International Journal of Gynecological Cancer最新文献

{"title":"Multi-center, international endometrial cancer consortium highlights.","authors":"Luigi De Vitis, Anna Giudici, Vincenzo Tarantino, Stuart Ostby, Kelly Bruce, Daniel Breitkopf, Alexander Olawaiye, Ramez N Eskander, Robert L Coleman, Amir Momeni-Boroujeni, Michael Deavers, Maryam Shahi, Giovanni Scambia, Giorgia Dinoi, Matthew Powell, John Weroha, Lora H Ellenson, Behrouz Zand, Amanika Kumar, Jessica Gorzelitz, Jennifer Mueller, Angelica Nogueira-Rodrigues, Mario M Leitao, Karolina Kilowski, Allison Garda, Kaled Alektiar, Evelyn Reynolds, Andrea E Wahner Hendrickson, David Mutch, Nadeem R Abu-Rustum, Pedro T Ramirez, Andrea Mariani, Gretchen E Glaser","doi":"10.1016/j.ijgc.2025.101805","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101805","url":null,"abstract":"<p><p>The multi-center, international consortium on endometrial cancer held in January 2025 at Mayo Clinic in Rochester, Minnesota brought together leading experts in gynecologic oncology to explore the latest advancements in the understanding, diagnosis, and treatment of endometrial cancer. Discussions centered on key topics, including updates in molecular testing and disease staging, emerging treatment strategies for advanced and recurrent disease, fertility-sparing management, and critical pathology challenges, particularly, the assessment of lympho-vascular space invasion. Each topic was examined in dedicated working group sessions, fostering in-depth exchanges to identify research priorities and develop actionable strategies. This summary highlights the central themes and insights from the meeting, outlining a roadmap for future advancements in the field. By promoting inter-disciplinary collaboration, the meeting laid the foundation for future research, policy recommendations, and clinical innovations aimed at improving patient outcomes.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 5","pages":"101805"},"PeriodicalIF":4.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012281","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":"Role of lymphadenectomy for apparent early-stage low-grade serous ovarian carcinoma.","authors":"Elizabeth Tubridy, Stefan Gysler, Nawar A Latif, Emily M Ko, Robert L Giuntoli, Sarah H Kim, Dimitrios Nasioudis","doi":"10.1016/j.ijgc.2025.101798","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101798","url":null,"abstract":"<p><strong>Objective: </strong>Investigate the prevalence of lymph node metastasis and impact of lymphadenectomy on the survival of patients with apparent early-stage low-grade serous ovarian carcinoma.</p><p><strong>Methods: </strong>Patients with apparent early-stage low-grade serous ovarian carcinoma diagnosed between 2004 and 2015 were identified in the National Cancer Database. The performance of lymphadenectomy and incidence of lymph node metastasis were assessed from pathology report. Overall survival was compared with the log-rank test, and a Cox model was constructed to control for a priori selected confounders.</p><p><strong>Results: </strong>A total of 977 patients were identified. The rate of lymphadenectomy was 65.9%, whereas the median number of lymph nodes removed was 12. There were no differences between patients who did and did not undergo lymphadenectomy in terms of patient age, race, insurance status, apparent disease stage, and type of treatment facility. The rate of adjuvant chemotherapy use was higher in patients who underwent lymphadenectomy (33.5% vs 26.4%, p = .024). The overall incidence of lymphadenectomy metastasis was 7.5%, which was higher in patients with stage IC (10.1%) than in those with stage IA disease (5.6%), p = .031. Patients who underwent lymphadenectomy had better overall survival than those who had did not, p < .001; the 5-year overall survival rates were 91.6% and 83.3%, respectively. After controlling for confounders, performance of lymphadenectomy was associated with better overall survival (HR 0.67, 95% CI 0.48-0.93).</p><p><strong>Conclusions: </strong>The incidence of lymph node metastases among apparent early-stage low-grade serous ovarian carcinoma is not negligible, especially in patients with apparent stage IC disease. Performance of lymphadenectomy may be associated with a survival benefit likely secondary to stage migration.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 5","pages":"101798"},"PeriodicalIF":4.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966238","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":"Tumor-intrinsic chemosensitivity assessed by KELIM and prognosis by BRCA status in patients with advanced ovarian carcinomas.","authors":"Ondine Becker, Alice Durand, Marion Chevrier, Laetitia Collet, Laurence Gladieff, Florence Joly, Baptiste Sauterey, Christophe Pomel, Hélène Costaz, Patricia Pautier, Cécile Guillemet, Thibault de la Motte Rouge, Renaud Sabatier, Jean-Marc Classe, Thierry Petit, Eric Leblanc, Frédéric Marchal, Pierre-Emmanuel Colombo, Emmanuel Barranger, Aude-Marie Savoye, Lise Bosquet, Isabelle Ray-Coquard, Matthieu Carton, Oliver Colomban, Benoit You, Manuel Rodrigues","doi":"10.1136/ijgc-2024-005815","DOIUrl":"10.1136/ijgc-2024-005815","url":null,"abstract":"<p><strong>Objective: </strong>Treatment of high-grade serous ovarian carcinomas relies on surgery and chemotherapy, potentially followed by bevacizumab and/or poly (ADP-ribose) polymerase inhibitors (PARPi). The modeled CA-125 ELIMination rate constant K (KELIM) is a pragmatic indicator of tumor primary chemosensitivity. Although it is well established that BRCA mutations are associated with platinum sensitivity, the relationship between BRCA status and KELIM score has yet to be elucidated. This study aimed to evaluate the interactions between BRCA and KELIM, and their respective prognostic values.</p><p><strong>Methods: </strong>We retrospectively collected data from 743 patients with high-grade serous ovarian carcinomas included in a French nationwide registry (NCT03275298) treated with neoadjuvant platinum-based chemotherapy followed by surgery. We analyzed the interactions between BRCA and KELIM, and their impacts on progression-free survival and overall survival.</p><p><strong>Results: </strong>BRCA-mutated (BRCAm) patients had higher standardized KELIM than BRCA-wild type (BRCAwt) tumors (median 1.16 vs 1.06, respectively; p=0.001). The prognostic value of the KELIM score was independent of BRCA in multivariate analyses. KELIM score and BRCA could be combined to define three prognostic groups: (1) an unfavorable prognostic group with both BRCAwt and unfavorable KELIM (median progression-free survival 12.0months); (2) an intermediate prognostic group with either BRCAm and unfavorable KELIM, or BRCAwt and favorable KELIM (median progression-free survival of 16.0 and 18.8months, respectively; HR 0.64 compared with the unfavorable group, p<0.001); and (3) a favorable prognostic group with both BRCAm and favorable KELIM (median progression-free survival 28.8 months; HR 0.37 compared with the unfavorable group, p<0.001).</p><p><strong>Conclusions: </strong>The KELIM score provides complementary prognostic information with respect to BRCA, and discriminates different prognoses within BRCAm or BRCAwt patients. Patients with both BRCAwt/unfavorable KELIM have a poor prognosis, underscoring the urgent need for novel therapeutic strategies.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101866"},"PeriodicalIF":4.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557818","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":"Regression of high-grade squamous intraepithelial cervical lesions and associated risk factors (RECER).","authors":"Lukas Dostalek, Daniel Brynda, Radim Marek, Julia Hederlingova, Irina Tripac, Kristyna Nemejcova, Miroslava Slovackova, Tomas Zima, David Cibula, Jiri Slama","doi":"10.1016/j.ijgc.2025.101768","DOIUrl":"10.1016/j.ijgc.2025.101768","url":null,"abstract":"<p><strong>Background: </strong>Avoiding conization may reduce the risk of pre-term labor in future pregnancies, making conservative treatment of high-grade cervical dysplasia an increasingly discussed approach, especially for younger patients. However, data on the integration of individual predictive factors into routine clinical practice remain limited.</p><p><strong>Primary objective: </strong>The primary objective of the Regression of High-Grade Squamous Intraepithelial Cervical Lesions and Associated Risk Factors (RECER) study is to assess the rate of spontaneous regression in high-grade cervical squamous dysplasia (cervical intraepithelial neoplasia [CIN] 2 and 3) and identify associated predictive factors within clinical practice, without necessitating conization.</p><p><strong>Study hypothesis: </strong>We hypothesize that the characterization of cervical lesions, including colposcopic findings and patient-specific factors, along with a sufficient rate of spontaneous regression, will aid in identifying a subgroup of patients who may derive the greatest benefit from conservative management of high-grade cervical lesions.</p><p><strong>Trial design: </strong>The RECER trial is a multi-center prospective cohort study. Patients with histologically confirmed high-grade squamous intraepithelial lesions (CIN 2 or 3) undergo colposcopic assessments every 4 months. Colposcopic images are compared to evaluate lesion dynamics. In case of progression, conization is indicated, whereas in case of regression, documentation of a biopsy with low-grade dysplasia (CIN 1) or no dysplasia is required. Patients with stable disease are further followed up.</p><p><strong>Major inclusion/exclusion criteria: </strong>Patients aged 18 to 40 years with bioptically confirmed high-grade lesion (CIN 2 or 3), a fully visible squamo-columnar junction, and a willingness to undergo conservative management can be included. Excluded are patients with unsatisfactory colposcopy, pregnancy, glandular lesions, invasive disease, or a history of treatment for severe cervical dysplasia.</p><p><strong>Primary endpoint: </strong>The primary end point is the regression rate of high-grade cervical dysplasia.</p><p><strong>Sample size: </strong>300 patients ESTIMATED DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS: As of October 2024, a total of 127 patients have been recruited from 4 participating sites across 3 countries. Estimated date of last patient enrollment: September 2026; estimated date for results presentation: January 2028.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov: NCT06147388.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 5","pages":"101768"},"PeriodicalIF":4.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001119","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":"Sentinel SENECA risk factors for unsuccessful bi-lateral sentinel lymph node mapping in endometrial cancer.","authors":"Félix Boria, Enrique Chacón, R Rajagopalan Iyer, Francesco Fanfani, Francesca Falcone, Petra Bretová, Ana Luzarraga Aznar, Robert Fruscio, Marcin Jedryka, Richard Tóth, Artem Stepanyan, Gurkan Kiran, Cecilia Darin, Agnieszka Rychlik, Ester Miralpeix, Meriem Koual, Roberto Berretta, Natalia Anna Palasz, Duska Beric, Dimitrios Tsolakidis, Soledad Fidalgo, Richard Schwameis, Somashekhar Sp, Ibrahim Yalcin, Radovan Pilka, Cagatay Taskiran, Despoina Myoteri, Estibaliz Iza Rodriguez, Dariusz G Wydra, Silvia Catot, Mathias Fehr, Frederic Goffin, Maria Ercilia Ibarra, Stamatios Petousis, Enrique Moratalla Bartolomé, Mareike Bommert, Alfonso Quesada, Shamistan Aliyev, José Ángel Mínguez, Luis Chiva","doi":"10.1016/j.ijgc.2025.101771","DOIUrl":"10.1016/j.ijgc.2025.101771","url":null,"abstract":"<p><strong>Objective: </strong>Our study aims to assess the risk factors associated with bi-lateral sentinel lymph node (SLN) mapping failure in endometrial cancer.</p><p><strong>Methods: </strong>The SENECA study was a retrospective multi-center international observational study that reviewed data from 2139 women with clinical stage I-to-II endometrial cancer across 64 centers in 17 countries. Between January 2021 and December 2022, patients underwent surgical treatment with SLN assessment, following the guidelines of the European Society of Gynaecological Oncology. Risk factors associated with the absence of bi-lateral mapping were analyzed using χ² and t tests. All factors that showed statistical associations were included in a multi-variate regression analysis.</p><p><strong>Results: </strong>Among the 2139 patients, the bi-lateral lymph node detection rate was 82.7%, whereas the unilateral detection rate was 97.3%. In multi-variate analysis, 5 risk factors remained statistically associated with unsuccessful bi-lateral lymph node mapping: high-grade histology (OR 1.35, 95% CI 1.02 to 1.79, p=.03), myometrial invasion >50% (OR 1.37, 95% CI 1.07 to 1.75, p=.012), low-volume surgeon <20 cases/year (OR 2.11, 95% CI 1.55 to 2.89, p<.01), open surgical approach (OR 1.72, 95% CI 1.06 to 2.78 , p=.03), and non-indocyanine green tracer (OR 4.59, 95% CI 2.64 to 7.99, p<.01). The addition of bi-lateral pelvic lymphadenectomy and/or paraaortic lymphadenectomy to SLN biopsy caused an increased rate of intra-operative complications (2% vs 8.4%, p<.01) and all-grade post-operative complications (4.1% vs 11.2%, p<.01).</p><p><strong>Conclusions: </strong>Our study identifies 5 risk factors associated with unsuccessful lymph node mapping in endometrial cancer. Efforts should be made to perform this technique with indocyanine green, through minimally invasive surgery, and performed or supervised by an experienced surgeon with ≥20 endometrial cancer cases per year.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101771"},"PeriodicalIF":4.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795460","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":"Surgical resection of a hepato-gastric recurrence of a high-grade serous ovarian cancer.","authors":"Giulio Ricotta, Elodie Gauroy, Mathilde Del, Gwenaël Ferron, Emmanuel Cuellar, Alejandra Martinez","doi":"10.1016/j.ijgc.2025.101896","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101896","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":"101896"},"PeriodicalIF":4.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158574","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":"Highlights from the 26th European Congress on Gynaecological Oncology in Rome: interview compilation of the ENYGO-IJGC editorial fellows.","authors":"Martina Aida Angeles, Esra Bilir, Ilker Kahramanoglu, Helena Obermair, Alexander Shushkevich, Núria Agustí, Aleksandra Strojna, Ana Luzarraga Aznar, David Viveros-Carreño, Nicolò Bizzarri, Andrej Cokan, Houssein El Hajj, Mathilde Del, Elena Rodríguez, Osnat Elyashiv, Stamatios Petousis, Joanna Kacperczyk-Bartnik, Manel Montesinos-Albert, Nadeem Abu-Rustum, Philipp Harter, Isabelle Ray-Coquard, Alejandra Martinez, David Cibula, Henrik Falconer, Rene Pareja, Claudia Marchetti, Murat Gultekin, Frédéric Amant, Mansoor Raza Mirza, Pedro T Ramirez","doi":"10.1016/j.ijgc.2025.101913","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101913","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101913"},"PeriodicalIF":4.1,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132280","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":"Accuracy of human papillomavirus testing using self-collected urine samples for detecting high-grade squamous intra-epithelial lesion or worse: a diagnostic meta-analysis.","authors":"Ke-Yu Hsiao, Hsiu-Ling Lin, Hui-Mei Chen, Cheng-Chieh Chen","doi":"10.1016/j.ijgc.2025.101904","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101904","url":null,"abstract":"<p><strong>Objective: </strong>Self-collection methods are regarded as a strategy to promote human papillomavirus (HPV) testing for cervical cancer screening. HPV testing using urine specimens is non-invasive and could eliminate barriers such as embarrassment and discomfort. However, concerns regarding the accuracy of this method persist. Hence, the current meta-analysis aims to verify the accuracy of urine HPV nucleic acid amplification testing.</p><p><strong>Methods: </strong>A comprehensive search was conducted in the PubMed, Embase, and Cochrane Library databases to identify studies that evaluated the performance of urine HPV nucleic acid amplification testing. The inclusion criteria were as follows: studies that evaluated the diagnostic accuracy of HPV testing for high-grade squamous intra-epithelial lesion or worse (HSIL+) with self-collected urine specimens. In addition, studies that provided sufficient data for conducting a meta-analysis were assessed. To ensure the rigor of the study, those using histopathology or colposcopy as the reference standard were deemed sufficiently rigorous for inclusion. The meta-analysis was conducted using the bi-variate random-effects model.</p><p><strong>Results: </strong>A total of 21 studies with 6603 samples were identified. The meta-analysis yielded a pooled sensitivity of 83.0% (95% CI 77.5% to 87.3%) and a pooled specificity of 51.3% (95% CI 39.2% to 63.3%) of HPV nucleic acid amplification testing with self-collected urine specimens for HSIL+. In terms of detection technology, a pooled sensitivity of 85.2% and a pooled specificity of 49.4% were obtained from the sub-group analysis of manuscripts that used DNA-based testing.</p><p><strong>Conclusions: </strong>Our meta-analysis indicates that urine HPV nucleic acid amplification testing achieves high sensitivity for detecting HSIL+. A notable benefit of DNA-based urine HPV nucleic acid amplification testing is its heightened sensitivity compared with RNA-based methods.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101904"},"PeriodicalIF":4.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093877","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":"FIGO 2023 classification of endometrial cancers: reflections from low- and middle-income countries.","authors":"Lawrencia Bawuah Dsane, Heleen van Beekhuizen, Jogchum Beltman, Augustine Tawiah, Dennis Sunten","doi":"10.1016/j.ijgc.2025.101910","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101910","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 7","pages":"101910"},"PeriodicalIF":4.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142261","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 role of molecular classification in endometrial cancer: a focus on patients with low-volume metastasis-a retrospective multi-center study and literature review.","authors":"Gabriella Schivardi, Giuseppe Caruso, Luigi A De Vitis, Giuseppe Cucinella, Emilia Palmieri, Angela J Fought, Michaela E McGree, Maryam Shahi, Francesco Multinu, Vanna Zanagnolo, Glauco Baiocchi, Louise De Brot, Jessica N McAlpine, Kathryn McRae, Tommaso Occhiali, Giuseppe Vizzielli, Rainer Kimmig, Tommaso Grassi, Robert Giuntoli, Andrea Mariani, Gretchen E Glaser","doi":"10.1016/j.ijgc.2025.101912","DOIUrl":"https://doi.org/10.1016/j.ijgc.2025.101912","url":null,"abstract":"<p><strong>Objective: </strong>The prognosis and optimal management of patients with endometrial cancer with low-volume lymph node metastases remains unclear, particularly, regarding the role of molecular classification. This study investigates the distribution and prognostic role of molecular classes in this cohort of patients, while reviewing existing literature on this topic.</p><p><strong>Methods: </strong>A multi-center, retrospective cohort study involving 8 institutions evaluated 134 patients with endometrial cancer and low-volume metastasis (isolated tumor cells: ≤0.2 mm in diameter or micro-metastasis: >0.2 to ≤2.0 mm). All patients were categorized into 1 of 4 molecular classes: POLE mutated (POLEmut), mismatch repair-deficient (MMRd), p53 abnormal (p53abn), and non-specific molecular profile (NSMP). Recurrence-free survival was estimated using Kaplan-Meier methods and differences between molecular classes were tested using log-rank test. Cox proportional hazards regression models were fit to evaluate the association between molecular class and recurrence after surgery.</p><p><strong>Results: </strong>Of 134 patients, 78 (58.2%) had isolated tumor cells and 56 (41.8%) had micro-metastasis. Molecular classification revealed 78 (58.2%) NSMP, 37 (27.6%) MMRd, 15 (11.2%) p53abn, and 4 (3.0%) POLEmut tumors. No significant differences in recurrence-free survival were observed among molecular classes (log-rank p = .52). At 5 years, recurrence-free survival rates were 84.6% for NSMP, 65.9% for MMRd, and 76.9% for p53abn. No recurrences occurred in POLEmut patients. Predictors of recurrence included micro-metastasis (p = .01) and lympho-vascular space invasion (p = .02), whereas molecular classification was not independently associated with recurrence. The literature review revealed insufficient data on this topic to draw definitive conclusions.</p><p><strong>Conclusions: </strong>Although molecular classification enhances risk stratification in endometrial cancer, its impact should be contextualized in patients with low-volume lymph node metastasis. Pathological factors, such as lymph node metastasis size and lympho-vascular space invasion, continue to represent a key predictor of recurrence. Integrating molecular data with traditional risk factors remains pivotal, especially in intermediate-risk molecular classes, to refine management strategies.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 6","pages":"101912"},"PeriodicalIF":4.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215765","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}