International Journal of Gynecological Cancer最新文献

{"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}

{"title":"High human papillomavirus viral load and local immune dysregulation are associated with poor clinical outcomes in patients with cervical cancer.","authors":"Xionge Mei, Seth-Frerich Fobian, Marloes IJff, Johannes Crezee, Gregor G W van Bochove, Luc R C W van Lonkhuijzen, Constantijne H Mom, Colette B M van den Broek, Jan Koster, Willem de Koning, Andrew P Stubbs, Renske D M Steenbergen, Timo L M Ten Hagen, Louis Vermeulen, Lukas J A Stalpers, Arlene L Oei","doi":"10.1016/j.ijgc.2025.101924","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101924","url":null,"abstract":"<p><strong>Objective: </strong>Human papillomavirus (HPV) infection is the primary cause of cervical cancer. Higher viral load, that is, a greater abundance of HPV DNA in a tumor, has been associated with poorer clinical outcomes, and may play a role in the more accurate prediction of (non-) responders to treatment. In this study, we investigated the correlation between HPV viral load, clinical outcomes, and immune parameters related to HPV infection.</p><p><strong>Methods: </strong>HPV viral load was quantified using quantitative polymerase chain reaction on biopsies from a prospective cohort of women diagnosed with cervical cancer. Patients were categorized into 2 HPV viral load groups based on the optimal fit of a non-linear piecewise regression model. Immunohistochemical staining was used to measure tumor cell characteristics (Ki67, p16^INK4a, Pan-CK), as well as local tumor immune parameters (CD3, CD4, CD8, FOXP3) and immune checkpoint expression (PD-1, PD-L1). Kaplan-Meier curves were generated to compare recurrence-free and overall survival.</p><p><strong>Results: </strong>In the 44 women included in our study, high HPV viral load was significantly associated with shorter overall and recurrence-free survival (p = .045 and p = .046, respectively; 2-sided) and positively correlated with an increased risk of lymph node and distant metastasis. In addition, a high HPV viral load was linked to lower percentages of tumor-infiltrating lymphocytes and reduced expression levels of PD-1 and PD-L1.</p><p><strong>Conclusions: </strong>The viral load of HPV in cervical cancer correlates positively to metastasis and recurrence and negatively to survival rates, potentially because of local immune suppression. These results might indicate a lower response to immune checkpoint inhibition in the high viral load group and that other treatment options should still be explored.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101924"},"PeriodicalIF":4.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191787","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":"Leading causes of death after a diagnosis of endometrial cancer: a systematic review and meta-analysis.","authors":"Heather J Agnew, Holly Baker-Rand, Sarah J Kitson, Emma J Crosbie","doi":"10.1016/j.ijgc.2025.101926","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101926","url":null,"abstract":"<p><strong>Objective: </strong>Despite curative treatment, an endometrial cancer (EC) diagnosis is associated with an elevated risk of death compared with age-matched women in the general population. This study aimed to quantify their risk of death from EC, cardiovascular disease, and other causes.</p><p><strong>Methods: </strong>A systematic review of Medline, Embase, and CENTRAL databases was performed to February 2024. Studies reporting cause of death after a diagnosis of EC were included. Mortality rates and 95% CIs were calculated using a random-effects model. Heterogeneity was assessed through visual inspection of forest plots and the I² statistic. Risk of bias and evidence quality were appraised using the Newcastle-Ottawa scale and Grading of Recommendations Assessment, Development and Evaluation (GRADE), respectively. The effect of ethnicity, stage, grade, and time from diagnosis was examined.</p><p><strong>Results: </strong>In total, 22 studies including 323,551 participants were analyzed and 102,711 (31.7%) died within 20 years of diagnosis, 62.6% (n = 64,155) from non-EC causes. In the 12 studies that reported cardiovascular death, 24.6% of participants (n = 24,309) died from cardiovascular disease. Those with local disease at presentation were more likely to die from non-EC causes than those with advanced disease at presentation (48.9% vs 13.5%). A total of 2 studies reported cause of death by ethnicity; overall, Black individuals were more likely to die than individuals of White or Other ethnicities (40.8% vs 27.9% vs 18.9%). Deaths related to non-EC causes, including cardiovascular disease, overtook EC-specific deaths >5 years after diagnosis. Significant heterogeneity was noted, despite sub-group analyses, and the findings were based on very low certainty evidence.</p><p><strong>Conclusions: </strong>Individuals with a history of EC are at increased risk of death from other causes. Oncology follow-up appointments provide the ideal opportunity to optimize cardiovascular risk factors to reduce preventable deaths. Future research needs to reflect the global majority.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101926"},"PeriodicalIF":4.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191788","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":"Clinical value of circulating tumor DNA for patients with epithelial ovarian cancer.","authors":"Émilie Laude, Henri Azaïs, Mehdi Ben Sassi, Anne-Sophie Bats, Valérie Taly, Pierre Laurent-Puig","doi":"10.1016/j.ijgc.2025.101925","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101925","url":null,"abstract":"<p><p>Despite progress in recent years, epithelial ovarian cancer remains a pathology with a poor prognosis, primarily because of late and invasive diagnosis. Conventional follow-up relies on imaging, CA125, and predictive tools such as KELIM-CA125 and the chemotherapy response score. However, these methods are non-specific and result in delays before obtaining results. Recently, many research teams have focused on liquid biopsies, which provide direct access to tumor material in biological fluids. This review examines the clinical potential of circulating tumor DNA (ctDNA) in epithelial ovarian cancer. A systematic search of the PubMed database was conducted. Inclusion criteria were studies published in English, original research articles, reviews, or meta-analyses focused on ctDNA and ovarian cancer. Exclusion criteria included non-peer-reviewed sources, articles with insufficient data, and studies not directly related to the topic. In epithelial ovarian cancer, ctDNA allows quantitative evaluation of tumor burden and qualitative analysis by detecting specific tumor DNA variations, such as epigenetic modifications or genetic mutations. Furthermore, its half-life is less than 2 hours, enabling dynamic monitoring of tumor evolution. This capability could facilitate earlier diagnosis, better screening, and more effective therapeutic follow-up. The qualitative approach also has the potential to predict chemoresistance. Technologies used to detect ctDNA in blood include quantitative polymerase chain reaction, digital polymerase chain reaction, and next-generation sequencing, which allow quantification and identification of DNA molecule modifications. CtDNA is a promising biomarker for epithelial ovarian cancer and could address several challenges in its management. However, further research is needed to establish its role in routine clinical practice, particularly, to identify a detection method that is highly sensitive, specific, and generalizable to a wide patient population.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101925"},"PeriodicalIF":4.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158586","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":"Survival outcomes and safety of nimotuzumab combined with radiotherapy ± chemotherapy for locally advanced cervical cancer.","authors":"Jiwei Li, Manbo Cai, Changjun Xie, Sijuan Ding, Tao Wu, Wen Zou, Jingjing Wang","doi":"10.1016/j.ijgc.2025.101930","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101930","url":null,"abstract":"<p><strong>Objective: </strong>Chemoradiotherapy is currently the main treatment for locally advanced cervical cancer. Nevertheless, the survival profile of locally advanced cervical cancer patients remains unsatisfactory because of metastasis and recurrence. We aimed to assess the survival outcomes and safety of radiotherapy ± chemotherapy combined with nimotuzumab (a human monoclonal antibody against epidermal growth factor receptor that has anti-tumor activities) for patients with locally advanced cervical cancer.</p><p><strong>Methods: </strong>Patients with stage IIB to IVA (International Federation of Gynecology and Obstetrics 2018) pathological and diagnosed locally advanced cervical cancer from January 2021 to December 2022 were collected in this retrospective, multi-center, and single-arm study. All patients received platinum-based radiotherapy ± chemotherapy with nimotuzumab (200 mg once a week for 6 weeks). Primary end point was overall survival. Secondary end points were progression-free survival and safety. The adverse events were recorded. Statistical analysis was performed using Statistics Analysis System software (v 9.4).</p><p><strong>Results: </strong>A total of 60 patients were collected with a median follow-up of 17.4 months (95% CI 14.8 to 19.2). The median age was 58 years (range; 35-90). A total of 16 patients (26.7%) had stage II, 38 patients (63.3%) had stage Ⅲ, and 6 patients (10%) had stage Ⅳ. The median overall survival was not reached, and the median progression-free survival was 20.4 months (95% CI 16.3 to not evaluable). Radiotherapy ± chemotherapy with nimotuzumab achieved 90.7% 1- and 2-year overall survival. Moreover, 1-year progression-free survival was 82.1%, and the 2-year progression-free survival was 47.7%. The most common treatment-related grade 3 to 4 adverse events included neutropenia (15%), anemia (21.7%), and thrombocytopenia (5%). No drug-related severe adverse events or deaths occurred.</p><p><strong>Conclusions: </strong>The addition of nimotuzumab to radiotherapy ± chemotherapy was associated with favorable oncologic outcomes for patients with locally advanced cervical cancer, and the toxicity was tolerable and manageable.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101930"},"PeriodicalIF":4.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199013","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":"Bilateral oophorectomy and the probability of amnestic mild cognitive impairment among carriers of a pathogenic variant in BRCA1 or BRCA2.","authors":"Chen Ji, Shana J Kim, Raymond H Kim, Louise Bordeleau, William D Foulkes, Seema Panchal, Stephanie A Cohen, Sophie Sun, Larissa McKetton, Angela K Troyer, Ping Sun, Steven A Narod, Joanne Kotsopoulos","doi":"10.1016/j.ijgc.2025.101929","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101929","url":null,"abstract":"<p><strong>Objective: </strong>Early surgical menopause is associated with a higher risk of mild cognitive impairment among women in the general population; this association has not been studied among women with a BRCA1 or BRCA2 mutation. This study aimed to describe the impact of clinical and host factors including bilateral oophorectomy on the probability of amnestic mild cognitive impairment among BRCA mutation carriers.</p><p><strong>Methods: </strong>This cross-sectional study extends from a longitudinal observational study of hereditary breast and ovarian cancer that has been ongoing since 1995. The Cogniciti Brain Health Assessment was administered from 2017 to 2020 among 752 women with a BRCA mutation in Canada and the United States. The probability of amnestic mild cognitive impairment was derived from the age at test completion and 2 memory task results from the Cogniciti Brain Health Assessment, and was categorized as high or low. Self-reported details on clinical and host factors were collected from biennial research questionnaires.</p><p><strong>Results: </strong>There were 21 (2.8%) women with a high probability of amnestic mild cognitive impairment and 731 (97.2%) women with a low probability. Women with a high probability were on average older at the time of cognitive assessment (63.9 vs 57.4 years, p < .001) and less likely to undergo oophorectomy for cancer prevention (55.0% vs 86.3%, p < .001) compared with women with a low probability. Among those who underwent oophorectomy for cancer prevention, women with a high probability were older at the time of surgery compared with those with a low probability (55.0 vs 46.3 years, p = .04).</p><p><strong>Conclusions: </strong>The findings suggest no short-term impact of bilateral oophorectomy on the probability of amnestic mild cognitive impairment among BRCA mutation carriers. A higher probability was predominantly attributed to older age at cognitive assessment. It is prudent to continue to monitor this population for potential long-term adverse effects following preventive surgery or cancer treatment.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101929"},"PeriodicalIF":4.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247703","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":"IGCS 2024 Dublin: Highlights of research presented at the annual meeting.","authors":"Florencia Noll, Aarthi Jayraj, Anisa Mburu, Geetu Bhandoria, Teresa L Pan, Giuseppe Caruso, Navya Nair, Irina Tsibulak, Luigi De Vitis, Emma Allanson, Mine Daggez, Raikhan Bolatbekova, Rosa Montero-Macías, Sarita Kumari, Christina Uwins, Osnat Elyashiv, Gabriella Schivardi, Jennifer Davies-Oliveira, Heng-Cheng Hsu","doi":"10.1016/j.ijgc.2025.101931","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101931","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101931"},"PeriodicalIF":4.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247708","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 ENYGO Multidisciplinary Tumor Board (MDTB): cancer in pregnancy.","authors":"Alexander Shushkevich, Martin Hruda, Anna Babkova, Ilker Kahramanoglu, Zoltan Novak, Damiano Arciuolo, Frederic Amant, Lukas Rob","doi":"10.1016/j.ijgc.2025.101920","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101920","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101920"},"PeriodicalIF":4.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132386","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 tertiary lymphoid structures in molecular subgroups of endometrial carcinoma.","authors":"Manohar Pradhan, Wanja Kildal, Ljiljana Vlatkovic, Kari Anne R Tobin, Kristina Lindemann, Gunnar B Kristensen, Andreas Kleppe, Hanne A Askautrud","doi":"10.1016/j.ijgc.2025.101915","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101915","url":null,"abstract":"<p><p>Tertiary lymphoid structures, lymphoid cell clusters formed in response to cancer or chronic disease, serve as a prognostic marker in multiple cancer types, including endometrial carcinoma. We assessed the prognostic significance of tertiary lymphoid structures, using the surrogate marker L1 cell adhesion molecule (L1CAM), in 1208 endometrial carcinoma patients in all stages, histological subtypes, and risk groups. Immunohistochemical evaluation of L1CAM in 1 tissue section from each patient revealed tertiary lymphoid structure-positivity in 287 of 1208 (23.8%) cases. In univariable analyses, patients with tertiary lymphoid structure-positive tumors had significantly longer time to recurrence (HR 0.61, p < .001) and cancer-specific survival (HR 0.53, p < .001) compared to patients with tumors without tertiary lymphoid structures. In multivariable analyses with standard clinical and pathological markers as well as modern molecular classification, the presence of tertiary lymphoid structures was an independent prognostic marker for time to recurrence (HR 0.63, p < .001) and cancer-specific survival (HR 0.54, p < .001). The presence of tertiary lymphoid structures was more frequent in POLE-mutated (59.4%) and mismatch repair deficient (32.3%) compared to p53-abnormal (15.8%) and no specific molecular profile (14.7%) tumors. In patients with p53-abnormal tumors, the presence of tertiary lymphoid structures was significantly associated with better outcomes for both time to recurrence (HR 0.51, p = .014) and cancer-specific survival (HR 0.52, p = .021) in multivariable analyses. These findings suggest that the evaluation of tertiary lymphoid structures by L1CAM may enhance prognostic precision in endometrial carcinoma.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101915"},"PeriodicalIF":4.1,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132385","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}