International Journal of Gynecological Cancer最新文献

{"title":"A message from the Editor-in-Chief: call for applications for the next International Journal of Gynecological Cancer Editor-in-Chief.","authors":"Pedro T Ramirez","doi":"10.1016/j.ijgc.2025.102014","DOIUrl":"10.1016/j.ijgc.2025.102014","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 9","pages":"102014"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775364","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":"Impact of surgery and molecular classification in stage IV endometrial cancer.","authors":"Matteo Loverro, Emanuele Perrone, Vincenzo Tarantino, Giovanni Esposito, Camilla Culcasi, Fulvia Pirrelli, Raffaella Sardo Infirri, Eleonora Palluzzi, Virginia Vargiu, Veronica Celli, Francesco Fanfani","doi":"10.1016/j.ijgc.2025.102015","DOIUrl":"10.1016/j.ijgc.2025.102015","url":null,"abstract":"<p><strong>Objective: </strong>Evidence supporting the role of surgery after neoadjuvant chemotherapy in advanced endometrial cancer remains limited. Additionally, the prognostic relevance of molecular classification in this setting is poorly defined. We aimed to evaluate overall survival in patients with peritoneal and/or extra-abdominal spread, focusing on surgical approach and molecular sub-type.</p><p><strong>Methods: </strong>We retrospectively analyzed all patients with Fédération Internationale de Gynécologie et d'Obstétrique 2009 stage IVB (Fédération Internationale de Gynécologie et d'Obstétrique 2023 IIIB2, IVB, IVC) endometrial cancer treated between January 2012 and September 2023. Patients were stratified according to immunohistochemistry-based molecular classification, intra-abdominal disease extension, and treatment strategy. Kaplan-Meier and Cox regression analyses were used to assess overall survival. Differences across groups were evaluated using appropriate nonparametric and categorical statistical tests.</p><p><strong>Results: </strong>Among 363 eligible patients, 229 (63.1%) underwent primary cytoreduction, 52 (14.3%) had interval debulking surgery, 55 (15.2%) received chemotherapy alone, and 27 (7.4%) were untreated. Patients receiving neoadjuvant or exclusive chemotherapy more frequently had extra-abdominal (p < .001) and upper abdominal disease (p < .001). In patients with extra-pelvic disease, overall survival was comparable between primary and interval surgery (p = .82). Among those treated with neoadjuvant treatment, surgical cytoreduction was strongly associated with improved overall survival (p < .001). Mismatch repair-deficient patients had better overall survival than those with p53 abnormal tumors (34 vs 21 months, p = .026). No specific molecular profile-estrogen receptor positive tumors showed longer overall survival than both p53 abnormal and no specific molecular profile-estrogen receptor negative sub-types (60 vs 34 and 21 months, p = .018 and p = .041, respectively). In multivariate analysis, extra-pelvic disease (p = .042) and exclusive chemotherapy (p < .0001) were independent negative prognostic factors.</p><p><strong>Conclusions: </strong>In advanced endometrial cancer, surgery remains a key component of management. Our findings suggest a potential survival advantage for patients who undergo surgery-either as primary treatment or following neoadjuvant chemotherapy-compared to those treated with chemotherapy alone. Molecular classification may offer prognostic insight even in stage IV disease, although further validation is required. These findings provide a benchmark for future studies in the evolving landscape of immunotherapy and personalized treatment.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 9","pages":"102015"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812043","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 and pathological characteristics and outcomes of small cell neuroendocrine carcinoma of the uterine cervix.","authors":"Mariya Kobayashi, Satoshi Nakagawa, Tatsuo Masuda, Mamoru Kakuda, Kosuke Hiramatsu, Tadashi Iwamiya, Shinya Matsuzaki, Kae Hashimoto, Yutaka Ueda, Michiko Kodama, Munetaka Takekuma, Maximilian Klar, Lynda D Roman, Jason D Wright, Koji Matsuo","doi":"10.1016/j.ijgc.2025.102011","DOIUrl":"10.1016/j.ijgc.2025.102011","url":null,"abstract":"<p><strong>Objective: </strong>To describe the clinical and pathological characteristics and outcomes of small cell neuroendocrine carcinoma of the uterine cervix at the population level in the United States.</p><p><strong>Methods: </strong>The National Cancer Institute's Surveillance, Epidemiology, and End Results Program was retrospectively queried. The study population included 54,987 patients with cervical cancer from 2004 to 2021. Descriptive analysis was performed based on histology.</p><p><strong>Results: </strong>Histology types included squamous cell carcinoma (n = 38,145, 69.4%), adenocarcinoma (n = 14,333, 26.1%), adenosquamous carcinoma (n = 1,970, 3.6%), and small cell neuroendocrine carcinoma (n = 539, 1.0%). Over the 18-year study period, the incidence rate of small cell neuroendocrine carcinoma increased by 3.2% per year (95% CI 1.2 to 5.7, p = .003). Based on this trajectory, the incidence of small cell neuroendocrine carcinoma is estimated to reach 2.0% by 2035. Small cell neuroendocrine carcinoma was associated with larger cervical tumors (60 mm versus 27-40 mm), a higher lymph node metastasis ratio (25.0% versus 14.3%-15.4%), higher distant metastasis rate even in small tumor (10 mm, 10.3% versus 0.5-2.6%; and 20 mm, 14.8% versus 3.9-5.3%), and stage IV disease (40.1% versus 11.9%-15.2%) than other histologies (p < .001). Among distant metastasis cases, small cell neuroendocrine carcinoma was more likely to spread to the liver (36.1% versus 14.3%-15.4%) or bone (28.8% versus 17.3%-19.1%) and to involve multiple distant organ metastases (≥2 organs: 37.3% vs 27.8%-30.2%; and ≥3 organs: 18.1% vs 9.2%-10.1%) compared with other histologies (p < .001). Across stages I to IV, small cell neuroendocrine carcinoma had lower 5-year overall survival rates than other histologies: stage I, 58.0% versus 82.5% to 91.3%; stage II, 38.4% versus 60.7% to 64.6%; stage III, 31.3% versus 49.5% to 51.4%; and stage IV, 8.1% versus 18.2% (p < .05). Early-death rates within two months from diagnosis of small cell neuroendocrine carcinoma were substantially higher than other histologies (9.0% vs 2.2%, p < .001).</p><p><strong>Conclusions: </strong>This population-based assessment suggests that, although rare, the incidence of small cell neuroendocrine carcinoma of the uterine cervix is gradually increasing in the United States. Multiple distant organ metastases, especially to the liver and bone, and poor survival outcomes characterize small cell neuroendocrine carcinoma of the uterine cervix.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 9","pages":"102011"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835020","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":"Sarcopenia shortens overall survival of patients with platinum-resistant recurrent ovarian cancer: inverse probability of treatment-weighting analysis.","authors":"Masahiro Aichi, Sho Hasegawa, Satoru Shinoda, Yukio Suzuki, Natsuko Kamiya, Yumi Ishidera, Yuichi Imai, Etsuko Miyagi, Taichi Mizushima","doi":"10.1136/ijgc-2024-005323","DOIUrl":"10.1136/ijgc-2024-005323","url":null,"abstract":"<p><strong>Objective: </strong>The association between sarcopenia and prognosis in patients with platinum-resistant recurrent ovarian cancer remains unclear. This study investigated whether sarcopenia is a prognostic factor in patients with platinum-resistant recurrent ovarian cancer.</p><p><strong>Methods: </strong>A total of 52 patients diagnosed with platinum-resistant recurrent ovarian cancer who had undergone non-platinum chemotherapy at our institution formed our study population. Body composition and clinicopathological data of these patients were collected retrospectively. Abdominal computed tomography (CT) scans obtained at the time of platinum-resistant recurrent ovarian cancer diagnosis were used to measure the cross-sectional area of skeletal muscles at L3 level. These values were corrected for height to calculate the skeletal muscle index, and accordingly sarcopenia was defined. Overall survival was defined as the primary outcome of the study. The impact of sarcopenia on overall survival was assessed using Cox proportional hazards regression models with inverse probability weighting of treatment based on propensity scores and log-rank tests.</p><p><strong>Results: </strong>The median patient age was 63 years (IQR: 53-71). The most common International Federation of Gynecology and Obstetrics (FIGO) 2018 stage was stage III (50%) and the most common histology was serous or adenocarcinoma (67.3%). The optimal cut-off value of skeletal muscle index was 35.6 cm²/m², which was calculated using the data of 21 patients with sarcopenia and 31 without sarcopenia. Sarcopenia was significantly associated with shorter overall survival (HR 1.93; 95% CI 1.06-3.49; p=0.03). Subgroup analysis based on patient attributes and prognostic factors suggested a consistent prognostic impact of sarcopenia. Sarcopenia was identified as a significant risk factor, particularly in patients who had higher CA125 levels (HR, 2.47; 95% CI, 1.07 to 5.69; p=0.034) and a higher neutrophil-to-lymphocyte ratio (HR, 2.92; 95% CI, 1.02 to 8.31; p=0.045).</p><p><strong>Conclusion: </strong>Sarcopenia significantly shortened the overall survival of patients with platinum-resistant recurrent ovarian cancer.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101849"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897419","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":"A multicenter retrospective study to assess feasibility, safety and efficacy of first-line carboplatin-paclitaxel versus carboplatin monotherapy in a frail, elderly epithelial ovarian cancer population^☆.","authors":"Eve Merry, Ronas Taner Kesmez, Tamara Yu, Michael Flynn, Jonathan Ledermann, Michelle Lockley, Nicola Macdonald, Mary McCormack, Shibani Nicum, Shanthini Crusz, Rowan Miller","doi":"10.1136/ijgc-2024-005394","DOIUrl":"10.1136/ijgc-2024-005394","url":null,"abstract":"<p><strong>Objective: </strong>Underrepresentation of elderly ovarian cancer patients in clinical trials has led to lack of clarity regarding optimal first-line chemotherapy in this cohort. The Elderly Women with Ovarian Cancer (EWOC)-1 trial demonstrated that 3-weekly carboplatin (3wC) resulted in worse survival and feasibility compared with standard 3-weekly carboplatin-paclitaxel (3wCP) in frail, elderly ovarian cancer patients. Our retrospective study compares feasibility, safety, and efficacy of first-line 3wCP and 3wC in a frail ovarian cancer cohort.</p><p><strong>Methods: </strong>Clinical data were retrospectively analyzed for newly-diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV, ≥70-year-old epithelial ovarian cancer patients, treated by clinician choice with 3wC or 3wCP at two London cancer centers over a 2 year period. Charlson Comorbidity Index (CCI) and Eastern Cooperative Oncology Group (ECOG) performance status provided surrogate markers of frailty. Common Terminology Criteria for Adverse Events v5.0 graded toxicity.</p><p><strong>Results: </strong>A total of 107 patients were treated with 3wC (n=30) and 3wCP (n=77). Age, performance status, and CCI were significantly different between cohorts, with 3wC patients older (84 vs 75 years, p<0.001), with more comorbidities (median CCI 4 vs 3, p<0.001) and worse performance status (47% vs 17% PS ≥2, p=0.015). Surgical outcomes differed significantly between cohorts, with 20 (67%) 3wC patients not undergoing surgery, compared with 22 (29%) 3wCP patients (p<0.001). Median follow-up was 45.8 months (IQR 38.7-56.3 months). While we observed improved progression-free (HR 0.55, 95% CI 0.33 to 0.90, p=0.017) and overall survival (HR 0.44, 95% CI 0.27 to 0.73, p=0.001, log-rank test) in a univariate cox proportional hazards comparison between 3wCP and 3wC, this was not significant on multivariate analysis. Completion of six planned chemotherapy cycles was achieved by the majority, with similar discontinuation rates between groups (13% 3wC vs 8% 3wCP, p>0.05). Overall grade ≥3 hematological toxicity rates were similar between regimens (33% 3wC vs 44% 3wCP, p=0.37) with grade ≥3 neutropenia (p=0.019) and grade ≥3 thrombocytopenia (p=0.006) more common with 3wCP and 3wC, respectively. No treatment-related deaths occurred.</p><p><strong>Conclusion: </strong>Our data demonstrates that standard 3wCP is a well-tolerated, feasible first-line treatment for frail, elderly ovarian cancer patients. Improved survival with 3wCP was not significant when corrected for established clinical prognostic factors.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101853"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132682","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 characteristics and prognosis of rhabdomyosarcoma in the female reproductive system: a population-based analysis using SEER data.","authors":"Xinyan Gao, Yan Kong, Ying Ning, Zhumei Cui, Ke Lei, Tian Tian","doi":"10.1016/j.ijgc.2025.101989","DOIUrl":"10.1016/j.ijgc.2025.101989","url":null,"abstract":"<p><strong>Objective: </strong>Rhabdomyosarcoma of the female reproductive system is rare, and as a result, management strategies are unclear. In this study, we categorized rhabdomyosarcoma based on location (cervical, uterine, vulvovaginal) and analyzed prognostic factors to guide individualized treatment.</p><p><strong>Methods: </strong>Data from the Surveillance, Epidemiology, and End Results database (2000-2021) were used to identify patients with cervical, uterine, and vulvovaginal rhabdomyosarcoma. Multivariate Cox regression identified prognostic factors, and Kaplan-Meier analysis assessed overall survival and disease-specific survival.</p><p><strong>Results: </strong>For cervical rhabdomyosarcoma (n = 76), radical surgery improved disease-specific survival (91.9% vs 62.8%, p = .005), but conservative surgery was sufficient for patients aged <49 years, with a tumor diameter <4 cm, or with the embryonal subtype. In uterine rhabdomyosarcoma (n = 253), the embryonal subtype showed better overall survival (62.3% vs 23%, p < .0001) and disease-specific survival (65.9% vs 31%, p < .0001), especially for tumors ≤14 cm. For vulvovaginal rhabdomyosarcoma (n = 60), no survival differences were observed between local and radical surgery in patients aged <16 years or with tumors <8 cm. Adjuvant chemotherapy in cervical rhabdomyosarcoma has been shown to enhance the overall survival rate of patients undergoing radical surgery; however, radiotherapy appears to diminish their overall survival outcomes. In the case of uterine rhabdomyosarcoma of the embryonic subtype, chemotherapy concurrently improves both overall and disease-specific survival rates, while radiotherapy does not demonstrate a significant impact. For vulvovaginal rhabdomyosarcoma, chemotherapy is effective in improving the overall survival rate among non-surgical patients, whereas radiotherapy shows no effect on the survival outcomes across all subgroups.</p><p><strong>Conclusions: </strong>Conservative treatment is suitable for young patients with cervical rhabdomyosarcoma who have small tumors or the embryonal subtype, while radical surgery benefits the overall population. Embryonal uterine rhabdomyosarcoma has better outcomes, and young patients with vulvovaginal rhabdomyosarcoma of the embryonal subtype can undergo local surgery. For these 3 sites, chemotherapy is indispensable, while radiotherapy should be administered with caution.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 9","pages":"101989"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667613","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":"Trusting emulated trials: when real-world data predict real-world results in ovarian cancer.","authors":"Floriane Jochum, Anne-Sophie Hamy, Elise Dumas, Paul Gougis, Cherif Akladios","doi":"10.1016/j.ijgc.2025.102006","DOIUrl":"10.1016/j.ijgc.2025.102006","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 9","pages":"102006"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764817","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":"PPP2R1A mutation status as a predictive and prognostic factor in molecularly characterized endometrial carcinoma: a cohort study.","authors":"Masuma Khatun, Annukka Pasanen, Anna Kanerva, Riitta Koivisto-Korander, Taru Tuomi, Ralf Bützow, Mikko Loukovaara","doi":"10.1016/j.ijgc.2025.101934","DOIUrl":"10.1016/j.ijgc.2025.101934","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate associations of mutations in PPP2R1A, encoding the Aα subunit of protein phosphatase 2A (PP2A), with molecular sub-groups, clinicopathologic factors, predictive/prognostic biomarkers, and survival in endometrial carcinoma.</p><p><strong>Methods: </strong>This retrospective study used sequencing, immunohistochemistry, and dual-color chromogenic in situ hybridization to assess PPP2R1A mutations, molecular sub-groups, and PD-L1, human epidermal growth factor receptor 2 (HER2), estrogen receptor, and L1 cell adhesion molecule status.</p><p><strong>Results: </strong>A total of 436 patients were analyzed (median follow-up: 48 months). A total of 37 tumors (8.4%) harbored PPP2R1A mutations. They were associated with stage II to IV disease (p = .010), molecular sub-group (p < .001), and histotype (p < .001). Among PPP2R1A-mutated tumors, 54.1% (n = 20) were p53-abnormal, and 40.5% (n = 15) were non-endometrioid. Mismatch repair, PD-L1, HER2, and L1 cell adhesion molecule status did not differ between the PPP2R1A-mutated and wild-type groups. Estrogen receptor expression was more common in wild-type tumors (p = .003). Of the 33 PPP2R1A-mutated tumors with known mismatch repair and PD-L1 immunohistochemistry and HER2 amplification status, 51.5% (n = 17) were negative for all signatures. When estrogen receptor was included as a predictive parameter, 13.3% (4 of 30) were negative for all 4. PPP2R1A mutations were associated with poorer progression-free (p = .001) and disease-specific survival (p < .001) but not overall survival (p = .058). After adjusting for molecular sub-groups and clinicopathological risk groups, PPP2R1A mutations were not associated with outcomes. Among PPP2R1A-mutated tumors, p53 abnormalities were associated with poorer outcomes than the p53 wild-type phenotype.</p><p><strong>Conclusions: </strong>Although PPP2R1A mutations are linked to aggressive clinicopathological features, they do not independently predict endometrial carcinoma survival. Given the absence of non-hormonal targets in half of PPP2R1A-mutated carcinomas, PP2A-targeted therapies are needed. Survival analysis suggests that the role of p53 in progression likely extends beyond its interaction with PP2A.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101934"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225410","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":"Advanced cytoreductive procedures: patient positioning and exposition maneuvers in 10 steps.","authors":"Ana Luzarraga Aznar, Vicente Bebia, Ursula Acosta, Giulio Bonaldo, José Luis Sánchez-Iglesias, Asunción Pérez-Benavente, Antonio Gil-Moreno, Gwenael Ferron, Martina Aida Angeles","doi":"10.1136/ijgc-2024-005886","DOIUrl":"10.1136/ijgc-2024-005886","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101877"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046606","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":"A cost-effectiveness analysis of sentinel lymph node biopsy compared with lymphadenectomy in intermediate- and high- risk endometrial carcinoma.","authors":"Pernille Bjerre Trent, Ane Gerda Eriksson, Anne Cathrine Staff, Knut Erling Juul-Hansen, Emily Annika Burger, Knut Reidar Wangen","doi":"10.1136/ijgc-2024-005906","DOIUrl":"10.1136/ijgc-2024-005906","url":null,"abstract":"<p><strong>Background: </strong>Sentinel lymph node biopsy (SLN) is increasingly used for surgical staging of endometrial carcinoma.</p><p><strong>Objective: </strong>To estimate the effect and cost-effectiveness of the implementation of an SLN algorithm for surgical staging in patients with intermediate- and high-risk endometrial carcinoma compared with lymphadenectomy.</p><p><strong>Methods: </strong>We performed a model-based, cost-effectiveness analysis using primary data from a tertiary referral hospital that included 829 patients with endometrial carcinoma undergoing surgical staging. We quantified the health and economic outcomes from two time periods, before and after implementation of the SLN algorithm by robotic surgery. Costs were measured directly from the hospital's financial department, while long-term health outcomes were estimated using self-reported lymphedema and health-related quality-of-life among survivors. Sensitivity analyses were conducted to evaluate uncertainty.</p><p><strong>Results: </strong>We projected that the SLN implementation period, predominately reflecting use of robotic SLN, simultaneously improved health outcomes (0.08 incremental quality-adjusted life-years) and lowered costs (US$1051) compared with the prior period involving robotic or open lymphadenectomy. SLN remained more beneficial and less costly across key sensitivity analyses-namely, varying the cost of the robotic platform, surgical equipment, number of yearly robotic procedures, percentage of robotic procedures versus percentage of laparotomies, length of stay, and lymphedema development. After 1000 simulations of the model, SLN implementation provided greater health benefits for lower costs (ie, cost saving) in 89% of simulations.</p><p><strong>Conclusion: </strong>Implementation of an SLN algorithm in the staging of intermediate- and high-risk endometrial carcinoma improved health outcomes for lower costs compared with lymphadenectomy. Cost-effectiveness could further improve by continuing to increase the proportion of robotic procedures.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101867"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464670","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}