International Journal of Gynecological Cancer最新文献

{"title":"Image-guided brachytherapy for locally advanced cervical cancer: clinical outcomes and fistula risk in stage IVA disease.","authors":"Yosef Landman, Cecilia De Sousa Smith, Suqi Ke, Michael Roumeliotis, Mohammad Rezaee, Junghoon Lee, Ehud J Schmidt, Chen Hu, Akila N Viswanathan","doi":"10.1016/j.ijgc.2026.104848","DOIUrl":"10.1016/j.ijgc.2026.104848","url":null,"abstract":"<p><strong>Objective: </strong>To report outcomes for patients with locally advanced cervical cancer, with a focus on stage IVA disease, and to explore factors associated with fistula formation.</p><p><strong>Methods: </strong>Clinical data from patients with cervical cancer treated with primary chemoradiotherapy and magnetic resonance imaging-guided brachytherapy were retrospectively reviewed. Oncologic outcomes (overall survival, disease-free survival, and central failure) were assessed using Kaplan-Meier, Cox regression, and competing-risk analyses. Logistic regression was used to assess factors associated with any fistula and late-occurring fistula.</p><p><strong>Results: </strong>A total of 151 patients had a median follow-up of 2.9 years; 22/151 (14.6%) had stage IVA disease. Compared with stages I to III, stage IVA disease was associated with worse disease-free survival (hazard ratio 2.79, 95% confidence interval 1.59 to 4.91, p < .001) and overall survival (hazard ratio 4.81, 95% confidence interval 2.48 to 9.32, p < .001), but not with central failure (hazard ratio 1.28, 95% confidence interval 0.36 to 4.63, p = .7). HR-CTV D90 is the minimum radiation dose (in Gy) delivered to 90% of the high-risk clinical target volume did not differ significantly by stage, although bladder and rectum D2cc doses were higher in patients stage IVA due to organ invasion. Multivariable analysis identified prognostic factors for any fistula of body mass index <20 kg/m² with an odds ratio 4.33 (1.11 to 16.90, p = .035), immune-compromised status odds ratio 5.84 (1.32 to 25.91, p = .020), stage IVA disease odds ratio 6.87 (1.99 to 23.75, p = .002), and larger primary tumor volume odds ratio 3.29 (1.53 to 7.08, p = .002). The only significant factors for oncologic outcomes were: for disease free survival, race (hazard ratio 0.57, 95% confidence interval 0.33 to 1, p = .05); for overall survival, stage IVA disease (hazard ratio 3.43, 95% confidence interval 1.67 to 7.06, p < .01); and for central failure, treatment duration > 56 days (hazard ratio 1.03, 95% confidence interval 1.002 to 1.06, p = .037). The 3-year cumulative incidence of central failure did not differ between stages I to III (10.2%) and IVA (14.3%) (p = .7).</p><p><strong>Conclusions: </strong>Patients with stage IVA disease have worse disease-free survival and overall survival, but not central failure, compared to patients with stages I to III disease. Magnetic resonance imaging-guided brachytherapy results in a low incidence of central failure across stages. Several comorbidities and disease-related factors impact the risk of fistula formation.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"36 9","pages":"104848"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630284","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 \"Utility of CA125 KELIM in predicting benefit from hyperthermic intraperitoneal chemotherapy in patients with advanced ovarian cancer: pooled analysis of KGOG3042 and KOV-HIPEC-01\" by Cho et al.","authors":"Qiongying Xu, Jiehua Han","doi":"10.1016/j.ijgc.2025.102848","DOIUrl":"10.1016/j.ijgc.2025.102848","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"102848"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846681","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":"Assessing the predictive value of the American College of Surgeons National Surgical Quality Improvement Program surgical risk model in a high-volume gynecologic oncology center in Turkey: a retrospective cohort study.","authors":"Atacem Mert Aytekin, Seyma Okumus, Ipek Betul Ozcivit Erkan, Bilgehan Saglik, Ayse Yavuz, Burchan Aydiner, Abdullah Serdar Acikgoz, Tugan Bese, Oguzhan Kuru","doi":"10.1016/j.ijgc.2026.104493","DOIUrl":"10.1016/j.ijgc.2026.104493","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the predictive performance of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator in estimating 30-day post-operative complications and mortality among patients undergoing elective gynecologic oncology surgery.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included 789 patients who underwent elective gynecologic oncology surgery at a tertiary center between January 2016 and February 2025. Pre-operative data for 19 risk factors included in the ACS NSQIP calculator were extracted from patient records. Individual complication risks were calculated and compared with actual post-operative outcomes using binary logistic regression analysis, receiver operating characteristic curve analysis, and the Brier score.</p><p><strong>Results: </strong>Severe complications, defined on the basis of ACS NSQIP composite criteria, occurred in 6.5% of patients, while \"any complication\" was observed in 10.1%. The ACS NSQIP model demonstrated excellent predictive performance for mortality (area under the curve [AUC] = 0.965, Brier = 0.006), good performance for cardiac complications (AUC = 0.885), although calibration was moderate (Brier = 0.077), and acceptable performance for venous thromboembolism (AUC = 0.789, Brier = 0.006). The model showed acceptable discrimination and calibration for serious complications (AUC = 0.701, Brier = 0.057), whereas predictive accuracy for \"any complication\" was fair but statistically significant (AUC = 0.657, Brier = 0.086). Acceptable discriminatory performance was also observed for surgical site infection (AUC = 0.776, Brier = 0.037) and re-operation (AUC = 0.725, Brier = 0.011). In contrast, despite moderate AUC values, predictive performance for renal failure and pneumonia was limited, as associations were not statistically significant in logistic regression analyses. The model performed poorly for sepsis, urinary tract infection, and re-admission.</p><p><strong>Conclusions: </strong>The ACS NSQIP Surgical Risk Calculator provides a clinically applicable tool for pre-operative risk assessment in gynecologic oncology surgery, particularly for predicting mortality and selected systemic complications, including cardiac events and venous thromboembolism.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"104493"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131617","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":"Response to immuno-targeted therapy in recurrent endometrial carcinoma.","authors":"Caixia Han, Peihai Zhang","doi":"10.1016/j.ijgc.2026.104642","DOIUrl":"10.1016/j.ijgc.2026.104642","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"104642"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573850","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 \"Contextualizing the risk of prolonged oral contraceptive use in high-risk HPV-positive referral populations\" by Farah Farzaneh et al.","authors":"Farah Farzaneh, Fatemeh Dastyar, Maryam Sadat Hosseini, Marzieh Mohammadi, Amir Soltani","doi":"10.1016/j.ijgc.2026.104736","DOIUrl":"10.1016/j.ijgc.2026.104736","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"104736"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163068","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":"Retrieving a ball stuck in a bucket: a dual-approach strategy for challenging pelvic surgery in ovarian cancer.","authors":"Hiroyuki Kanao, Mayumi Kamata, Kyohei Nishikawa, Risako Ozawa","doi":"10.1016/j.ijgc.2026.104807","DOIUrl":"10.1016/j.ijgc.2026.104807","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"104807"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396418","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":"External Validation of the IOTA Two-Step Strategy for Pre-operative Characterization of Adnexal Masses: Comparison with ADNEX, O-RADS and a Sequential Simple Rules-ADNEX Approach.","authors":"Matteo Marchetti, Giulia Spagnol, Eleonora Panizzolo, Massimo Carollo, Tommaso Vezzaro, Jacopo Ferrari, Chiara Vio, Chiara Munerol, Roberto Tozzi, Marco Noventa","doi":"10.1016/j.ijgc.2026.104824","DOIUrl":"10.1016/j.ijgc.2026.104824","url":null,"abstract":"<p><strong>Objective: </strong>To externally validate the International Ovarian Tumor Analysis two-step strategy, using modified Benign Descriptors followed by the Assessment of Different Neoplasias in the Adnexa model, in a single-center, surgically managed tertiary-center cohort and to compare its diagnostic performance with that of Assessment of Different Neoplasias in the Adnexa, the Ovarian-Adnexal Reporting and Data System and Simple Rules followed by Assessment of Different Neoplasias in the Adnexa for the pre-operative characterization of adnexal masses.</p><p><strong>Methods: </strong>This retrospective diagnostic accuracy study included consecutive women who underwent trans-vaginal ultrasound within 6 months before surgery for an adnexal mass between January 1, 2022, and May 31, 2025, at a tertiary gynecologic oncology center. Histopathology was used as the reference standard. Ultrasound examinations adhered to International Ovarian Tumor Analysis terminology. Risk assessment was performed using Assessment of Different Neoplasias in the Adnexa, Ovarian-Adnexal Reporting and Data System, the International Ovarian Tumor Analysis two-step strategy, and Simple Rules followed by Assessment of Different Neoplasias in the Adnexa. Diagnostic performance was evaluated using the area under the receiver operating characteristic curve, sensitivity, specificity, and predictive values. Statistical comparisons were performed using 95% confidence intervals.</p><p><strong>Results: </strong>A total of 432 women were included (median age, 52 years [interquartile range 44-63]; 225/432, 52.1% post-menopausal). Histopathology showed benign tumors in 288/432 women (66.7%), borderline tumors in 21/432 (4.9%) and malignant tumors in 123/432 (28.5%). All models demonstrated excellent discrimination (area under the receiver operating characteristic curve >0.90). Assessment of Different Neoplasias in the Adnexa and the International Ovarian Tumor Analysis two-step strategy showed the highest performance (area under the receiver operating characteristic curve ≥0.94; sensitivity>93%; specificity, 83%-85%). Ovarian-Adnexal Reporting and Data System showed comparable discrimination (area under the receiver operating characteristic curve, 0.929; sensitivity, 91.7%; specificity, 81.6%). Simple Rules followed by Assessment of Different Neoplasias in the Adnexa achieved the highest specificity (90.3%) with lower sensitivity (86.1%).</p><p><strong>Conclusions: </strong>The International Ovarian Tumor Analysis two-step strategy showed high diagnostic performance for the pre-operative characterization of adnexal masses, with results comparable to those of Assessment of Different Neoplasias in the Adnexa alone and Ovarian-Adnexal Reporting and Data System. Sequential strategies provided different sensitivity-specificity trade-offs, supporting their role as structured diagnostic approaches for expert ultrasound-based assessment of surgically managed adnexal masses.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"36 9","pages":"104824"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497386","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":"Correlation of pelvic magnetic resonance imaging with diagnostic loop electrosurgical excision procedure/cone biopsy and hysterectomy pathology: an exploratory analysis of the CX.5/SHAPE trial.","authors":"Marie Plante, Janice S Kwon, Sven Mahner, Beatrice Cormier, Suzanne Fortin, Pierrick Theret, Anne-Sophie Bats, Cor de Kroon, Willemien Van Driel, John Tidy, Karin Williamson, Peter Hillemanns, Frederic Goffin, Stephan Polterauer, Brynhildur Eyjolfsdottir, Patrick J Maguire, Se Ik Kim, Mostafa Atri, Lois Shepherd, Dongsheng Tu","doi":"10.1016/j.ijgc.2026.104835","DOIUrl":"10.1016/j.ijgc.2026.104835","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the concordance between preoperative loop electrosurgical excision procedure (LEEP)/cone margins, pelvic magnetic resonance imaging, and final pathology from the hysterectomy specimen in the CX.5/SHAPE trial.</p><p><strong>Methods: </strong>This exploratory analysis included patients who underwent preoperative LEEP/cone biopsy and pelvic magnetic resonance imaging prior to hysterectomy. Primary outcomes included the correlation between pelvic magnetic resonance imaging and final pathology: (1) \"undercall\" (no disease on magnetic resonance imaging but disease on final pathology); (2) \"overcall\" (disease on magnetic resonance imaging but none on final pathology), and (3) \"concordance\" (disease or no disease on both magnetic resonance imaging and final pathology), Oncologic outcomes were evaluated according to the 3 magnetic resonance imaging groups. Magnetic resonance imaging sequences included T1 and high-resolution T2, and diffusion-weighted imaging; the use of gadolinium was not mandatory.</p><p><strong>Results: </strong>A total of 480 patients had a pelvic magnetic resonance imaging performed after a diagnostic LEEP/cone procedure. The magnetic resonance imaging undercall rate was 27.1% (95% confidence interval 23.2% to 31.3%), the overcall rate 8.5% (95% confidence interval 6.2% to 11.4%), and concordance rate 64.4% (95% confidence interval 59.5% to 68.7%) with sensitivity of 30.5% (95% confidence interval 24.0 to 37.6) and specificity of 86.0% (95% confidence interval 81.5 to 90.0) for residual disease. Higher magnetic resonance imaging concordance was associated with negative versus positive LEEP/cone margins (76.6% vs 57.3%, p < .0001). Adenocarcinoma was associated with a lower positive predictive value (41.9%) compared to squamous (66.2%) and adenosquamous (50%) (p = .04). Overall, 10 patients had no disease on preoperative magnetic resonance imaging and tumors greater >2 cm on final pathology (undercall); 6 had simple hysterectomy (under-treatment). Conversely, 41 patients had disease on preoperative magnetic resonance imaging and no residual disease on final pathology (overcall); 20 had radical hysterectomy (over-treatment). There were no differences in pelvic recurrences (p = .09) or deaths (p = .16) between magnetic resonance imaging correlation groups. Positive LEEP/cone margins and residual disease on magnetic resonance imaging were associated with more adjuvant treatment (13.0%) compared with negative margins and no disease on magnetic resonance imaging (2.5%).</p><p><strong>Conclusions: </strong>There was modest concordance between preoperative magnetic resonance imaging following LEEP/Cone procedure and final hysterectomy pathology in the SHAPE trial, but there was limited impact on rates of under- and over-treatment.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"36 9","pages":"104835"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602665","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":"Corrigendum to \"SUROVA Study: Global Real-World Treatment Strategies And Mortality Risk Prediction In Advanced Ovarian Cancer\" [International Journal of Gynecological Cancer 36 (2026) 102688].","authors":"Luis Chiva, Pilar Ordas, Jagannath Mishra, Ali Ayhan, Yoo-Young Lee, Giorgio Bogani, Somashekhar Sp, Marta Lomnytska, Maciej Stukan, Robert Fruscio, Bernabe Fora Chura, Rosa A Salcedo-Hernandez, Pierandrea De Iaco, Dimitrios Haidopoulos, Valentyn Svintsitskiy, Vandana Jain, Paul Stanciu, Friederike Luise Rawert, Celal Akdemir, Reem Abdallah, Enrique Chacon, Jose Angel Minguez, Antonio Gil-Moreno, Kateryna Kharchenko, Malihe Hasanzadeh Mofrad, Gerhard Gebauer, Berta Díaz-Feijoo, Giuseppe Scibilia, Marko Klaric, Erik Škof, Feras Abu Saadeh, Michael D Mueller, Sami Saarelainen, Álvaro Tejerizo García, Christina Fotopoulou, Pluvio Coronado, Fuat Demirkiran, Frederic Goffin, Dimitrios Tsolakidis, Antonio Gonzalez-Martin","doi":"10.1016/j.ijgc.2026.104977","DOIUrl":"10.1016/j.ijgc.2026.104977","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"104977"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873997","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 \"Long-term oral contraceptive use as a risk factor for high-grade cervical lesions in women with high-risk human papillomavirus: a retrospective cohort analysis\" by Farzaneh et al.","authors":"Lauren Jill Tostrud, Isabel Beshar, Paul D Blumenthal","doi":"10.1016/j.ijgc.2026.104498","DOIUrl":"10.1016/j.ijgc.2026.104498","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"104498"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197570","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}