International Journal of Gynecological Cancer最新文献

{"title":"Modified radical hysterectomy for stage IB1 (≤2 cm) cervical cancer: assessment of temporal trends and oncologic outcomes in the United States.","authors":"Koji Matsuo, Joel Agarwal, Ling Chen, Christian Pino, Mihiri S Karunaratne, Katelyn B Furey, Maximilian Klar, Lynda D Roman, Jason D Wright","doi":"10.1016/j.ijgc.2025.101676","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101676","url":null,"abstract":"<p><strong>Objective: </strong>The oncologic safety of less-radical surgery for early-stage cervical cancer is currently being actively investigated. Given the paucity of data, this study assessed the temporal trends and oncologic outcomes associated with modified radical hysterectomy for stage IB1 (≤2 cm) cervical cancer in the United States.</p><p><strong>Methods: </strong>This retrospective cohort study used data from the Commission-on-Cancer's National Commission on Cancer Database. The study population was 2902 patients with clinical stage IB1 (≤2 cm) cervical cancer from 2010 to 2020. Temporal trends based on hysterectomy modality (radical hysterectomy, modified radical hysterectomy, and simple hysterectomy) were assessed using linear segmented regression with log-transformation, and the overall survival was assessed using a multivariable Cox proportional hazard regression model.</p><p><strong>Results: </strong>There was a statistically significant increase in modified radical hysterectomy from 2013 to 2020 (annual percentage rate increase 4.4, 95% CI 0.7 to 16.0, p=.040) and a decrease in simple hysterectomy from 2012 to 2020 (-2.3, 95% CI -3.7 to -1.3, p<.001). The lymphovascular space invasion rates (26.8%, 26.8%, and 23.1% for the radical, modified radical, and simple hysterectomy groups, respectively, p=.10) and pathological nodal metastasis rates (5.0%, 4.4%, and 4.0%, respectively, p=.54) were similar among the 3 groups. The use of adjuvant radiotherapy was higher in the simple hysterectomy group (13.0%, 13.0%, and 18.2% in the radical, modified radical, and simple hysterectomy groups, respectively, p<.001). The 5-year overall survival rates for radical hysterectomy, modified radical hysterectomy, and simple hysterectomy were 96.6 %, 96.3 %, and 95.8 %, respectively (p=.0.66). In multivariable analysis, modified radical hysterectomy (adjusted HR 1.23, 95% CI 0.73 to 2.06) and simple hysterectomy (adjusted HR 1.02, 95% CI 0.70 to 1.48) were not associated with decreased overall survival compared with radical hysterectomy.</p><p><strong>Conclusions: </strong>The results of this cohort study in the United States suggest that modified radical hysterectomy for stage IB1 (≤2 cm) may not be associated with overall survival. This observed survival association warrants further investigation stage IB1 (≤2 cm) cervical cancer that does not meet the low-risk criteria.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101676"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630417","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":"High-grade serous ovarian cancer-bridging the gap between epidemiology and prevention with biology.","authors":"Smadar Bauer, Amit Oza, Stephanie Lheureux","doi":"10.1016/j.ijgc.2025.101662","DOIUrl":"10.1016/j.ijgc.2025.101662","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"101662"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382373","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":"Dedicated research navigators: a tool to decrease disparities in clinical trial enrollment?","authors":"Teresa K L Boitano, Jaclyn A Wall, Lia Bos, Gabrielle Rocque, Courtney Williams, Haller Smith, J Michael Straughn, Charles A Leath, Warner K Huh, Rebecca C Arend","doi":"10.1016/j.ijgc.2024.100066","DOIUrl":"https://doi.org/10.1016/j.ijgc.2024.100066","url":null,"abstract":"<p><strong>Objective: </strong>The goal of this study was to evaluate the impact of a formalized research team and screening process on racial disparities associated with clinical trial enrollment at a tertiary academic center.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients with gynecologic malignancies approached for clinical trial enrollment from March 2018 to February 2022. A dedicated research navigator team and protocol were implemented to review and approach all (potentially) eligible clinical trial patients. The control group consisted of patients enrolled prior to the research navigator team. A survey was also performed in the research navigator team group to evaluate the reasons why patients decline clinical trials. Analysis was performed using SPSS version 26.</p><p><strong>Results: </strong>A total of 411 patients were included in this cohort with 187 in the control group and 224 in the research navigator team. There was a high rate of minority inclusion with 27.3% of patients being Black. Enrollment in the clinical trials increased from 15.0% to 36.9% after the initiation of the research navigator team. Patients were more likely to enroll if they had recurrent disease vs primary disease (p < .001). The most common reasons for patients declining clinical trials were the desire to receive treatment locally (25.0%), concern about the trial (21.7%), and wanting to receive the standard of care treatment (15.0%).</p><p><strong>Conclusions: </strong>Using a dedicated research navigator team increased the identification of eligible patients and decreased racial disparities in clinical trial enrollment at our tertiary academic center. The most common reason women declined enrollment was to receive treatment locally. Continued identification of barriers to trial enrollment remains paramount in working to improve outcomes for gynecologic oncology patients.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"100066"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457891","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":"Extraperitoneal robotic approach for recurrent para-aortic lymphocele.","authors":"Giuseppina Fais, Henri Azaïs, Michele Peiretti, Olivier Pellerin, Enrica Bentivegna, Anne Sophie Bats","doi":"10.1016/j.ijgc.2024.100043","DOIUrl":"https://doi.org/10.1016/j.ijgc.2024.100043","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"100043"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457917","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":"In memoriam: Ali Ayhan (1940-2024).","authors":"Yavuz Ayhan, Cagatay Taskiran","doi":"10.1016/j.ijgc.2024.100002","DOIUrl":"https://doi.org/10.1016/j.ijgc.2024.100002","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"100002"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457934","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":"Patient-initiated follow-up in low-risk endometrial cancer after surgery: a systematic review.","authors":"Megan Leitch, Ayesha Arshad, Paul A Cohen, Emma R Allanson","doi":"10.1016/j.ijgc.2024.100037","DOIUrl":"https://doi.org/10.1016/j.ijgc.2024.100037","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of patient-initiated follow-up in surgically treated early-stage endometrial cancer on quality of life, survival, and health care costs in patients with low-risk early-stage endometrial cancer.</p><p><strong>Methods: </strong>We searched the Cochrane Centre Register of Controlled trials, MEDLINE, Embase, LILACS, and CINAHL databases up to August 24, 2024. Inclusion criteria were randomized controlled trials, cohort studies, and observational studies that included women aged >18 years with stage 1A, grade 1 and 2 endometrial cancers, as per the International Federation of Gynecology and Obstetrics 2009 staging criteria, who underwent surgery as their primary treatment and did not require adjuvant therapy. Included studies were those that assessed the impact of patient-initiated follow-up in low-risk endometrial cancer. The primary outcome was quality of life. The secondary outcomes were overall survival, cancer-specific survival, recurrence-free survival, cost/health care utilization, and adverse events. Data were extracted and the evidence were synthesized.</p><p><strong>Results: </strong>A total of 6 studies with a total of 1081 participants matched the selection criteria and were included. There was 1 multi-center randomized controlled trial and 5 cohort studies. Patient-initiated follow-up had no impact on fear of cancer recurrence in 1 study, and the quality of life, assessed in 2 studies, was acceptable. In 5 studies that included 853 patients and a median follow-up between 10 and 60.7 months, there were 22 recurrences and the overall survival was 93% to100%.</p><p><strong>Conclusion: </strong>Patient-initiated follow-up may be a viable mode of surveillance for patients with low-risk endometrial cancer and appears to have little impact on quality of life. Evidence for the impact of patient-initiated follow-up on survival on this patient population is lacking. Large, randomized controlled trials are needed to assess long-term outcomes.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"100037"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457977","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":"Progression-free survival as a potential surrogate end point for overall survival in advanced cervical carcinoma.","authors":"Ramon Yarza, Melpomeni Kountouri, Helena Guedes, Catherine O'Gorman, Jose Manuel Estrada-Lorenzo, Corneel Coens, Judith Kroep, Fernanda Herrera, Ainhoa Madariaga","doi":"10.1016/j.ijgc.2024.100012","DOIUrl":"https://doi.org/10.1016/j.ijgc.2024.100012","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis was performed to study the potential of progression-free survival as a surrogate end point for trials evaluating the use of systemic therapy in advanced cervical cancer.</p><p><strong>Methods: </strong>We performed a systematic review selecting phase II and III randomized trials including locally advanced, recurrent, and metastatic cervical cancer, with mature progression-free survival and overall survival data. Our study adhered to the Reporting Items for Systematic Reviews and Meta-Analyses checklist and was registered in International Prospective Register of Systematic Reviews (CRD42023405604). Exclusions comprised trials involving adjuvant treatment as the primary end point. The magnitude of progression-free survival and overall survival was assessed using standardized z-scores. Subgroup analyses were conducted based on treatment type, line of treatment, and prior radiotherapy exposure. Surrogacy was evaluated according to the recommendations by the Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen.</p><p><strong>Results: </strong>A total of 20 studies were included in the final analysis. In the overall population, a moderate correlation between progression-free survival and overall survival was observed (r = 0.75, p < .001). The surrogate threshold effect (STE) indicated a threshold for progression-free survival z-score (z-progression-free survival of 2.53), intersecting with null overall survival outcome (z = 1.96). Subgroup analysis revealed a weak and nonsignificant correlation in chemotherapy trials (r = 0.5, p = .12) with a higher STE (z-progression-free survival = 2.83). Conversely, chemoimmunotherapy combinations exhibited a robust and statistically significant correlation (r = 0.99, p = 0.01) with a lower STE (z-progression-free survival = 2.39). Trials exploring advanced therapy lines demonstrated a higher and more significant correlation (r = 0.98, p = .02) with a lower STE at 2.08, whereas upfront-line therapy trials showed a moderate correlation (r = 0.67, p = 0.01) with an STE magnitude of 2.58.</p><p><strong>Conclusion: </strong>Progression-free survival exhibits a moderate correlation with a modest STE. For chemoimmunotherapy combinations, there is a strong correlation between overall survival and progression-free survival, with a notably lower STE. This suggests that the relationship between progression-free survival and overall survival may vary significantly based on the treatment strategy.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"100012"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457797","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":"RELEVANT-C study: patient-reported prevalence of lower extremity lymphedema after sentinel lymph node mapping vs lymphadenectomy after surgery for early-stage cervical cancer.","authors":"Kathryn M Miller, Chrissy Liu, Qin Zhou, Alexia Iasonos, Ray Baser, Bhavani Ramesh, Yukio Sonoda, Jennifer J Mueller, Vance Broach, Nadeem R Abu-Rustum, Mario M Leitao","doi":"10.1016/j.ijgc.2024.100063","DOIUrl":"https://doi.org/10.1016/j.ijgc.2024.100063","url":null,"abstract":"<p><strong>Objective: </strong>To compare the prevalence of patient-reported lower extremity lymphedema and evaluate patient-reported quality of life after sentinel lymph node mapping vs comprehensive lymphadenectomy with or without sentinel lymph node mapping for the surgical management of early-stage cervical cancer.</p><p><strong>Methods: </strong>In July 2022, we mailed a survey that included a validated 13-item lower extremity lymphedema screening questionnaire to patients who underwent lymph node evaluation at the time of primary surgery for the 2018 International Federation of Gynecology and Obstetrics stage IA1 to IIB cervical cancer between January 1, 2006, and January 31, 2019. We excluded patients diagnosed with lower extremity lymphedema prior to surgery and those who answered ≤6 survey items, and we carried out 2 group comparisons: sentinel lymph node mapping vs lymphadenectomy with or without sentinel lymph node mapping, and patients with lower extremity lymphedema vs patients without.</p><p><strong>Results: </strong>Of 459 potential participants, 90 (20%) responded to the survey, all of which were evaluable (37 sentinel lymph nodes; 53 lymphadenectomies ± sentinel lymph nodes). Self-reported lower extremity lymphedema prevalence was 10.8% (4/37) in the sentinel lymph node mapping group and 43.4% (23/53) in the lymphadenectomy with or without sentinel lymph node mapping group (OR 6.32, 95% CI 2.14 to 23.5, p = .002). Histologic subtype and number of lymph nodes removed were associated with increased prevalence of lower extremity lymphedema. After adjusting for the histology subtype, lymphadenectomy retained independent association with an increased prevalence of lower extremity lymphedema over sentinel lymph node mapping (OR 4.96, 95% CI 1.61 to 18.8, p = .009). Patients with self-reported lower extremity lymphedema had significantly worse quality of life compared to those without self-reported lower extremity lymphedema.</p><p><strong>Conclusions: </strong>We found sentinel lymph node mapping to be independently associated with a significantly decreased prevalence of patient-reported lower extremity lymphedema and with improved quality of life in patients undergoing surgical management of early-stage cervical cancer.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"100063"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457867","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":"Suggestion of new algorithm to simplify pelvic exenteration.","authors":"Cagatay Taskiran, Burak Giray, Emin Erhan Donmez, Tonguc Arslan, Dogan Vatansever, Macit Arvas","doi":"10.1016/j.ijgc.2024.101614","DOIUrl":"https://doi.org/10.1016/j.ijgc.2024.101614","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"101614"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457880","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":"Laparoscopic bariatric surgery with hysterectomy for endometrial cancer to improve long-term outcomes: A review article.","authors":"Emma Goddard, David Pace, Laurie Twells, Joannie Neveu","doi":"10.1016/j.ijgc.2024.100033","DOIUrl":"https://doi.org/10.1016/j.ijgc.2024.100033","url":null,"abstract":"<p><p>Endometrial cancer is the most common gynecologic malignant disease in Canada, and women with an elevated body mass index carry an increased lifetime risk of developing this disease. As rates of obesity have risen, the rates of endometrial cancer have seen a similar rise. Given this association, women diagnosed with endometrial cancer often suffer from several obesity-related co-morbidities, including type 2 diabetes, hypertension, and cardiovascular disease. Studies have suggested that women with early-stage endometrial cancer have a higher potential to die of obesity-related complications than recurrence and that weight reduction would be beneficial for these patients to improve quality-of-life and long-term obesity-related morbidity and mortality. Bariatric surgery is currently the only treatment modality to result in sustained long-term weight loss for this cohort of patients. Early evidence has suggested that combining bariatric surgery with total laparoscopic hysterectomy may improve the underlying metabolic disease, the patients' quality of life, and the long-term obesity-related morbidity and mortality. Additionally, the inclusion of bariatric surgery in treatment of patients with obesity and endometrial cancer may decrease the projected lifetime health care cost when compared to hysterectomy alone. This narrative review aims to examine the evidence surrounding endometrial cancer and its link to obesity. Further, we hope to explore current treatments for the aforementioned conditions and the possible benefits and feasibility of a combined intervention of vertical sleeve gastrectomy and total laparoscopic hysterectomy for patients with obesity and endometrial cancer.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"100033"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457958","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}