International Journal of Gynecological Cancer最新文献

{"title":"Comprehensive cadaveric dissection of female pelvic neuroanatomy: the autonomic system.","authors":"Stefano Ferla, Diego Raimondo, Agnese Virgilio, Krystel Nyangoh Timoh, Renato Seracchioli, Benoit Rabischong","doi":"10.1016/j.ijgc.2025.101936","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101936","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101936"},"PeriodicalIF":4.1,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247704","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":"Oncological outcomes, surgical margins, and adjuvant treatment delays in vulvar cancer patients with or without reconstruction during primary surgery.","authors":"Milla K Mörsky, Reita H Nyberg, Maarit H Vuento, Synnöve Staff, Ilkka S Kaartinen","doi":"10.1016/j.ijgc.2025.101942","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101942","url":null,"abstract":"<p><strong>Objective: </strong>As vulvar reconstruction has been proposed to improve surgical margins and could affect the timing of adjuvant therapy in patients with vulvar cancer, we aimed to compare oncological outcomes, surgical margins, and adjuvant treatment delays of patients with or without a vulvar reconstruction in their primary vulvar cancer surgery.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center study comprising patients who underwent surgery due to primary vulvar squamous cell carcinoma in Tampere University Hospital, Finland, in 2005-2018. The primary outcome was the number of vulvar recurrences. Secondary outcomes were time to vulvar recurrence, disease-free and overall survival, surgical margins, and adjuvant treatment delays.</p><p><strong>Results: </strong>Overall, 126 patients were included (reconstruction n = 37, direct closure n = 89). Median follow-up time was 46.0 (interquartile range [IQR] 15.5-102.0) vs 55.0 months (IQR 17.0-102.0) in the reconstruction and direct closure groups, respectively. Vulvar recurrences occurred in 18.9% vs 20.2% of patients, respectively (p = 0.87). Time to vulvar recurrence, disease-free survival, or overall survival were comparable between the groups despite an overrepresentation of large [40.0 mm (IQR 25.5-55.0) vs 20.0 mm (IQR 13.0-35.0), p < 0.001], medial (81.1% vs 56.2%, p = .008), multifocal (29.7% vs 7.9%, p = .001), deeply invasive tumors [8.0 mm (IQR; 4.5-14.5) vs 3.5 mm (IQR 2.0-8.0), p < .001] presenting with perineural (32.3% vs 13.6%, p = .035) and lymphovascular space invasion (42.9% vs 15.6%, p = .003) in the reconstruction group. Surgical margins did not differ between the groups despite differences in pathological characteristics. Adjuvant therapy was not delayed in the reconstruction group compared to direct closure group [median delay 59.0 (IQR 52.0-73.8) vs 61.0 days (IQR 50.0-66.0), p = .59], and there was no statistically significant difference in the need for adjuvant therapy.</p><p><strong>Conclusions: </strong>Vulvar reconstruction was associated with non-inferior oncological outcomes compared to the direct closure group, though this conclusion is limited by the retrospective nature of the study. Frequent co-operation between gynecologic oncologists and plastic surgeons is encouraged.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101942"},"PeriodicalIF":4.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234037","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":"Effect of prior adjuvant radiotherapy on immunotherapy outcomes in recurrent endometrial cancer.","authors":"Tao Guo, Yuxi Zhao, Jia Zeng, Enyu Tang, Yuanyuan Zhang, Lingying Wu","doi":"10.1016/j.ijgc.2025.101937","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101937","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the impact of adjuvant external beam radiotherapy (EBRT) following initial surgery on the efficacy of immunotherapy in patients with recurrent endometrial cancer.</p><p><strong>Methods: </strong>This is a single-institution retrospective cohort study. Patients who underwent initial surgery for endometrial cancer and received immunotherapy for recurrence between January 2020 and December 2023 were recruited. Patients who received post-operative EBRT were assigned to the EBRT group. Patients who did not undergo EBRT or who received brachytherapy without EBRT were assigned to the control group. Progression-free survival was used as the end point. Kaplan-Meier curves were used for comparing progression-free survival. The multi-variate analysis was performed using the Cox proportional hazards regression model.</p><p><strong>Results: </strong>A total of 91 patients were included in the analysis; 33 had a history of EBRT, while 58 had not received prior EBRT. In Kaplan-Meier curves, patients who did not receive EBRT showed a numerically lower risk of disease progression (HR 0.47, 95% CI 0.25 to 0.90, p = .010). In multi-variate analysis, EBRT (HR 5.28, 95% CI 1.54 to 22.06) and proficient mismatch repair/micro-satellite instability-low/micro-satellite stable status (HR 3.15, 95% CI 1.19 to 8.90) were risk factors for disease progression during immunotherapy.</p><p><strong>Conclusions: </strong>In patients with recurrent endometrial cancer who received immunotherapy, the therapeutic efficacy may be compromised by prior post-operative adjuvant EBRT.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101937"},"PeriodicalIF":4.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208430","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":"Three-dimensional reconstruction and laparoscopic liver resection for recurrent ovarian cancer: quaternary cytoreductive surgery.","authors":"Riccardo Oliva, Agostino Maria De Rose, Francesco Ardito, Giacomo Guidi, Camilla Certelli, Matteo Bruno, Anna Fagotti, Valerio Gallotta","doi":"10.1016/j.ijgc.2025.101914","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101914","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101914"},"PeriodicalIF":4.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142348","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":"Metastasis without malignancy: a rare case of recurrent benign metastasizing leiomyoma with multi-system involvement.","authors":"Beatriz Navarro Santana, Octavio Arencibia, Miguel Andújar, Jano Rubio, Alicia Martin","doi":"10.1016/j.ijgc.2025.101940","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101940","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101940"},"PeriodicalIF":4.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234035","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 benefit of sentinel lymph node evaluation in pre-operative grade 1 endometrial cancer.","authors":"David Knigin, Patricia Nadeau, Emad Matanes, Shannon Salvador, Walter H Gotlieb, Susie Lau","doi":"10.1016/j.ijgc.2025.101939","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101939","url":null,"abstract":"<p><strong>Objective: </strong>Debate is ongoing whether patients with pre-operative grade 1 endometrial cancer should undergo surgery by gynecologists without lymph node assessment. The objective of this study is to evaluate the value of having the surgery performed by a gynecologic oncologist with sentinel lymph node assessment.</p><p><strong>Methods: </strong>Single-center retrospective cohort study on patients who underwent robotic surgery for endometrial cancer between 2011-2020. All consecutive cases with grade 1 endometrioid cancer on pre-operative biopsy were included. Sentinel lymph nodes assessment was systematically performed. We defined clinical impact as the proportion of cases where pelvic lymph node status knowledge led to a change in adjuvant therapy.</p><p><strong>Results: </strong>The study cohort included 383 patients. The median age and body mass index were 62 (range; 30-92) years and 32.5 (range; 16.9-85.6) kg/m², respectively. The discordance between pre-operative and post-operative histology or grade occurred in 47.8%. The bilateral sentinel lymph nodes detection rate was 76%. The overall median number of sampled lymph nodes was 4 (0-36), and if a sentinel lymph node was identified, it was 2 (1-2). The rate of positive lymph nodes was 6.3%. Routine sentinel lymph nodes assessment led to treatment escalation in 4.2% of patients and external radiation sparing in 8.4% of patients. The overall clinical benefit was estimated at 12.5%.</p><p><strong>Conclusions: </strong>Surgical staging with sentinel lymph nodes for pre-operative grade 1 endometrioid endometrial carcinoma, when done by a gynecologic oncologist, offers substantial clinical benefit by informing adjuvant treatment decisions based on lymph node status, avoiding overtreatment, with its inherent side effects, and undertreatment, which may affect oncological outcomes.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101939"},"PeriodicalIF":4.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225411","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 \"the prognostic value of tertiary lymphoid structures in molecular subgroups of endometrial carcinoma\" by Pradhan et al.","authors":"Gabriel Levin, Basile Tessier-Cloutier, Xing Zeng","doi":"10.1016/j.ijgc.2025.101943","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101943","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101943"},"PeriodicalIF":4.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199010","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":"Repurposing Food and Drug Administration-approved cancer therapies: exploring endocrine and targeted pathways in low-grade serous ovarian cancer treatment.","authors":"Vivek Podder, Rachel N Grisham, Robert L Coleman, Lauren Patterson Cobb, Bradley J Monk, Thomas J Herzog, David M Gershenson, Brian M Slomovitz","doi":"10.1016/j.ijgc.2025.101938","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101938","url":null,"abstract":"<p><p>Low-grade serous ovarian cancer is a rare epithelial ovarian cancer with limited responsiveness to conventional chemotherapy, particularly, in advanced or recurrent settings. Low-grade serous ovarian cancer is characterized by an indolent growth pattern and a high prevalence of mitogen-activated protein kinase pathway alterations (KRAS, BRAF, NRAS) and hormone receptor positivity, highlighting the potential for targeted therapies. MEK inhibitors (eg, trametinib, binimetinib) specifically target the mitogen-activated protein kinase pathway, whereas endocrine therapies and cyclin-dependent kinase 4/6 (CDK4/6) inhibitors exploit hormone-driven pathways. This review explores the repurposing of the therapeutic potential of both MEK inhibitors and breast cancer therapies, as endorsed by the National Comprehensive Cancer Network, to improve outcomes in low-grade serous ovarian cancer. This review synthesizes evidence supporting the repurposing of MEK inhibitors and breast cancer therapies (endocrine therapies, CDK4/6 inhibitors, and mammalian target of rapamycin inhibitors) as treatment approaches for low-grade serous ovarian cancer. Trametinib significantly improved progression-free survival in the GOG 281 trial, establishing MEK inhibition as a key therapeutic option. In addition, molecular similarities in estrogen receptor/progesterone receptor, phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin, and CDK4/6 pathways between low-grade serous ovarian cancer and breast cancer provide a strong rationale for therapeutic crossover. Endocrine therapies demonstrated efficacy in low-grade serous ovarian cancer, particularly when combined with targeted agents to address resistance mechanisms. CDK4/6 inhibitors showed promise by blocking cell cycle progression and enhancing the response to endocrine therapies. In addition, mammalian target of rapamycin inhibitors have yielded clinical benefits in selected patients, emphasizing the importance of biomarker-driven treatment. Repurposing MEK inhibitors and endocrine-based approaches is shaping the treatment landscape for low-grade serous ovarian cancer, particularly in recurrent or advanced cases with limited treatment options. However, the variability in pathway alterations necessitates precise molecular profiling and optimized combination strategies. Future studies leveraging patient-derived models and advanced profiling techniques are critical for refining these approaches. These efforts may help expand National Comprehensive Cancer Network-endorsed options, and provide new hope for patients with hormone-sensitive low-grade serous ovarian cancer.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101938"},"PeriodicalIF":4.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247709","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":"Unnecessary exclusions: eligibility criteria in gynecologic oncology interventional clinical trials impairs access.","authors":"Sharonne Holtzman, Riva Letchinger, Lily McCarthy, Isabel S Chess, Daniel Liu, Sunidhi Singh, Dmitry Zamarin, Konstatin Zakashansky, Stephanie V Blank","doi":"10.1016/j.ijgc.2025.101927","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101927","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the eligibility requirements in gynecologic oncology clinical trials that may impair patient access to clinical trials.</p><p><strong>Methods: </strong>Using clinicaltrials.gov, gynecologic oncology interventional studies conducted between September 1, 1997 and September 1, 2023 were surveyed. Studies were included if they were interventional and conducted in the United States, with available protocols. Differences in means were estimated, and hypothesis testing was conducted under the general framework for bimodal logistic regression or paired t tests where appropriate.</p><p><strong>Results: </strong>Of the 606 included interventional clinical trials, 256 (42.2%) were for uterine cancer, 99 (16.3%) for ovarian, fallopian tube or peritoneal cancer, 55 (9.1%) for cervical cancer, and 197 (32.5%) involved multiple gynecologic oncology cancers. Of all eligible clinical trials, 351 (57.9%) had an exclusion criterion based on renal function, 206 (34.0%) had a diagnosis of human immunodeficiency virus, 194 (32.0%) had a mental health or psychiatric condition, and 170 (28.1%) had an exclusion criterion based on investigator discretion. Renal exclusion was more likely in clinical trials for uterine cancer (p = .04). Exclusion based on investigator decision was more likely in uterine cancer (p = .001) and ovarian cancer trials (p = .007) than in cervical cancer trials.</p><p><strong>Conclusions: </strong>The most frequent exclusion criteria in gynecologic oncology clinical trials were based on renal function, followed by diagnosis of human immunodeficiency virus status and diagnosis of psychological/mental illness. Our study emphasizes the importance of understanding eligibility requirements of clinical trials to increase access to clinical trials for all patients.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101927"},"PeriodicalIF":4.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208432","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":"Long-term impact of surgical route and tumor size on risk of recurrence among early-stage cervical cancer patients in a managed care population.","authors":"Rosa A Guerra, Lue-Yen Tucker, Ramey Littell, Allison H Kay","doi":"10.1016/j.ijgc.2025.101928","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101928","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare survival outcomes between minimally invasive surgery (MIS) and open surgery for early-stage cervical cancer in a managed care community patient population.</p><p><strong>Methods: </strong>This retrospective study included adult patients who underwent a hysterectomy or trachelectomy for a pre-operative clinical-pathologic diagnosis of stage IA1 to IIA1 cervical cancer as defined by the International Federation of Gynecology and Obstetrics 2018 cervical cancer staging. Patients were diagnosed with cervical cancer between January 2005 and December 2018 at a Kaiser Permanente Northern California hospital. We compared outcomes between patients with stage IA2 to IIA1 cervical cancer who underwent a radical MIS and those who underwent open surgery. We separately analyzed patients with stage IA1 disease.</p><p><strong>Results: </strong>A total of 227 patients (55%) with stage IA2 to IIA1 disease underwent MIS and were compared with 187 patients (45%) in the open cohort. In most cases, MIS involved robotic-assisted surgery (77%). The median length of follow-up was 82.6 months (interquartile range; 53.8-106.4) for MIS and 156.6 months (interquartile range; 139.1-168.7) for the open group. There were 27 recurrences in the MIS group (12%) and 8 recurrences in the open group (4%) (p < .01). The 10-year recurrence-free survival was significantly lower in the MIS group (87%, 95% CI 81.0% to 90.7%) than in the open group (97%, 95% CI 92.4% to 98.4%, p < .01). Among patients with tumor size <2 cm, the 10-year recurrence-free survival was significantly lower with MIS (89%, 95% CI 82.7% to 93.5%) than with open surgery (98%, 95% CI 92.3% to 99.5%, p < .01). The 10-year disease-specific survival was also inferior for MIS (96%, 95% CI 92.0% to 98.2%) than for open surgery (100%, 95% CI 100% to 100%, p < .01). None of the 133 patients with stage IA1 disease experienced a cancer recurrence, regardless of surgical approach. Prior cone biopsy was associated with a lower risk of recurrence (adjusted HR 0.48, 95% CI 0.22 to 1.03).</p><p><strong>Conclusions: </strong>Patients with stage IA2 to IIA1 cervical cancer, including those with tumors <2 cm, had inferior survival outcomes following MIS compared with open surgery. Patients with stage IA1 cervical cancer have a very low risk of recurrence regardless of surgical approach.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101928"},"PeriodicalIF":4.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274810","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}