Journal of Gynecologic Oncology最新文献

{"title":"The activity of immune checkpoint inhibitors in patients with recurrent cervical cancer developed in previously irradiated field: clinical and immunohistochemical investigations.","authors":"Seiji Mabuchi, Naoko Komura, Harumi Nakamura, Michihide Maeda, Takeshi Yokoi, Shinsuke Koyama, Tomoko Ueda","doi":"10.3802/jgo.2026.37.e13","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e13","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to 1) evaluate the efficacy of immune checkpoint inhibitors (ICIs) in cervical cancer patients according to the site of disease, 2) investigate the mechanism responsible for differential ICIs sensitivities with focuses on CD8⁺ T lymphocytes and programmed death-ligand 1 (PD-L1) expression.</p><p><strong>Methods: </strong>We retrospectively reviewed clinical data from patients with recurrent or metastatic cervical cancer treated with pembrolizumab or cemiplimab between January 2019 and January 2024 (clinical cohort). Target diseases were classified according to the site of diseases: within previously irradiated field (in-field diseases), out-of-field diseases, and both. Immunohistochemical investigations were performed using paired tumor samples (i.e. initial cervical tumor and locally-recurrent tumor developed after definitive radiotherapy: Immunohistochemical cohort). Survival rates were estimated using the Kaplan-Meier method and compared using the log-rank test.</p><p><strong>Results: </strong>Fifty patients treated with pembrolizumab-containing chemotherapies (n=39) or cemiplimab (n=11) were assessed. Of these, six patients (12.0%) had in-field diseases alone, twenty-eight patients (56.0%) had out-of-field diseases, and the remaining sixteen (32%) patients had both types of diseases. In-field diseases demonstrated a significantly lower response rate compared to out-of-field diseases (36.3% vs. 72.7%, p=0.004). Patients with in-field diseases demonstrated significantly shorter progression-free survival (p=0.003) and overall survival (p=0.003) than those with out-of-field diseases. In-field diseases were associated with decreased tumor-infiltrating CD8⁺ T lymphocytes and PD-L1 expression.</p><p><strong>Conclusion: </strong>In-field cervical cancer recurrence was associated with decreased sensitivity to ICIs-containing chemotherapies when compared to out-of-field diseases. Decreased tumor-infiltrating CD8⁺ T lymphocytes and PD-L1 expression are possible reasons for this differential sensitivity to ICI-containing chemotherapies.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149334","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":"Diagnostic accuracy of intraoperative frozen section at radical abdominal trachelectomy for early-stage cervical cancer.","authors":"Risa Matsuda, Hiroshi Nishio, Akihisa Ueno, Tomoya Matsui, Takashi Iwata, Hajime Okita, Wataru Yamagami","doi":"10.3802/jgo.2026.37.e18","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e18","url":null,"abstract":"<p><strong>Objective: </strong>Intraoperative frozen section examination is crucial for confirming the oncological safety of radical abdominal trachelectomy (RAT) for early-stage cervical cancer. This study evaluated the diagnostic accuracy of frozen section during RAT at our institution.</p><p><strong>Methods: </strong>We retrospectively identified patients with International Federation of Gynecology and Obstetrics 2008 stage IA1-IB1 (tumor size ≤2 cm) cervical cancer treated between 2002 and 2021. In performing RAT, frozen section analysis was routinely performed on uterine surgical margins and grossly enlarged lymph nodes, and was confirmed to be negative. Medical records were reviewed to compare the frozen section diagnoses with the final pathology.</p><p><strong>Results: </strong>Among the 326 patients initially planned to undergo RAT, 298 (91.4%) underwent RAT, while 28 (8.6%) were converted to radical hysterectomy. The histological types were squamous cell carcinoma in 251 (77.0%) patients and adenocarcinoma in 67 (20.6%). Of 361 frozen section for surgical margins, 4 false negatives were identified. Discrepancies were due to freezing artifacts, staining quality on frozen sections, and slight differences in cross-sections between frozen and paraffin-embedded sections. Among 446 intraoperative lymph-node biopsies, one false-negative was recorded. Sensitivities of frozen section examination were 93.5% (58/62) for surgical margins and 94.1% (16/17) for lymph nodes. Lymph-node metastases were identified in systematic lymphadenectomy specimens of 21/326 (6.4%) patients planned to undergo RAT, with 10/21 (47.6%) detected intraoperatively. Lymph-node metastases were found in 7/112 (6.3%) patients without lymph-node biopsy.</p><p><strong>Conclusion: </strong>Frozen section examination during RAT provides satisfactory diagnostic performance, although biopsy of grossly enlarged lymph nodes is an unreliable method.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086366","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":"Relationship between the lateral dissection lines of various radical hysterectomies and anatomical structures in the female pelvis: an educational video from the Sapporo Cadaver Surgical Workshop.","authors":"Hiroyuki Kanao, Masato Tamate, Motoki Matsuura, Sachiko Nagao, Miseon Nakazawa, Shutaro Habata, Tsuyoshi Saito","doi":"10.3802/jgo.2026.37.e21","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e21","url":null,"abstract":"<p><strong>Objective: </strong>Radical hysterectomy with pelvic lymph node dissection is the treatment of choice for cervical cancer. All gynecologic oncologists should master this technique. The surgical procedure requires a wide dissection of the female pelvis. Performing radical hysterectomy without a thorough knowledge of the anatomy of the female pelvis can lead to serious complications. For novice surgeons to safely perform radical hysterectomy, mastering the 3-dimensional anatomy of the pelvis and aligning the dissection lines of radical hysterectomy to the female pelvic anatomy is crucial. Educational materials that demonstrate the anatomical relationship between dissection lines in radical hysterectomy and the surrounding pelvic structures are lacking. We aimed to create educational material to overcome these problems.</p><p><strong>Methods: </strong>Laparoscopic nerve sparing, non-nerve sparing, and super-radical hysterectomies, exposing pivotal pelvic anatomical structures, were performed on a Thiel-embalmed cadaver.</p><p><strong>Results: </strong>Nerve sparing, non-nerve sparing, and super-radical hysterectomies were laparoscopically performed in the right hemi-pelvis of the cadaver. We exposed the external and internal iliac vessels; obturator, sciatic, femoral, hypogastric, and pelvic splanchnic nerves and the pelvic nerve plexus; internal obturator, piriform, and coccygeal muscles; sacrospinous ligament; and ischial spine. Thus, we demonstrated where the dissection lines of the various radical hysterectomies are in a female pelvis.</p><p><strong>Conclusion: </strong>Using a Thiel-embalmed cadaver, we demonstrated the relationship between the dissection lines of various radical hysterectomies and pivotal sidewall anatomical structures in a female pelvis. The anatomical detail shown in the video captured during this procedure may assist surgeons to safely perform various radical hysterectomies.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086306","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 and validation of a prediction model for lymph node metastasis based on molecular typing in clinically early-stage endometrial carcinoma.","authors":"Qiuyue Han, Quanhong Jiang, Jiaqi Xu, Yuan Zhang, Zhuang Li, Yong Zhao, Zhaoyang Zhang, Ziyuan Yang, Helgi B Schiöth, Yawen Zhang, Lingliya Tang, Shuaixin Wang, Beihua Kong, Ruifen Dong","doi":"10.3802/jgo.2026.37.e19","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e19","url":null,"abstract":"<p><strong>Objective: </strong>To develop and externally validate a machine learning-based preoperative model integrating molecular typing and clinical features to predict lymph node metastasis (LNM) in patients with early-stage endometrial carcinoma (EC).</p><p><strong>Methods: </strong>This retrospective study included 465 patients with clinically early-stage EC treated at Qilu Hospital of Shandong University. Tumors were classified into molecular subtypes using The Cancer Genome Atlas-based methods. Least Absolute Shrinkage and Selection Operator regression identified five preoperative predictors: molecular typing (CN-H vs. non-CN-H), histological subtype, depth of myometrial invasion, neutrophil-to-lymphocyte ratio, and CA125 levels. Multiple machine learning algorithms were evaluated, and logistic regression (LR) was selected based on optimal discrimination and clinical applicability. Model performance was assessed using area under the curve (AUC), calibration plots, and decision curve analysis (DCA). A web-based nomogram was developed for clinical use.</p><p><strong>Results: </strong>The LR model demonstrated excellent discrimination, with AUCs of 0.843 in the training cohort and 0.809 in the testing cohort. The CN-H subtype was significantly associated with increased LNM risk. The model enabled effective risk stratification and calibration curves and DCA confirmed the model's accuracy and clinical utility.</p><p><strong>Conclusion: </strong>By integrating molecular and preoperative clinical features, this model offers accurate LNM risk stratification for early-stage EC. It supports clinical decision-making and has been implemented as a user-friendly online tool. Further prospective multicenter validation is warranted.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086209","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":"Suppressor of TCR signaling 2 (Sts-2) as a potential immunotherapy target and prognostic biomarker in cervical cancer.","authors":"Yinlong Chen, Qin Chen, Xiaoqing Guo, Qingliang Zheng","doi":"10.3802/jgo.2026.37.e20","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e20","url":null,"abstract":"<p><strong>Objective: </strong>More efficient immune targets are needed for the treatment of cervical cancer. This study aimed to identify potential targets for immunotherapy and prediction in cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) by conducting bioinformatics analysis and verifying the results with clinical tissue samples.</p><p><strong>Methods: </strong>A retrospective analysis of RNA sequencing data from 304 patients sourced from The Cancer Genome Atlas (TCGA) and another 300 patients from the Gene Expression Omnibus (GEO) was performed to investigate the correlation between suppressor of TCR signaling 2 (Sts-2) expression and clinical parameters in cervical cancer. To authenticate our findings, we utilized a combination of immunohistochemistry, quantitative polymerase chain reaction, and western blotting techniques in a separate cohort consisting of 6 cervical cancer tissue samples.</p><p><strong>Results: </strong>The Sts-2 gene was discovered to be substantially co-expressed with a multitude of immune checkpoint molecules, including programmed cell death protein 1 (r=0.8, p<0.001), TIGIT (r=0.87, p<0.001), LAG3 (r=0.71, p<0.001), and CTLA4 (r=0.74, p<0.001), in CESC patients. Both the TCGA and GEO datasets have independently validated that Sts-2 expression levels significantly correlate with overall survival rates, thus demonstrating its prognostic importance. A single-gene Gene Set Enrichment Analysis indicated that Sts-2 was highly enriched in T cell-related immune pathways. Moreover, using the Tumor Immune Dysfunction and Exclusion algorithm, it was suggested that high Sts-2 expression might predict a more favorable response to immunotherapy.</p><p><strong>Conclusion: </strong>The heightened expression of Sts-2 serves as a dual indicator of elevated T cell content and a favorable prognosis in cervical cancer.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086285","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":"Enhancement of circular RNA 0002577 in serum exosomes in patients with endometrial cancer accelerates disease progression via general transcription factor II-I repeat domain-containing 1 (GTF2IRD1).","authors":"Yueying Li, Ya Liu, Jialu Feng, Juan Du, Wenyan Tian, Liping Zhang","doi":"10.3802/jgo.2026.37.e17","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e17","url":null,"abstract":"<p><strong>Objective: </strong>Uterine corpus endometrial carcinoma (UCEC) is a common gynecologic malignancy with poor prognosis in advanced stages. Circular RNA (circRNA) and exosomes have been documented as significant contributors to the advancement of tumor cells, but the specific regulatory mechanisms between them is unclear. Therefore, our study attempts to explore the mechanism between them.</p><p><strong>Methods: </strong>Firstly, we isolated and identified exosomes, and then validated their role in UCEC progression by experiments in vivo and in vitro. Secondly, a human competing endogenous RNA (ceRNA) array was used to identify the circRNA with the most significant differences in expression from serum of UCEC patient, and validated its role in UCEC progression by experiments in vitro. Then, we find the target gene of this circRNA by RNA sequencing, and further clarify the correlation between the 2 and their role in tumor cell progression through experiments in vitro.</p><p><strong>Results: </strong>Serum exosomes in patients with UCEC can promote the progression of UCEC. The human ceRNA array identified that circRNA 0002577 (circ_0002577) was up-regulated and was the most significantly altered circRNA. Moreover, the up-regulated circ_0002577 in exosomes derived from UCEC patients promote proliferation and migration of UCEC. Based on RNA sequencing results, general transcription factor II-I repeat domain-containing 1 (<i>GTF2IRD1</i>) gene was identified as being highly correlated with circ_0002577. Additionally, a positive correlation between circ_0002577 and GTF2IRD1 was confirmed by experiments in vitro.</p><p><strong>Conclusion: </strong>Exosomes promote UCEC progression through circ_0002577 mediated regulation of <i>GTF2IRD1</i>, highlighting the potential therapeutic targets in treatment for UCEC.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: The Asia-Pacific Gynecologic Oncology Trials Group (APGOT): building a Pan-Asian and Oceania women's cancer research organization.","authors":"David Tan, Noriko Fujiwara, Keiichi Fujiwara, Philip Beale, Jae-Weon Kim, Joseph Ng, Se Ik Kim, Alison Evans, Byoung-Gie Kim","doi":"10.3802/jgo.2025.36.e131","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e131","url":null,"abstract":"<p><p>This corrects the article on p. e33 in vol. 34, PMID: 36890293.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086337","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 novel non-invasive mRNA-lncRNA biomarker panel for accurate prediction of cervical squamous cell carcinoma and adenocarcinoma.","authors":"Yixuan Cen, Mengyan Tu, Yanan Zhang, Yan Ren, Junfen Xu","doi":"10.3802/jgo.2025.36.e81","DOIUrl":"10.3802/jgo.2025.36.e81","url":null,"abstract":"<p><p>Squamous cell carcinoma (SCC) and adenocarcinoma (ADC) represent predominant histological subtypes of cervical cancer. To improve screening efficacy, we leveraged RNA sequencing data from 4 cervical SCC samples, 4 cervical ADC samples, and 8 normal cervix samples and conducted a comprehensive mRNA and long noncoding RNA (lncRNA) profiling analysis followed with a multi-phase study comprising 556 samples. Validating the RNA sequencing data in a clinical sample set comprising 45 normal cervix tissues, 45 SCC tissues, and 45 ADC tissues, we identified 9 mRNAs (SMC1B, OTX1, GRP, CELSR3, HOXC6, ITGB6, WDR62, SEPT3, and KLHL34) and 4 lncRNAs (FEZF1-AS1, LINC01305, LINC00857, and LINC00673) differentially expressed in both SCC and ADC samples. Utilizing quantitative reverse transcription polymerase chain reaction analysis and receiver operating characteristic (ROC) curve analysis in a training set (45 normal, 126 SCC, and 82 ADC tissues), we refined a novel mRNA-lncRNA-based panel (SMC1B/CELSR3/FEZF1-AS1/LINC01305). Employing logistic regression model and ROC analysis, this panel exhibited significant distinctions and promising area under the curve (AUC) values in both SCC (AUC=0.9520, p<0.0001) and ADC (AUC=0.9748, p<0.0001) tissues. Subsequent validation in an independent set (11 normal, 32 SCC, and 20 ADC tissues) demonstrated its diagnostic accuracy in both SCC (AUC=0.9659, p<0.0001) and ADC (AUC=0.9636, p<0.0001) patients. Notably, this tissue-based biomarker panel robustly discriminated precancerous lesion and cervical cancer patients from non-disease controls in a blood-based validation set (30 normal, 25 HSIL and 50 cervical cancer) with an AUC value of 0.9320. This study presents a non-invasive, efficient diagnostic panel for cervical cancer screening.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e81"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the role of liver metastasectomy in the treatment of stage IV endometrial cancer.","authors":"Xavier L Baldwin, Jihye Park, Joyce Pak, Leslie H Clark, Hong Jin Kim, Michael T LeCompte","doi":"10.3802/jgo.2025.36.e79","DOIUrl":"10.3802/jgo.2025.36.e79","url":null,"abstract":"<p><strong>Objective: </strong>Hepatic metastasectomy for gynecologic cancers remains controversial. Management of advanced endometrial cancer (EC) is complex. The purpose of this study is to analyze the efficacy of liver metastasectomy (LM) in the treatment of metastatic EC.</p><p><strong>Methods: </strong>The National Cancer Database was used to create a retrospective cohort of adult women with EC metastatic to the liver between 2010 and 2016. Overall survival and all-cause mortality were estimated with inverse probability of treatment weighting (IPTW) curves and IPTW Cox proportional hazard regression, respectively.</p><p><strong>Results: </strong>Among 999 EC patients with oligometastatic disease to the liver, 162 (16.2%) underwent LM, 614 (61.5%) received chemotherapy, and 129 (12.9%) had chemotherapy and LM. Those who underwent chemotherapy, 1-, 2-, and 3-year survival for chemotherapy + LM versus chemotherapy alone were 67.8 versus 56.5%, 44.9 versus 33.4%, and 35.1 versus 23.1%, respectively. In unadjusted analysis, chemotherapy + LM group had reduced mortality risk (hazard ratio [HR]=0.68; 95% confidence interval [CI]=0.54-0.86) with longer median survival time (20.1 vs. 14.6 months, p=0.011) compared to chemotherapy alone. Adjusting for demographics and treatment characteristics, a possible reduction in mortality was associated with chemotherapy + LM (HR=0.74; 95% CI=0.55-1.01) compared to chemotherapy alone.</p><p><strong>Conclusion: </strong>This study of LM for EC suggests LM in addition to chemotherapy may be associated with improved outcomes for patients with EC.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e79"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjuvant chemotherapy after radical hysterectomy yields comparable outcomes to chemoradiation for stage IB2-IIB and IIIC1-2 cervical cancer: a single-center retrospective study.","authors":"Kenro Chikazawa, Ken Imai, Hiroyoshi Ko, Tomoyuki Kuwata, Ryo Konno","doi":"10.3802/jgo.2025.36.e82","DOIUrl":"10.3802/jgo.2025.36.e82","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate and compare recurrence-free survival (RFS) between radical hysterectomy followed by adjuvant chemotherapy and initial chemoradiotherapy for cervical cancer at our institution.</p><p><strong>Methods: </strong>In this retrospective study, we enrolled patients diagnosed with stage IB2-IIB cervical cancer according to the International Federation of Gynecology and Obstetrics 2018 staging system, who underwent either radical hysterectomy with pelvic lymphadenectomy followed by adjuvant chemotherapy or initial concurrent chemoradiation at our institution between 2009 and 2022.</p><p><strong>Results: </strong>Among these patients, 74 and 110 underwent radical hysterectomy and chemoradiation, respectively. The radical hysterectomy group exhibited significantly improved RFS compared with the chemoradiation group; however, no significant difference was observed in overall survival between the groups. Cox hazard analysis for RFS showed that, among the clinical risk factors identified before the initial treatment, only parametrial invasion was statistically significant. No significant difference in RFS was observed between the radical hysterectomy group and chemoradiation group. Regarding recurrence patterns, para-aortic lymph node recurrence occurred significantly more frequently in the chemoradiation group than in the radical hysterectomy group. Postoperative ureteral injury was reported in once case and postoperative ureteral stenosis in 2 cases in the radical hysterectomy group. In contrast, vesicovaginal fistula and rectovaginal fistula were reported in one case each in the chemoradiation group.</p><p><strong>Conclusion: </strong>Radical hysterectomy followed by adjuvant chemotherapy provided RFS outcomes comparable to those achieved with initial chemoradiotherapy for stage IB2-IIB and IIIC1-2 cervical cancer. These findings suggest that both approaches are viable, although further prospective studies are needed.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e82"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}