International Journal of Gynecological Cancer最新文献

{"title":"Surgery plus post-operative radiotherapy versus definitive chemoradiotherapy in locally advanced endocervical adenocarcinoma.","authors":"Jong Yun Baek, Won Park, Won Kyung Cho, Hyun-Soo Kim, Byoung-Gie Kim, Jeong-Won Lee, Chel Hun Choi, Tae-Joong Kim, Yoo-Young Lee","doi":"10.1016/j.ijgc.2025.102013","DOIUrl":"10.1016/j.ijgc.2025.102013","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated whether treatment outcomes for endocervical adenocarcinoma differ according to treatment modality (surgery plus post-operative radiotherapy versus definitive chemoradiotherapy) and human papillomavirus (HPV) status.</p><p><strong>Methods: </strong>We retrospectively analyzed 105 patients with clinical stage IIB to IIIC endocervical adenocarcinoma, classified according to the 2018 International Federation of Gynecology and Obstetrics staging system, who were treated with surgery plus post-operative radiotherapy or definitive chemoradiotherapy at a single institution between 2011 and 2022. HPV status was determined based on the 2020 World Health Organization classification. Among the 105 patients, 61 had HPV-associated tumors and 44 had HPV-independent tumors. Patients were categorized into 4 groups: HPV-associated surgery plus post-operative radiotherapy (n = 46), HPV-associated definitive chemoradiotherapy (n = 15), HPV-independent surgery plus post-operative radiotherapy (n = 27), and HPV-independent definitive chemoradiotherapy (n = 17). Progression-free survival, locoregional recurrence-free survival, and overall survival were evaluated.</p><p><strong>Results: </strong>Baseline characteristics differed significantly among the 4 groups, particularly in clinical stage, tumor size, and parametrial invasion. The 3-year progression-free, locoregional recurrence-free, and overall survival rates were 47.4%, 54.7%, and 69.8%, respectively. By group, survival rates were 55.4%, 66.4%, and 76.9% for HPV-associated surgery plus post-operative radiotherapy; 52.5%, 52.5%, and 93.3% for HPV-associated definitive chemoradiotherapy; and 54.3%, 56.8%, and 67.5% for HPV-independent surgery plus post-operative radiotherapy, compared with significantly poorer rates of 11.8%, 20.6%, and 33.1% for HPV-independent definitive chemoradiotherapy (p < .05). These differences remained significant after multivariate adjustment, while no significant survival differences were observed between other groups. In a sub-group analysis of HPV-independent patients with clinical T2 to T3 disease, definitive chemoradiotherapy remained associated with worse outcomes than surgery plus post-operative radiotherapy.</p><p><strong>Conclusions: </strong>Definitive chemoradiotherapy showed outcomes comparable to surgery plus post-operative radiotherapy in HPV-associated adenocarcinoma, but was associated with significantly worse survival in HPV-independent cases. Further studies are warranted to confirm these findings.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 9","pages":"102013"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768642","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":"Randomized study evaluating optimal dose, efficacy, and safety of E7386 plus lenvatinib versus treatment of physician's choice in advanced/recurrent endometrial carcinoma previously treated with platinum-based chemotherapy and immune checkpoint inhibitors.","authors":"Ramez N Eskander, Jung-Yun Lee, Mansoor Raza Mirza, Domenica Lorusso, Helen MacKay, Isabelle Ray-Coquard, Ana Oaknin, Antonio Gonzalez-Martin, Kosei Hasegawa, Bradley R Corr, Xiaohua Wu, Alexandra Leary, Tianle Hu, Lea Dutta, Chinyere E Okpara, Jodi McKenzie, Vicky Makker","doi":"10.1016/j.ijgc.2025.101812","DOIUrl":"10.1016/j.ijgc.2025.101812","url":null,"abstract":"<p><strong>Background: </strong>Randomized controlled trial data for patients with endometrial cancer who experience disease progression after anti-programmed cell death [ligand] 1 (PD-[L]1) therapy are lacking. E7386, a novel small-molecule inhibitor, has been shown to enhance anti-angiogenesis when combined with lenvatinib. The escalation and expansion parts of Study 102 showed preliminary anti-tumor activity and manageable safety of E7386 plus lenvatinib in patients with advanced, un-resectable, or recurrent endometrial cancer previously treated with anti-PD-(L)1.</p><p><strong>Primary objective: </strong>This study aimed to determine the optimal dose of E7386 in combination with lenvatinib.</p><p><strong>Study hypothesis: </strong>E7386 plus lenvatinib will show a manageable safety profile and clinically meaningful anti-tumor activity in patients with advanced, un-resectable, or recurrent endometrial carcinoma previously treated with chemotherapy and anti-PD-(L)1 therapy.</p><p><strong>Trial design: </strong>Study 102 is an open-label, global, phase 1b/2 trial. Patients with endometrial carcinoma will be randomized 1:1:1:1 to E7386 120 mg twice daily plus lenvatinib 14 mg once daily, E7386 60 mg twice daily plus lenvatinib 14 mg once daily, lenvatinib 24 mg once daily monotherapy, or treatment of physician's choice (doxorubicin 60 mg/m² once every 3 weeks or paclitaxel 80 mg/m² once weekly [3 weeks on/1 week off]).</p><p><strong>Major inclusion/exclusion criteria: </strong>Eligible patients are aged ≥18 years with Eastern Cooperative Oncology Group performance status of 0 to 1 and must have advanced, un-resectable, or recurrent endometrial carcinoma that has progressed on/after prior platinum-based chemotherapy and PD-(L)1-directed therapy. Up to 3 previous lines of therapy are permitted. Individuals with prior treatment with lenvatinib or E7386 or known intolerance and/or known hypersensitivity to E7386, lenvatinib, doxorubicin, or paclitaxel, or any of their excipients, are not eligible to participate.</p><p><strong>Primary end points: </strong>The primary end points are safety and the objective response rate per Response Evaluation Criteria in Solid Tumors version 1.1 by investigator assessment at week 24.</p><p><strong>Sample size: </strong>The study aims to include 120 patients across approximately 80 investigational sites in North America, Europe, and Asia-Pacific regions. Estimated Dates for Completing Accrual and Presenting Results: Enrollment is expected to take approximately 9 months, with presentation of results in 2026.</p><p><strong>Trial registration: </strong>The trial is registered at ClinicalTrials.gov, NCT04008797.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101812"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009703","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":"Erratum to 'Phase 2b, open-label, single-arm, multicenter pilot study of the efficacy, safety, and tolerability of dostarlimab in women with early-stage mismatch repair-deficient endometrioid endometrial adenocarcinoma' [International Journal of Gynecological Cancer Volume 35 Issue 4 (2025) 101644].","authors":"Andreas Obermair, Val Gebski, Jeffrey Goh, Anna Kuchel, Alison Brand, Blossom Mak, Orla McNally, Eva Baxter, Thomas Jobling, Linda Mileshkin","doi":"10.1016/j.ijgc.2025.101961","DOIUrl":"10.1016/j.ijgc.2025.101961","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101961"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283858","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":"Development of a prognosis model for PARP inhibitor therapies based on multiple genomic alterations associated with homologous recombination deficiency in ovarian cancer.","authors":"Tong Shu, Fan Yang, Lin Gao, Jinhua Zhou, Chao Zhang, Youguo Chen, Hong Zheng, Jundong Li","doi":"10.1016/j.ijgc.2025.101987","DOIUrl":"10.1016/j.ijgc.2025.101987","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop a high-performance prognostic model to predict poly(ADP-ribose) polymerase inhibitor (PARPi) treatment outcomes in patients with ovarian cancer.</p><p><strong>Methods: </strong>This was a retrospective cohort study. Inclusion criteria were high-grade serous or endometroid carcinoma, clear cell carcinoma with platinum-sensitive disease (>6 months without progression from the end of platinum) or platinum-responsive disease eligible for front-line PARPi therapy. All collected samples underwent OncoWES-HRD analysis, with an Homologous recombination deficiency (HRD) score threshold set at 39. We performed LASSO regression analysis to develop a predictive model for assessing the effectiveness of PARPi treatment in patients with ovarian cancer. The data were analyzed using R software.</p><p><strong>Results: </strong>We collected primary tumors from 221 Chinese patients with ovarian cancer, of whom 99 patients with high-grade serous ovarian carcinoma received PARPi treatment. Based on the HRD score threshold, 144 patients were classified as HRD-positive and 77 as HRD-negative. We found that the HRD-positive group had higher mutation frequencies of ANKHD1 and MUC16 compared to the HRD-negative group. Furthermore, biomarkers such as clonal mutations, BRCA mutations, high indel burden, and high loss-of-heterozygosity were associated with notably higher HRD scores and longer progression-free survival. Using HRD genomic features, we established a LASSO regression-based risk score model for predicting PARPi treatment outcomes. This model showed promising performance compared to other HRD assessments (the OncoWES-HRD score and the OncoWES-HRD and BRCA metrics), with a higher area under the curve and significantly longer progression-free survival (p< .05) in both training and test cohorts.</p><p><strong>Conclusions: </strong>We developed a novel prognostic model that can predict PARPi treatment outcomes, offering a valuable tool for identifying patients who may benefit from PARPi therapy in ovarian cancer. However, the model needs further validation.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 9","pages":"101987"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690142","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":"Antibody-drug conjugates in gynecologic cancer: current landscape, clinical data, and emerging targets.","authors":"Jinhui He, Mi Chen, Li Jia, Ying Wang","doi":"10.1016/j.ijgc.2025.101978","DOIUrl":"10.1016/j.ijgc.2025.101978","url":null,"abstract":"<p><p>Antibody-drug conjugates (ADCs) are an emerging class of targeted therapies that combine monoclonal antibodies with potent cytotoxic payloads, demonstrating significant potential in the treatment of gynecologic malignancies. By selectively targeting tumor-associated antigens, ADCs enable precise drug delivery while minimizing off-target toxicity. Currently, mirvetuximab soravtansine and tisotumab vedotin have been approved by the Food and Drug Administration for the treatment of folate receptor-alpha-positive, platinum-resistant ovarian cancer and recurrent cervical cancer, respectively, exhibiting promising objective response rates and manageable toxicity profiles in pivotal clinical trials. However, ADC therapy faces challenges, including ocular toxicity, pulmonary toxicity, peripheral neuropathy, tumor antigen heterogeneity, and acquired resistance. Additionally, multiple investigational ADCs, such as upifitamab rilsodotin (targeting NaPi2b), trastuzumab deruxtecan (targeting HER2), and sacituzumab govitecan (targeting trophoblast cell surface antigen 2), have demonstrated preliminary efficacy in ongoing clinical trials, offering new therapeutic opportunities for gynecologic malignancies. This review comprehensively summarizes the current clinical applications and research progress of ADCs in gynecologic cancers, including key clinical trials, therapeutic efficacy, safety profiles, and associated challenges. Furthermore, we discuss future optimization strategies, including the identification of novel targets, rational combination therapies, and molecular design improvements to advance ADC-based precision treatment in gynecologic oncology.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 9","pages":"101978"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760062","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":"Comprehensive genomic profiling and clinico-pathologic characterization of primary ovarian leiomyosarcoma.","authors":"Matteo Bruno, Elisa De Paolis, Angelo Minucci, Alessia Piermattei, Giulia Maneri, Angela Santoro, GianFranco Zannoni, Giovanni Scambia, Carolina Maria Sassu, Francesca Ciccarone, Camilla Nero, Claudia Marchetti, Anna Fagotti","doi":"10.1016/j.ijgc.2025.102010","DOIUrl":"10.1016/j.ijgc.2025.102010","url":null,"abstract":"<p><strong>Objective: </strong>Primary ovarian leiomyosarcomas are exceptionally rare, accounting for less than 0.1% of ovarian malignancies. Their treatment strategies remain poorly defined, and data on comprehensive genomic profiling are lacking. This study aims to characterize the pathological features and genomic landscape of primary ovarian leiomyosarcoma, highlighting similarities with uterine leiomyosarcomas based on available literature.</p><p><strong>Methods: </strong>We retrospectively analyzed 7 histologically confirmed cases of primary ovarian leiomyosarcoma diagnosed between 2013 and 2023 at a tertiary referral center. Clinical data, histopathological findings, and immunohistochemical profiles were reviewed. Genomic profiling was performed using the TruSight Oncology 500 assay, targeting 523 cancer-related genes. Only oncogenic or likely oncogenic alterations (Tier classification system I-II) were considered.</p><p><strong>Results: </strong>All patients had International Federation of Gynecology and Obstetrics stage IA disease and underwent radical surgery. Two patients experienced pelvic recurrence; both showed increased Ki-67 and complete loss of estrogen and progesterone receptors in the relapsed tumors. Histologically, tumors exhibited spindle or epithelioid morphology with variable atypia and mitotic indices. Genomic profiling revealed a high prevalence of TP53 (71%) and PTEN (57%) alterations. Additional copy number alterations were identified in homologous recombination repair genes (BRCA2, CHEK1/2, and ATM), fibroblast growth factor (FGF) family members (FGF7/9/14), and platelet-derived growth factor receptor beta. Tumor mutational burden was low to medium in all cases, and microsatellite status was stable.</p><p><strong>Conclusions: </strong>Primary ovarian leiomyosarcomas exhibit a complex genomic landscape marked by genomic instability, sharing key alterations with uterine leiomyosarcomas. TP53 and PTEN mutations may play a central role in their pathogenesis. This first genomic profiling analysis of ovarian leiomyosarcomas provides a basis for further research and potential targeted therapeutic approaches in this rare malignancy.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 9","pages":"102010"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768641","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":"Prognostic value of PD-L1, tumor-infiltrating lymphocytes, and CD117 in vulvovaginal melanoma.","authors":"Chiau-Sheng Jang, I-Chieh Chuang","doi":"10.1016/j.ijgc.2025.101996","DOIUrl":"10.1016/j.ijgc.2025.101996","url":null,"abstract":"<p><strong>Objective: </strong>Vulvovaginal melanoma represents a rare and aggressive melanoma subtype with distinct mutation patterns, such as a higher frequency of KIT (CD117) mutations, and is associated with poor clinical outcomes. This study investigated the prognostic implications of PD-L1 expression, tumor-infiltrating lymphocytes (TILs), and CD117 expression in patients with vulvovaginal melanoma.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on histologically confirmed vulvovaginal melanoma cases diagnosed between January 2010 and December 2020. Immunohistochemical evaluation was performed to assess PD-L1 and CD117 expression, while TIL density was graded using published guidelines. Associations between PD-L1 expression and key clinicopathological features were also evaluated. The primary outcome was disease-specific survival, defined as the interval from diagnosis to death specifically attributable to vulvovaginal melanoma, analyzed using Kaplan-Meier estimates and Cox regression models.</p><p><strong>Results: </strong>Among 47 patients, 70% presented with advanced-stage disease (stage III-IV). PD-L1 expression was detected in 22 patients (47%), and brisk TIL infiltration was observed in 12 patients (26%). PD-L1 positivity correlated with advanced disease stage (p = .002), non-brisk/absent TILs (p = .003), and lymphovascular invasion (p = .047). Kaplan-Meier analysis demonstrated significantly better disease-specific survival in PD-L1-negative tumors (3-year disease-specific survival: 48% vs 18%, p = .008) and in tumors with brisk TIL infiltration (3-year disease-specific survival: 67% vs 21%, p = .003). Combined stratification identified PD-L1-negative/brisk TIL tumors as the most favorable subgroup, while PD-L1-positive/non-brisk/absent TIL tumors exhibited the poorest prognosis (p < .001). In multivariate analysis, PD-L1 expression (HR 1.68, 95% CI 1.10 to 2.55, p = .015), TIL status (HR 0.62, 95% CI 0.43 to 0.89, p = .012), and disease stage (HR 1.85, 95% CI 1.22 to 2.81, p = .004) remained independent prognostic factors. Additionally, CD117 positivity was observed in 30% of tumors (n = 14), although its prognostic significance was not retained in multivariate analysis.</p><p><strong>Conclusions: </strong>The study establishes PD-L1 expression and TIL density as independent prognostic factors in vulvovaginal melanoma, suggesting their potential utility for risk stratification and therapeutic decision-making.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 9","pages":"101996"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812044","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":"Erratum to 'Effect of substantial lymphovascular space invasion on location of first disease recurrence in surgical stage I endometrioid endometrial adenocarcinoma' [International Journal of Gynecological Cancer Volume 35 Issue 4 (2025) 101651].","authors":"Christian Dagher, Pernille Bjerre Trent, Rofieda Alwaqfi, Ben Davidson, Lora H Ellenson, Qin Zhou, Alexia Iasonos, Jennifer J Mueller, Kaled Alektiar, Vicky Makker, Jacqueline Feinberg, Evan Smith, Sarah H Kim, Sana Hatoum, Mario M Leitao, Nadeem R Abu-Rustum, Ane Gerda Z Eriksson","doi":"10.1016/j.ijgc.2025.101962","DOIUrl":"10.1016/j.ijgc.2025.101962","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101962"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247706","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":"Erratum to 'Factors influencing surgeons' decision for diverting ileostomy and associated complications in ovarian cancer cytoreductive surgery' [International Journal of Gynecological Cancer Volume 35 Issue 4 (2025) 101640].","authors":"Liat Hogen, Thirushi Siriwardena, Lina Salman, Marcus Q Bernardini, Sarah E Ferguson, Stephane Laframboise, Genevieve Bouchard-Fortier, Eshetu G Atenafu, Taymaa May","doi":"10.1016/j.ijgc.2025.101959","DOIUrl":"10.1016/j.ijgc.2025.101959","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101959"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283857","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":"Erratum to 'Chemo-conization in Early-sTage cERvical caNcer >2 cm scheduled for fertility-sparing approach: an analysis of the ETERNITY project' [International Journal of Gynecological Cancer Volume 35 Issue 4 (2025) 101643].","authors":"Giorgio Bogani, Giovanni Scambia, Mario Malzoni, Jvan Casarin, Giuseppe Vizzielli, Frédéric Amant, Francesco Raspagliesi","doi":"10.1016/j.ijgc.2025.101960","DOIUrl":"10.1016/j.ijgc.2025.101960","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101960"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247705","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}