Journal of Gynecologic Oncology最新文献

{"title":"Evolving epidemiology and prognostic impact of young age in endometrial cancer: a multicenter retrospective study.","authors":"Yaoyuan Cui, Yu Fu, Gang Chen, Chaoyang Sun","doi":"10.3802/jgo.2026.37.e123","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e123","url":null,"abstract":"<p><strong>Objective: </strong>This multicenter retrospective study characterized epidemiological trends and high-risk factors in endometrial cancer (EC) in China from 2000 to 2019, and evaluated whether young age (≤45 years) is an independent prognostic factor, with tumor aggressiveness as a potential mediator.</p><p><strong>Methods: </strong>We reviewed records of 16,798 EC patients from 29 centers; 11,019 with complete clinical data were included for survival analysis. Propensity score matching (PSM) balanced clinicopathological features between patients aged ≤45 and >45 years. Kaplan-Meier and multivariable Cox models assessed survival. Mediation analysis used a latent variable for tumor aggressiveness, incorporating grade, lymphovascular space invasion (LVSI), and myometrial invasion depth.</p><p><strong>Results: </strong>EC incidence markedly increased, with a modest decline in mean age at diagnosis. Patients aged ≤45 years exhibited less aggressive tumors: higher proportions of G1/G2 histology, absence of LVSI, and superficial myometrial invasion (all p<0.001). After PSM, which yielded 1,432 matched pairs, young age remained independently associated with improved overall survival (hazard ratio [HR]=0.54; 95% confidence interval [CI]=0.39-0.75; p=0.001) and disease-free survival (HR=0.64; 95% CI=0.46-0.89; p=0.008). Tumor aggressiveness significantly mediated the age-survival association (indirect effect coefficient, -0.101; p<0.001), accounting for a substantial portion of the survival advantage.</p><p><strong>Conclusion: </strong>EC incidence is rising and age at diagnosis is declining in China. Young age is an independent prognostic factor for improved survival, with part of the benefit attributable to less aggressive tumor phenotypes. These findings support integrating age into risk stratification and developing age-stratified management strategies.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816123","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":"P16/Ki67 dual staining versus cytology for identifying high-grade cervical intraepithelial neoplasia (CIN2+/CIN3+) in triage management of HR-HPV-positive women: a systematic review and meta-analysis.","authors":"Hang Zhou, Yu Dai, Hua Zhang, Yuan Yang, Ruoji Pi, Lingling Zhu, Wen Chen","doi":"10.3802/jgo.2026.37.e68","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e68","url":null,"abstract":"<p><strong>Objective: </strong>The co-expression of P16 and Ki67 suggests the presence of high-grade cervical intraepithelial neoplasia, which makes P16/Ki67 dual staining a promising marker in cervical cancer screening. This study provides a systemic review of the established evidence on the performance of P16/Ki67 versus cytology in detecting cervical intraepithelial neoplasia (CIN)2+/CIN3+ among high-risk human papillomavirus (HR-HPV)-positive women and HR-HPV-positive individuals with cytology-negative results for triage management.</p><p><strong>Methods: </strong>Studies published from database inception to April 26, 2024, were systematically searched. A total of 26 studies were eventually included in the study, comprising 26,424 women, with 14,625 classified as P16/Ki67-positive and 11,799 as P16/Ki67-negative.</p><p><strong>Results: </strong>In the triage management of HR-HPV-positive women, P16/Ki67 achieved sensitivities of 85% for CIN2+ and 88% for CIN3+, with specificities of 63% and 57%, respectively. In comparison, cytology showed lower sensitivities of 76% for CIN2+ and 79% for CIN3+, with lower specificities of 57% and 54%. In triage management of human papillomavirus (HPV)-positive but cytology-negative women, 18.48% of the HPV-positive patients, initially missed by cytology, were correctly retrieved by the addition of P16/Ki67. A negative P16/Ki67 test result reduced the risk of underlying CIN3+ to 4% for HR-HPV-positive individuals and 1% for the HR-HPV-positive individuals with cytology-negative results, prompting a recommendation for follow-up at 1-year intervals.</p><p><strong>Conclusion: </strong>P16/Ki67 exhibits diagnostic superiority over liquid-based cytology in detecting CIN2+/CIN3+, among HR-HPV-positive women. Furthermore, its ability to identify patients missed by cytology highlights its value as a complementary tool for triage of HR-HPV-positive but cytology-negative population. By effectively reducing unnecessary colposcopy referrals, P16/Ki67 conserves healthcare resources and improves outcomes.</p><p><strong>Trial registration: </strong>PROSPERO Identifier: CRD42024567623.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699050","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 an homologous recombination deficiency scoring algorithm for unmatched ovarian tumor sample based on next-generation sequencing.","authors":"Zhizhong Wang, XinXin Yang, Taoran Cheng, Junnan Feng, Jinxiang Zheng, Tingjie Wang, Mingye Zhang, Hongxue Meng, Cai Jiang, Bing Wei","doi":"10.3802/jgo.2026.37.e97","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e97","url":null,"abstract":"<p><strong>Objective: </strong>Poly (ADP-ribose) polymerase inhibitors (PARPis) have emerged as a novel targeted therapy, necessitating the development of PARPi sensitivity tests for clinical application. However, the requirement for matched normal tissue complicates clinical testing procedures and increases the burden on patients. In this study, we optimized a bioinformatics algorithm utilizing the Panel of Normals to accommodate tumor-only scenarios.</p><p><strong>Methods: </strong>Paired samples from both clinical (Chinese population) and International Cancer Genome Consortium (ICGC) databases (Caucasian population) were employed to establish training cohorts. The tumor-only algorithm was developed based on these cohorts. The performance of the tumor-only algorithm was evaluated through linear regression against the paired sample algorithm. The validity of both algorithms was tested using progression-free survival data from patients treated with PARPis. Additionally, clinical samples from an independent institution were utilized to further validate the tumor-only algorithm.</p><p><strong>Results: </strong>In the training sets, we observed high correlations between the tumor-only and paired sample algorithms regarding tumoral purity and homologous recombination deficiency (HRD) scores, with most R² values exceeding 0.9. In the validation set, a slight decrease in correlation was noted, although the majority of R² values remained close to 0.9. Both algorithms effectively distinguished PARPi-sensitive patients. No statistically significant differences were identified between the training and validation cohorts concerning clinical characteristics. Cross-racial validation yielded similar results.</p><p><strong>Conclusion: </strong>The tumor-only algorithm demonstrated an equivalent capacity to the paired sample algorithm for classifying HRD status in ovarian cancer. This algorithm also showed cross-racial applicability, highlighting its potential for clinical use.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698978","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 significance of psoas muscle index at diagnosis in cervical cancer progression.","authors":"Seon-Mi Lee, Hyunkyoung Seo, Seongmin Kim, Hyun-Woong Cho, Kyung-Jin Min, Sanghoon Lee, Jin-Hwa Hong, Jae-Yun Song, Jae-Kwan Lee, Nak-Woo Lee","doi":"10.3802/jgo.2026.37.e95","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e95","url":null,"abstract":"<p><strong>Objective: </strong>To assess whether the psoas muscle index (PMI) measured using computed tomography (CT) at diagnosis can predict cancer progression and overall survival (OS) in patients with cervical cancer.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of patients diagnosed with cervical cancer at Korea University Anam Hospital from January 2019 to December 2023. Patients with incomplete data or those who were lost to follow-up were excluded. PMI was measured on axial CT images at the third lumbar vertebral (L3) level at diagnosis, defined as the sum of bilateral psoas diameters normalized to height squared (m²), and a cutoff value of 35 mm/m² was used to classify patients into low and high PMI groups. Survival outcomes were assessed using Kaplan-Meier analysis and the log-rank test. Cox proportional hazards models were used to identify prognostic factors.</p><p><strong>Results: </strong>Of the 178 patients, 92 were in the low PMI group and 86 in the high PMI group. Higher PMI was associated with significantly prolonged disease-free survival (DFS) (p<0.001), but not with OS (p=0.395). In multivariate Cox regression analysis, higher PMI independently predicted a lower likelihood of disease progression (adjusted hazard ratio, 0.30; p<0.001). However, PMI was not associated with OS.</p><p><strong>Conclusion: </strong>This study demonstrates that PMI measured at diagnosis may serve as a useful independent prognostic factor for cancer progression in patients with cervical cancer, particularly for predicting DFS.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645518","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":"Examining the relationship between cesarean section scar and endometrial cancer.","authors":"Keiichiro Nakamura, Yoshinori Tani, Hironori Itou, Miyuki Shimizu, Thi Hai Ly Dao, Hikari Nakato, Kazuhiro Okamoto, Chikako Ogawa, Eriko Eto, Hisashi Masuyama","doi":"10.3802/jgo.2026.37.e96","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e96","url":null,"abstract":"<p><strong>Objective: </strong>The incidence of endometrial cancer (EC) has been increasing annually. Studies have reported that cesarean section (CS) is associated with a higher risk of developing EC than vaginal delivery (VD). However, few studies have examined the relationship between CS and EC development.</p><p><strong>Methods: </strong>Data were extracted from the medical records of patients with EC and a history of childbirth who underwent EC treatment at 3 institutions. Factors contributing to EC development were analyzed between April 2010 and December 2024.</p><p><strong>Results: </strong>Among patients EC and a history of childbirth, 8.7% (69/794) had undergone CS, and 50.7% (35/69) developed a CS scar. Compared with patients who had a VD or those without a CS scar, patients with a CS scar showed significantly shorter intervals from delivery to EC onset (VD: p=0.013; non-CS scar: p=0.031). A narrower residual myometrial thickness/adjacent myometrial thickness (RMT/AMT) ratio of the CS scar was significantly associated with a shorter interval from the last delivery to EC onset (p=0.034) and was independently associated with earlier EC onset after the last delivery in both univariate and multivariate analyses (p<0.001 and p=0.030, respectively).</p><p><strong>Conclusion: </strong>A narrower RMT/AMT ratio in the CS scar was considerably associated with a shorter interval from the last delivery to EC onset.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645535","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":"Outcomes of node-positive cervical cancer treated with neoadjuvant chemotherapy followed by radical surgery: a single-center approach to a challenging disease.","authors":"Innocenza Palaia, Giorgia Perniola, Noemi Tonti, Federica Tomao, Angelina Pernazza, Giacomo Barchiesi, Lucia Manganaro, Francesca De Felice, Angela Musella, Giulia Paoni Saccone, Federica Tanzi, Sofia Mancini, Annarita Vestri, Danilo Alunni Fegatelli, Pierluigi Benedetti Panici, Ludovico Muzii, Violante Di Donato","doi":"10.3802/jgo.2026.37.e87","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e87","url":null,"abstract":"<p><strong>Objective: </strong>Chemoradiotherapy with brachytherapy (CCRT-B) is the standard treatment for locally advanced cervical cancer (LACC), but prognosis remains poor for patients with lymph node involvement (International Federation of Gynecology and Obstetrics [FIGO] stage IIIC1-2) and bulky disease. This study aimed to evaluate recurrence patterns, salvage therapies, and survival outcomes in patients with FIGO IIIC1-2 cervical cancer (CC) treated with platinum-based neoadjuvant chemotherapy (NACT) followed by radical surgery (RS), and to explore NACT + RS as a potential alternative to CCRT-B.</p><p><strong>Methods: </strong>This retrospective study included 97 patients with FIGO IIIC1-2 CC treated between 2012 and 2022 at Policlinico Umberto I, Rome. All patients received 3 cycles of platinum-based NACT followed by radical hysterectomy, bilateral salpingo-oophorectomy, and systematic pelvic lymphadenectomy, with para-aortic lymphadenectomy performed if indicated. Adjuvant radiotherapy was given in cases of positive vaginal or parametrial margins; chemotherapy or chemoradiotherapy was administered in patients with lymph node positivity after surgery.</p><p><strong>Results: </strong>With a median follow-up of 51 months, 33% of patients died from the disease, 5% from other causes, 58% were alive without disease, and 4% were alive with disease. The 2- and 5-year overall survival (OS) rates were 80.1% and 61.1%, respectively. Progression-free survival was 69.5% at 2 years and 58.5% at 5 years. Median OS after recurrence was 1.01 years. Recurrences occurred primarily in pelvic lymph nodes (22%) and central pelvis (9%).</p><p><strong>Conclusions: </strong>NACT followed by RS offers similar survival outcomes to CCRT-B in node-positive LACC and may be a viable alternative in specialized and well surgical-trained centers.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT06752135.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645538","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 phase II basket trial of Dual Anti-CTLA-4 and Anti-PD-1 Blockade in Rare Tumors (DART) SWOG S1609: vaginal cancer sub cohort results.","authors":"Young Kwang Chae, Josie Czeskleba, Sandip Pravin Patel, Alex Mentor, William Robinson, Nathaniel L Jones, Murtuza Rampurwala, Aung Naing, Joseph M Beck, Carolyn Moloney-Lineen, Liam Il-Young Chung, Christine M McLeod, Helen X Chen, Elad Sharon, Sara Threlkel, Megan Othus, Christopher W Ryan, Charles D Blanke, Razelle Kurzrock","doi":"10.3802/jgo.2026.37.e92","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e92","url":null,"abstract":"<p><strong>Objective: </strong>The SWOG S1609 Dual Anti-CTLA-4 &amp; Anti-PD-1 blockade in Rare Tumors (DART) trial is the first basket study to include a sub-cohort assessing ipilimumab and nivolumab in patients with primary vaginal cancers with differing histology.</p><p><strong>Methods: </strong>DART is a prospective, open-label, multicenter, multi-cohort phase II clinical trial of ipilimumab (1 mg/kg intravenously) 6 weekly plus nivolumab (240 mg intravenously) 2 weekly across multiple rare tumor cohorts, with the vagina cohort (any vaginal histology) reported here. The primary endpoint was objective response rate (ORR) per RECISTv1.1; progression-free survival (PFS), overall survival (OS), clinical benefit rate (CBR; overall response plus stable disease [SD] ≥6 months), and toxicity are secondary endpoints.</p><p><strong>Results: </strong>Seven evaluable patients (median age, 60 years; performance status 0-1; no prior exposure to immunotherapy) were analyzed, of whom 3 had adenocarcinoma, 2 had squamous cell carcinoma (SCC), one had small-cell carcinoma and one had undifferentiated histology. The ORR was 29%, with 1 patient (14%) with undifferentiated histology achieving complete response (lasting 14.8 months) and 1 patient with SCC histology (14%) attaining a partial response (lasting 45.2 months). The CBR was 43%. The 6-month PFS rate was 43% and the median OS was 11.7 months. Five patients (71.4%) experienced an adverse event (AE) with 4 (57.1%) having grade 3-4 AE's.</p><p><strong>Conclusion: </strong>Ipilimumab plus nivolumab showed efficacy (ORR was 29% and CBR of 43%) and durability (one patient with prolonged SD >6 months) in a sub cohort of patients with vaginal cancer of differing histology without new safety signals.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT02834013.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699011","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":"Significance of peritoneal washing cytology as a predictive factor for the long-term benefit of secondary debulking surgery in ovarian cancer.","authors":"Hiroaki Nagano, Akimasa Ichinoe","doi":"10.3802/jgo.2026.37.e94","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e94","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the significance of peritoneal washing cytology (PWC) as a predictive factor of the long-term benefits of secondary debulking surgery (SDS) for ovarian cancer (OC).</p><p><strong>Methods: </strong>We retrospectively reviewed the clinical records of patients with OC who underwent SDS for intraperitoneal recurrence (IPR). Various clinical data points were investigated, including the residual tumor size at SDS, PWC results at SDS, progression-free survival (PFS), and overall survival (OS).</p><p><strong>Results: </strong>Between 2007 and 2022, 207 patients with ovarian, fallopian, or peritoneal cancers were treated at our institution. IPR occurred in 49 patients, 20 of whom underwent SDS. This study included 18 patients, excluding 2 patients with squamous cell carcinoma. Complete resection of the SDS was achieved in 15 patients. PWC was negative in 12 patients but positive in 6; ascites was not observed in any patient. IPR occurred in all PWC-positive patients after SDS, although 3 patients had no residual tumors. In contrast, only 4 of the 12 PWC-negative patients (all without residual tumors) experienced IPR during follow-up (median: 78 months), 2 of whom had secondary IPR at SDS. The association between PWC and IPR after SDS was significant (p=0.009, Fisher's exact test). The PFS and OS after SDS were significantly higher in the PWC-negative group than in the PWC-positive group.</p><p><strong>Conclusion: </strong>PWC is a significant predictor of the long-term benefit of SDS in patients with OC and IPR.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645506","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":"Adjuvant concurrent chemoradiotherapy for early-stage cervical cancer patients with intermediate-risk factors in the era of intensity-modulated radiation therapy.","authors":"Sitong Wang, Gui-Fen Ma, Chunli Xiao, Juan Liu, Tingyan Shi, Li Ma, Gen-Lai Lin","doi":"10.3802/jgo.2026.37.e93","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e93","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate whether adjuvant concurrent chemotherapy with pelvic intensity-modulated radiotherapy (IMRT) improves the outcome of patients with early-stage cervical cancer with intermediate risk factors (IRFs) compared with IMRT alone.</p><p><strong>Methods: </strong>This study included a cohort of 244 women from January 2012 to October 2023 who underwent radical hysterectomy along with pelvic lymph node dissection (PLND) for stage IB-IIA cervical cancer with IRFs. One hundred thirty-nine patients were postoperatively treated with pelvic IMRT (45.0-50.4 Gy) and adjuvant concurrent chemoradiotherapy (CCRT) (weekly cisplatin or weekly or triweekly combination of paclitaxel and cisplatin). One hundred five patients were treated with pelvic IMRT alone. The significance of clinical parameters, overall survival (OS), and recurrence-free survival (RFS) of each arm were analyzed.</p><p><strong>Results: </strong>The median follow-up period was 61.2 months, with a range spanning from 6.3 to 144.4 months. The 5-year OS rates in the patients in the radiotherapy (RT) and CCRT arms were 96.7% and 94.4%, respectively (p=0.271). Five-year RFS was 88.1% in the RT arm and 86.9% in the CCRT arm (p=0.740). Multivariate analysis identified adenocarcinoma (AC) histology as the only significant prognostic factor affecting OS and RFS.</p><p><strong>Conclusion: </strong>This study demonstrates that even in the era of IMRT, CCRT is not more effective than RT alone in patients with stage IB-IIA cervical cancer with IRFs following radical hysterectomy with PLND.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645510","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":"Enhanced ovarian cancer diagnosis using deep learning on pelvic ultrasound with integrated clinical data: retrospective multicenter study.","authors":"Sohyeon Jeong, Hyewon Cho, Jooyeon Kim, Sanghoon Lee, Jae Yun Song, Jin Hwa Hong, Jae Kwan Lee, Seon Kyung Kim, Hyun-Woong Cho","doi":"10.3802/jgo.2026.37.e84","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e84","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop a deep learning (DL) model to enhance the differential diagnosis of benign and malignant ovarian tumors by integrating pelvic ultrasound images with clinical data, such as age and cancer antigen (CA)-125 levels.</p><p><strong>Methods: </strong>We analyzed pelvic ultrasound images, age, and CA-125 levels from 804 patients diagnosed with ovarian tumors (446 benign, 358 malignant) from 2015 to 2022. Images were segmented into cystic and solid components for feature extraction. Patients were divided into training (n=565), validation (n=76), and test datasets (n=163). ResNet50 and DenseNet121 models were trained on these data, with clinical information added to classifier architecture for improved prediction accuracy.</p><p><strong>Results: </strong>Using ultrasound images alone, ResNet50 and DenseNet121 achieved areas under the receiver operating characteristic curve (AUCs) of 0.84 and 0.82, respectively. When clinical data and segmented solid images were included, AUCs improved to 0.95 for ResNet50 and 0.96 for DenseNet121. For the test set, ResNet50 and DenseNet121 achieved sensitivities of 90% and 81%, specificities of 93% and 97%, positive predictive values of 92% and 95%, and negative predictive values of 92% and 86%.</p><p><strong>Conclusion: </strong>Binary classification model based on DL algorithms using ultrasound images can distinguish between benign and malignant ovarian tumors accurately. Segmentation of solid portion and clinical information of age and CA-125 at diagnosis combined with the pelvic ultrasound images increased the accuracy of the classification model.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574210","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}