.2025.102682","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102682","url":null,"abstract":"<p><strong>Objective: </strong>Poly(ADP-ribose) polymerase (PARP) inhibitor maintenance therapy is commonly used in patients with ovarian cancer. Prior studies have reported that serum cancer antigen 125 (CA125) poorly predicts disease progression for patients on PARP inhibitors. Human epididymal protein 4 (HE4) is a serum biomarker cleared by the United States (US) Food and Drug Administration (FDA) for monitoring disease in patients with ovarian cancer. The objective of this study was to assess the utility of serum HE4 levels as a biomarker for monitoring patients on PARP inhibitors and to compare HE4 performance parameters to those of serum CA125 levels.</p><p><strong>Methods: </strong>A retrospective chart review was performed evaluating patients on PARP inhibitors for ovarian cancer. Patients were included if they received a PARP inhibitor for at least 2 months and had at least 3 serial serum HE4 measurements during treatment. Changes in the serum CA125 and HE4 levels between measurements and over time were calculated and correlated with disease status. The null hypothesis was that HE4 was inferior to CA125.</p><p><strong>Results: </strong>A total of 102 patients with 103 treatment periods and 1554 evaluable serum samples were evaluated. Of these patients, 55 (53.9%) experienced a change in disease status while receiving PARP inhibitor treatment. An analysis using increases from serum baselines of ≥25.0% for HE4 and ≥15.0% for CA125 to indicate a change in disease status showed the accuracy of HE4 was 89.4% compared to 79.1% for CA125 (p < .001), indicating HE4 is not inferior to CA125 for monitoring disease status. Concordance comparison of HE4 accuracy over CA125 was 1.130 (McNemar's test p < .001), again indicating HE4 was not inferior to CA125. HE4 was shown not to be inferior to CA125 for monitoring patients with ovarian cancer on PARP inhibitors. An analysis using an increase from baseline of ≥25% for HE4 provided the highest accuracy for monitoring patients on PARP inhibitors.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102682"},"PeriodicalIF":4.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354726","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":"Survival in human papillomavirus and non-human papillomavirus-associated invasive endocervical adenocarcinoma: outcomes in a large, integrated healthcare system.","authors":"Grace Williams, Ameek Bindra, Deanna Fink, Miranda Ritterman Weintraub, Christine Garcia","doi":"10.1016/j.ijgc.2025.102683","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102683","url":null,"abstract":"<p><strong>Objectives: </strong>To ascertain outcome differences between human papillomavirus (HPV)-associated and non-HPV-associated endocervical adenocarcinoma within an integrated healthcare system.</p><p><strong>Methods: </strong>This retrospective cohort study examined patients aged 18 to 90 years diagnosed with invasive endocervical adenocarcinoma from 2011 to 2017 using our institution's cancer registry. Demographic and clinical variables were abstracted from records. Five-year overall survival and progression-free survival were assessed for HPV-associated and non-HPV-associated cancer types. Chi-square and Fisher exact tests compared categorical, while Wilcoxon rank-sum tests analyzed continuous variables. Kaplan-Meier curves compared 5-year survival between groups.</p><p><strong>Results: </strong>Among 144 patients, 34 (24%) had non-HPV-associated and 110 (76%) had HPV-associated cancers. Patients with non-HPV-associated endocervical adenocarcinoma had worse 5-year progression-free survival (72% vs 88%, p = .03) and overall survival (75% vs 92%, p < .01). Non-HPV-associated endocervical adenocarcinoma was more likely to be diagnosed at older ages (median 54 years vs 42 years, p < .01). A high percentage of early-stage diagnoses were observed (74% of non-HPV-associated endocervical adenocarcinoma and 86% of HPV-associated endocervical adenocarcinoma were diagnosed at stage I).</p><p><strong>Conclusions: </strong>While 5-year survival was worse in non-HPV-associated endocervical adenocarcinoma, differences were less pronounced than previously reported, potentially due to the high percentage of early-stage diagnoses, suggesting that stage remains the most important prognostic factor.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102683"},"PeriodicalIF":4.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318231","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":"Overcoming surgical gaps in gynecologic oncology in a low-resource setting: experience from the SheFights Cancer Foundation Camp in Kenya.","authors":"Anisa Mburu, Beverly Mitei, Busra Ahmed, Linda Nasengo, Amina Hassan","doi":"10.1016/j.ijgc.2025.102684","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102684","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 12","pages":"102684"},"PeriodicalIF":4.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312860","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":"Primary lymphoma of the uterine cervix.","authors":"Shi Hui Lee, Bryan Jun Yong Song, Li Yan Khor, Ravichandran Nadarajah","doi":"10.1016/j.ijgc.2025.102687","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102687","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 12","pages":"102687"},"PeriodicalIF":4.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312894","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 node-positive POLE-mutated endometrial cancer.","authors":"Giorgio Bogani, Francesco Raspagliesi, Valentina Chiappa, Tina Pasciuto, Emanuele Perrone, Francesco Fanfani","doi":"10.1016/j.ijgc.2025.102680","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102680","url":null,"abstract":"<p><p>The molecular classification of endometrial cancer has revolutionized risk stratification, with POLE-mutated tumors recognized for their excellent prognosis. However, the optimal management of patients with nodal involvement remains unclear. This multi-center retrospective study evaluates the outcomes of patients with stage IIIC endometrial cancer with positive sentinel lymph nodes harboring POLE mutations. Of 164 POLE-mutated cases undergoing sentinel node mapping, 11 (6.7%) had nodal metastases (classified as isolated tumor cells [n = 6; 54.5%], micro-metastases [n = 3; 27.3%], or macro-metastases [n = 2; 18.2%]). All patients except 1 received adjuvant therapy, tailored according to molecular and pathologic risk factors. After a median follow-up of 7.6 months, no recurrences were observed. These findings suggest excellent short-term outcomes, even in node-positive POLE-mutated endometrial cancer. Nevertheless, the study does not support omitting adjuvant therapy in this setting. Larger studies and long-term data, such as those expected from the ongoing Refining Adjuvant treatment IN endometrial cancer Based On molecular features (RAINBO)/ Blue trial are needed to guide safe de-escalation strategies.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 12","pages":"102680"},"PeriodicalIF":4.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312802","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":"Evaluating the risk of diaphragmatic hernia following left diaphragm resections during cytoreductive surgery for ovarian cancer: a Memorial Sloan Kettering Cancer Center Team Ovary study.","authors":"Ryan M Kahn, Sarah Anderson, Effi Yeoshoua, Christina Harlev, Sarah Ehmann, Qin Zhou, Alexia Iasonos, Nadeem R Abu-Rustum, Ahmed Al-Niaimi, Vance Broach, Ginger J Gardner, Kara C Long, Yukio Sonoda, Oliver Zivanovic, Dennis S Chi","doi":"10.1016/j.ijgc.2025.102673","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102673","url":null,"abstract":"<p><strong>Objective: </strong>To determine the incidence rate and risk factors associated with the development of diaphragm hernias following left diaphragm procedures at the time of ovarian cancer cytoreduction.</p><p><strong>Methods: </strong>We retrospectively reviewed data from patients diagnosed with epithelial ovarian, fallopian tube, or primary peritoneal carcinoma who underwent any timeframe of cytoreductive surgery (primary, interval, secondary, tertiary) at our institution from December 2010 to September 2024. Patients were included if they underwent left diaphragm peritonectomy or resection as part of their cytoreductive surgery. The diagnosis of left diaphragm hernia was made by computed tomography of the chest either as an incidental finding during follow-up surveillance or during work-up for symptomatology. We utilized statistical analysis with descriptive proportions with interquartile ranges.</p><p><strong>Results: </strong>A total of 267 patients with ovarian cancer underwent a left diaphragm peritonectomy or resection as part of their cytoreductive surgery at our institution and were included in the study. The overall median age was 62 years (interquartile range; 52-70) and body mass index 24.9 kg/m² (interquartile range; 22.1-28.5). Overall, 2.2% (6/267) of patients developed a left diaphragmatic hernia, with 33% (2/6) following a primary cytoreduction and 67% (4/6) following an interval cytoreduction; in addition, 83% (5/6) had a splenectomy at the time of cytoreduction. The median time from date of surgery to time of diagnosis was 12.3 months (range; 4.8-24.8). On univariate analysis, the OR of developing a left diaphragm hernia after undergoing splenectomy was 3.2 (p = .24).</p><p><strong>Conclusions: </strong>Diaphragmatic hernias occurred most often following the setting of concurrent splenectomy; however, splenectomy was not a statistically significant risk factor. These findings provide meaningful insight into the frequency and clinical context in which this complication may arise, addressing a critical knowledge gap in the surgical management of patients with ovarian cancer who require upper abdominal and thoracic procedures.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 12","pages":"102673"},"PeriodicalIF":4.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145300077","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":"Identifying the possible candidate population for adjuvant radiotherapy de-escalation for intermediate-risk cervical cancer.","authors":"Koji Matsuo, Shinya Matsuzaki, Yoshikazu Nagase, Sawa Keymeulen, Mihiri S Karunaratne, Alice J Lee, Matthew W Lee, Angelina E Lim, Hiroyuki Kanao, Muneaki Shimada, Munetaka Takekuma, Lynda D Roman","doi":"10.1016/j.ijgc.2025.102674","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102674","url":null,"abstract":"<p><strong>Objective: </strong>To explore whether there is a possible candidate population for treatment de-escalation with active surveillance without adjuvant radiotherapy for patients with stage IB cervical cancer meeting the intermediate-risk criteria.</p><p><strong>Methods: </strong>This retrospective cohort study queried the Commission-on-Cancer's National Cancer Database in the United States. The study population included 1133 patients with node-negative, parametria-free, surgical margin-uninvolved, stage IB intermediate-risk cervical cancer (tumor size 2-4 cm with lymphovascular space invasion, or tumor size of >4 cm regardless of lymphovascular space invasion) who had primary radical hysterectomy and lymph node evaluation from 2010 to 2022. Exposure was adjuvant radiotherapy status: external beam radiotherapy with or without chemotherapy (n = 642) or active surveillance without radiotherapy (n = 491). The main outcome measure was overall survival, assessed in a propensity score inverse probability of treatment weighting cohort.</p><p><strong>Results: </strong>At the whole-cohort level, hazard ratio (HR) for all-cause mortality comparing adjuvant radiotherapy de-escalation to adjuvant radiotherapy was 1.31 (95% confidence interval [CI] 0.92 to 1.86, p = .13). When stratified by histology type, adjuvant radiotherapy de-escalation was associated with increased all-cause mortality risk in squamous cell carcinoma (HR 1.55, 95% CI 1.02 to 2.34, p = .038) but not in adenocarcinoma or adenosquamous carcinoma (HR, 0.90; 95% CI 0.46 to 1.75, p = .75). When stratified by tumor differentiation, adjuvant radiotherapy de-escalation was associated with increased all-cause mortality risk in poorly-differentiated tumors (HR, 2.11; 95% CI 1.29 to 3.42, p =.003) but not in well- to moderately-differentiated tumors (HR, 0.83; 95% CI 0.50 to 1.37, p = .47).</p><p><strong>Conclusion: </strong>The results of this cohort study in the United States suggest that overall survival benefits of adjuvant radiotherapy for study-defined intermediate-risk stage IB cervical cancer may vary based on histology type and tumor differentiation. Specifically, patients with squamous cell carcinoma or poorly-differentiated tumors benefited from receiving adjuvant radiotherapy, while those with adenocarcinoma/adenosquamous carcinoma or well- to moderately-differentiated tumors did not. Whether there may be candidates for treatment de-escalation in intermediate-risk cervical cancer warrants further investigation with a prospective design.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 11","pages":"102674"},"PeriodicalIF":4.7,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274401","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}