{"title":"A hidden passenger: teratoma concealed by polycystic kidneys.","authors":"Katherine Martinez Carmona, Pedro T Ramirez","doi":"10.1016/j.ijgc.2025.102678","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102678","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 12","pages":"102678"},"PeriodicalIF":4.7,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329127","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}
Katherine Yoh, Ling Chen, Xiao Xu, Jennifer S Ferris, Shayan Dioun, Alexandre Buckley de Meritens, Caryn M St Clair, Tarah Pua, Thomas Randall, June Y Hou, Dawn L Hershman, Jason D Wright
{"title":"Use and outcomes of hormonal therapy for advanced-stage, low-grade serous ovarian cancer.","authors":"Katherine Yoh, Ling Chen, Xiao Xu, Jennifer S Ferris, Shayan Dioun, Alexandre Buckley de Meritens, Caryn M St Clair, Tarah Pua, Thomas Randall, June Y Hou, Dawn L Hershman, Jason D Wright","doi":"10.1016/j.ijgc.2025.102676","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102676","url":null,"abstract":"<p><strong>Objective: </strong>To examine trends in the use of hormonal therapy for advanced-stage, low-grade serous ovarian carcinoma and to compare survival outcomes of patients who received traditional chemotherapy, hormonal therapy alone, or the combination of both.</p><p><strong>Methods: </strong>Women with stage II to IV low-grade serous ovarian cancer diagnosed between 2011 and 2020 were identified from the National Cancer Data Base. Patients undergoing primary surgery followed by adjuvant chemotherapy, hormonal therapy, or both were included. A multinomial logistic regression model was used to examine factors associated with treatment. Propensity score-weighted Cox proportional hazards models (via inverse probability of treatment weighting) were applied to compare overall survival across the treatment groups.</p><p><strong>Results: </strong>Among 1532 women, 68.0% received chemotherapy alone, 12.3% received hormonal therapy alone, and 19.8% received combination therapy. Use of hormonal monotherapy increased from 0.8% in 2011 to 27.4% in 2020, and use of combination therapy increased from 0.8% to 32.6% (p < .001 for both). Hormonal therapy alone was more common in older patients (>70 years) (p = .001) and those with Medicare insurance (p < .001), while combination therapy was more common in women with stage III to IV disease (p = .001). After applying propensity score weighing, 5-year survival was 76.6% (95% CI 73.2% to 79.7%) for chemotherapy alone, 85.5% (95% CI 66.1% to 94.3%) for hormonal therapy alone, and 75.8% (95% CI 59.7% to 86.2%) for combination therapy. Compared to chemotherapy alone, the HR for all-cause mortality was 0.74 (95% CI 0.46 to 1.19) for hormonal therapy alone and 0.88 (95% CI 0.63 to 1.24) for combination therapy.</p><p><strong>Conclusions: </strong>In advanced-stage low-grade serous ovarian cancer, the use of hormonal therapy increased substantially over time. Comparable survival outcomes across modalities suggest hormonal therapy may be a viable treatment option, particularly for patients who will not tolerate the side effects of cytotoxic chemotherapy.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 12","pages":"102676"},"PeriodicalIF":4.7,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292074","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 the comment by Signorelli et al. on the article \"Correspondence on laparoscopic tumor load as an independent prognostic marker in advanced ovarian cancer: a 3-year cohort study by Marco D'Indinosante et al\".","authors":"Marco D'Indinosante, Denis Querleu, Anna Fagotti","doi":"10.1016/j.ijgc.2025.102670","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102670","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102670"},"PeriodicalIF":4.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250976","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}
Ryan M Kahn, Kimberly Murphy, Kaothar Oladoja, Effi Yeoshoua, Lindsey Finch, Christina Harlev, Olga T Filippova, Alli M Straubhar, Renee A Cowan, Alexia Iasonos, Qin Zhou, Yulia Lakhman, Debra M Sarasohn, Nadeem R Abu-Rustum, Vance Broach, Ahmed Al-Niaimi, Ginger J Gardner, Yukio Sonoda, Oliver Zivanovic, Kara C Long, Dennis S Chi
{"title":"A prospective comparison of resectability scores to enhance preoperative decision-making in the primary management of advanced ovarian cancer: a Memorial Sloan Kettering Cancer Center Team Ovary study.","authors":"Ryan M Kahn, Kimberly Murphy, Kaothar Oladoja, Effi Yeoshoua, Lindsey Finch, Christina Harlev, Olga T Filippova, Alli M Straubhar, Renee A Cowan, Alexia Iasonos, Qin Zhou, Yulia Lakhman, Debra M Sarasohn, Nadeem R Abu-Rustum, Vance Broach, Ahmed Al-Niaimi, Ginger J Gardner, Yukio Sonoda, Oliver Zivanovic, Kara C Long, Dennis S Chi","doi":"10.1016/j.ijgc.2025.102662","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102662","url":null,"abstract":"<p><strong>Objective: </strong>To compare cytoreductive outcomes of 2 published algorithms used to triage patients with ovarian cancer to primary debulking surgery versus diagnostic laparoscopy or neoadjuvant chemotherapy.</p><p><strong>Methods: </strong>This prospective comparative study was conducted from August 1, 2021, to January 31, 2025. All patients with suspected advanced ovarian cancer who were eligible for primary debulking surgery on initial evaluation were identified. Imaging was reviewed utilizing a standardized radiology synoptic report. Data from the synoptic report were combined with clinical factors to determine a Resectability Score using 1 of 2 algorithms, Resectability Score 1.0 (RS1.0) and Resectability Score 2.0 (RS2.0). The algorithms include different clinical and radiologic variables; both generate low- and high-risk scores, with high-risk scores indicating a greater likelihood of suboptimal primary debulking surgery. In high-risk cases, laparoscopic evaluation of resectability was recommended, but management was based on surgeon's discretion.</p><p><strong>Results: </strong>Of 237 patients identified, 200 had primary debulking surgery with final pathology confirming epithelial ovarian carcinoma. Of 144 patients (72%) who underwent laparotomy and primary debulking surgery, 110 (76%) were triaged directly to surgery and 34 (24%) first underwent diagnostic laparoscopy; 120 (83%) had complete gross resection, 135 (94%) had residual disease ≤1 cm, and 9 (6%) had residual disease >1 cm. Of 56 patients (28%) who underwent neoadjuvant chemotherapy, 43 (77%) first underwent diagnostic laparoscopy, and 13 (23%) were triaged directly to chemotherapy. Among all patients, 44 (22%) had high-risk scores using RS1.0 and 54 (27%) using RS2.0. RS2.0 more frequently predicted the ability to and inability to achieve complete gross resection (p > .05). RS2.0 more accurately identified high-risk disease warranting neoadjuvant chemotherapy (p = .035). Most surgeons (73%) preferred RS2.0, citing ease of use and faster calculation time.</p><p><strong>Conclusions: </strong>RS2.0 demonstrated favorable predictive accuracy for complete gross resection and was preferred among surgeons. The favorable complete gross resection rate (83%) highlights the value of individualized preoperative triage for primary debulking surgery versus neoadjuvant chemotherapy.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 12","pages":"102662"},"PeriodicalIF":4.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250922","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}
Allan Huang, Nawar A Latif, Stefan Gysler, Emily M Ko, Robert L Giuntoli, Sarah H Kim, Dimitrios Nasioudis
{"title":"Outcomes of the sentinel lymph node mapping algorithm for patients with locally advanced endometrial carcinoma.","authors":"Allan Huang, Nawar A Latif, Stefan Gysler, Emily M Ko, Robert L Giuntoli, Sarah H Kim, Dimitrios Nasioudis","doi":"10.1016/j.ijgc.2025.102651","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102651","url":null,"abstract":"<p><strong>Objective: </strong>Investigate the utilization and oncologic outcomes of the sentinel lymph node algorithm for patients with locally advanced endometrial cancer (involvement of the cervix, vagina, ovary, or parametria) (International Federation of Gynecology and Obstetrics stage II-IIIB).</p><p><strong>Methods: </strong>Patients diagnosed between 2012 and 2015 with endometrial carcinoma who underwent minimally invasive hysterectomy and had endocervical (T2), serosal/adnexal (T3A), or vaginal/parametrial involvement (T3B) and no distant metastases (M0) were identified in the National Cancer Database. Those who underwent sentinel lymph node biopsy (with or without lymphadenectomy) or systematic lymphadenectomy alone (defined as at least 20 lymph nodes removed) were included. Based on pathology reports, the incidence of lymph node metastases was compared with the χ<sup>2</sup> test. Overall survival was evaluated using Kaplan-Meier curves and compared with the log-rank test. A Cox model was constructed to evaluate survival after controlling for confounders.</p><p><strong>Results: </strong>A total of 2108 patients were identified; 1786 (84.7%) had systematic lymphadenectomy (of whom 78.1% had para-aortic lymphadenectomy) with a median of 26 lymph nodes removed, while 322 (15.3%) patients underwent sentinel lymph node biopsy. The rate of lymph node metastases was 35.8% in the systematic lymphadenectomy group and 32.6% in the sentinel lymph node biopsy group, P = .27. Rates of adjuvant chemotherapy (59.7% vs 62.4%, p = .36) and radiation therapy (61.5% vs 58.7%, p = .34) were comparable. Patients who had systematic lymphadenectomy were less likely to be discharged within 1 day of surgery (66.4% vs 78.6%, p < .001). There was no overall survival difference between patients who had sentinel lymph node biopsy and those who had systematic lymphadenectomy (p = .60; 4-year overall survival rates were 71.5% and 73.9%, respectively), even after controlling for confounders (HR 1.08, 95% CI 0.82 to 1.41).</p><p><strong>Conclusions: </strong>Patients with locally advanced endometrial cancer have a high incidence of lymph node metastases. For these patients, sentinel lymph node biopsy is associated with overall survival similar to that of systematic lymphadenectomy.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 12","pages":"102651"},"PeriodicalIF":4.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292094","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":"Authors' response to: \"Methodological concerns regarding AGO score validation in low-grade ovarian cancers\".","authors":"Emel Canaz, Eser S Ozyurek, Jalid Sehouli","doi":"10.1016/j.ijgc.2025.102658","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102658","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102658"},"PeriodicalIF":4.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199165","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":"Comparison of the efficacy and safety of five-day methotrexate versus pulse actinomycin D for low-risk gestational trophoblastic neoplasia: a single-center historical cohort study<sup>☆</sup>.","authors":"Eri Katayama, Hirokazu Usui, Natsuko Nakamura, Asuka Sato, Nozomi Sakai, Satoyo Otsuka, Rie Okuya, Yuji Habu, Ayumu Matsuoka, Kyoko Nishikimi, Shinichi Tate, Kaori Koga","doi":"10.1016/j.ijgc.2025.102657","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102657","url":null,"abstract":"<p><strong>Objective: </strong>In 2019, our institution changed the first-line regimen for low-risk gestational trophoblastic neoplasia from 5-day methotrexate (MTX) (20 mg × 5 days, intramuscular injection) to pulse actinomycin D (1.25 mg/m<sup>2</sup> intravenous) every 14 days. We compared the efficacy and safety of these regimens.</p><p><strong>Methods: </strong>Between 2007 and 2022, 105 low-risk gestational trophoblastic neoplasia cases were identified. The patients' background, outcomes, and adverse effects were analyzed retrospectively using the Mann-Whitney U test, Fisher's exact test, and propensity score-matching analyses.</p><p><strong>Results: </strong>Among the patients, 83 were treated before 2019 (MTX group), and 22 were treated after 2019 (actinomycin D group). Age and pre-treatment human chorionic gonadotropin levels were comparable between the groups. However, the International Federation of Gynecology and Obstetrics score was significantly greater in the MTX group (p < .05). The primary remission rate was significantly greater in the actinomycin D group (81.8%, 18/22) than in the MTX group (38.6%, 32/83, p < .01). Drug resistance was observed in 24.1% (20/83) and 18.2% (4/22) of patients in the MTX and actinomycin D groups, respectively (p = .78). The superior effects of actinomycin D were also observed in the analysis of matched patient backgrounds, including age, human chorionic gonadotropin levels, and International Federation of Gynecology and Obstetrics scores (p < .05). Severe adverse effects requiring a change in chemotherapy were reported in 37.3% (31/83) of the patients in the MTX group but none in the actinomycin D group.</p><p><strong>Conclusions: </strong>Pulse actinomycin D was more effective and safer than 5-day MTX. Considering the convenience of fewer hospital visits, the pulse actinomycin D regimen is a better option for low-risk gestational trophoblastic neoplasia in the Japanese population.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 12","pages":"102657"},"PeriodicalIF":4.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280195","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}
Mauro Signorelli, Matteo Secchi, Giuseppe Vizzielli
{"title":"Correspondence on \"Laparoscopic tumor load as an independent prognostic marker in advanced ovarian cancer: a 3-year cohort study\" by Marco D'Indinosante et al.","authors":"Mauro Signorelli, Matteo Secchi, Giuseppe Vizzielli","doi":"10.1016/j.ijgc.2025.102659","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.102659","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102659"},"PeriodicalIF":4.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244533","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}