Journal of Gynecologic Oncology最新文献

{"title":"The application of liquid biopsy techniques in cervical cancer diagnosis, prediction and therapeutic surveillance.","authors":"Jia Jiang, Libo Li, Cui Zhang, Can Yang, Yunmeng Dai, Yanping Chen, Yisidan Huang, Lu Xie, Yang Xiang, Jia Yuan, Yuting Zeng, Qiao Wang, Yuncong Liu, Hanqun Zhang, Yong Li","doi":"10.3802/jgo.2025.36.e121","DOIUrl":"10.3802/jgo.2025.36.e121","url":null,"abstract":"<p><p>Cervical cancer (CC) is a significant cause of cancer-related deaths in women and ranks as the fourth most common malignant tumor worldwide. Cervical histopathology is currently the primary diagnostic method for confirming the presence of CC. Tumor markers and imaging techniques play crucial roles in monitoring treatment effectiveness and prognostic follow-up. Unfortunately, these traditional examination methods are invasive and often lack sensitivity and accuracy. Therefore, there is a need for a less invasive and more sensitive test to facilitate early diagnosis, efficacy evaluation, and prognostic monitoring of CC. In recent years, liquid biopsy has been developed as a new detection method. It involves analyzing tumor components released into the peripheral circulation, such as cell-free RNA, circulating tumor DNA, circulating tumor cells, tumor-educated platelets, and exosomes. Liquid biopsy offers advantages such as being less invasive, highly reproducible, and capable of real-time monitoring. Moreover, liquid biopsy can play a crucial role in the early diagnosis of CC, guiding targeted therapy, assessing prognosis, and evaluating treatment effectiveness. This review focuses on the value of liquid biopsy application in CC, detection markers, and detection methods. It also explores how liquid biopsy can be used in the detection, prognosis, and monitoring the progression of CC. The advantages and limitations of liquid biopsy in CC are analyzed to promote its application and improve the diagnosis and treatment of the disease.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333249","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":"Global burden of uterine cancer in 204 countries and territories and its predicted level in 15 years, from 1990 to 2021.","authors":"Xiong Zhu, Siqi Zhang, Cui Zhang, Jia Jiang, Can Yang, Yisidan Huang, Yuting Zeng, Xiaoqing Luo, Libo Li, Yuncong Liu, Yanping Chen, Hanqun Zhang, Yong Li","doi":"10.3802/jgo.2025.36.e125","DOIUrl":"10.3802/jgo.2025.36.e125","url":null,"abstract":"<p><strong>Background: </strong>Uterine cancer (UC) is a major cause of cancer-related deaths among women. This study assesses the global burden of UC from 1990 to 2021.</p><p><strong>Methods: </strong>Data from the Global Burden of Disease 2021 study were used to analyze UC incidence, mortality, and disability-adjusted life years (DALYs) across 204 countries. Age-standardized rates were evaluated by age and Socio-Demographic Index (SDI), with trends forecasted to 2036 using Bayesian models.</p><p><strong>Results: </strong>In 2021, the global incidence of UC reached 473,614 cases (95% uncertainty interval [UI]=4,29916-5,13667), with an age-standardized incidence rate of 5.41 per 100,000 (95% UI=4.90-5.87), showing an upward trend since 1990, particularly in high-SDI regions. However, the mortality rate in high SDI regions exhibited a declining trend, with an estimated annual percentage change (EAPC) of -0.25 (95% confidence interval=-0.42 to -0.08). Although the number of deaths globally has increased, the age-standardized mortality rate has decreased compared to 1990 (EAPC: -0.85). The global age-standardized DALYs also show a downward trend, except in high SDI and low-middle SDI regions. The highest incidence was observed among individuals aged 70-74 in 2021. By 2036, new cases are projected to rise, though incidence, mortality, and DALYs are expected to decline.</p><p><strong>Conclusion: </strong>Regional disparities in the global UC burden highlight the need for tailored strategies, especially in low-income countries, to reduce its impact.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333248","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":"Comparison of laparoscopic and robotic-assisted minimally invasive surgery with sentinel lymph node navigation in low-risk endometrial cancer: a retrospective analysis.","authors":"Shinichi Togami, Nozomi Furuzono, Mika Mizuno, Hiroaki Kobayashi","doi":"10.3802/jgo.2025.36.e122","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e122","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate and compare the perioperative and oncologic outcomes of laparoscopic and robotic-assisted surgeries in patients with low-risk endometrial cancer who underwent minimally invasive surgery (MIS) for complete surgical staging, including sentinel lymph node mapping.</p><p><strong>Methods: </strong>A retrospective study included 190 patients diagnosed with low-risk endometrial cancer who underwent MIS combined with sentinel lymph node navigation surgery (SNNS) between December 2016 and December 2021. Among these patients, 66 underwent laparoscopic surgery, while 124 underwent robotic-assisted surgery. The analysis focused on patient characteristics, perioperative outcomes, and prognostic factors, including recurrence-free survival (RFS) and overall survival (OS). Statistical analysis was performed using Kaplan-Meier survival curves and appropriate comparative tests for outcome evaluation.</p><p><strong>Results: </strong>The median operative time and estimated blood loss were significantly longer and greater in the robotic surgery group than in the laparoscopic group (209.5 vs. 157.5 min, 20 vs. 5 mL, respectively). The identification rates of sentinel nodes were 97% and 95.2% in the laparoscopic and robotic groups, respectively, with no significant difference between the 2. Recurrence was observed in two and three cases in the laparoscopic robotic surgery groups, respectively. The 3-year RFS rates were 97.6% (95% confidence interval [CI]=0.8482-0.9769) and 93.9% (95% CI=0.9277-0.9922) for the robotic and laparoscopic groups, respectively, while the 3-year OS rates were 99.2% (95% CI=0.8561-0.9902) and 96.1% (95% CI=0.9450-0.9989), respectively, with no statistically significant differences.</p><p><strong>Conclusion: </strong>MIS combined with SNNS is a highly effective approach for managing low-risk endometrial cancer, providing comparable oncologic outcomes to laparoscopy while enhancing the quality of life of patients.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293857","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":"Navigating the future of fertility preservation: advanced predictive strategies for treatment outcomes of endometrial atypical hyperplasia and carcinoma.","authors":"Tianwei Xing, Huiyang Li, Ping-Li Sun, Hongwen Gao","doi":"10.3802/jgo.2025.36.e123","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e123","url":null,"abstract":"<p><p>Due to the decreasing age of onset and the postponement of childbearing, there is a growing number of patients with endometrial carcinoma (EC) and endometrial atypical hyperplasia (EAH) seeking fertility-sparing treatments. Progestogen-based therapy serves as the principal conservative approach for EC. However, the variability in treatment outcomes hampers the potential for delivering more tailored therapies in clinical practice. To better guide the treatment of patients with fertility preservation needs, we conducted a comprehensive review of existing literature to explore factors related to molecular classification, biomarkers and artificial intelligence (AI) technology that may predict fertility-sparing treatment outcomes, we also looked ahead to future research directions in this field. The pathology before and after treatment is the primary basis for assessing the effectiveness of fertility-sparing treatment for EC and EAH. However, it is challenging to predict the therapeutic outcomes based on the pathological morphology of the initial diagnosis. Traditional immunohistochemical markers, such as estrogen and progesterone receptors, are also very limited in predicting therapeutic response. In recent years, the prognosis of fertility-sparing treatment has also been considered to be correlated with the molecular classification and gene mutation markers of EC. However, there are currently few direct clinical studies available, and our focus will be on reviewing these studies and assessing their applicability. In addition, there are some studies utilizing AI to predict the molecular classification, genes and therapeutic response of EC. The integration of these features will aid in the development of advanced predictive strategies for fertility-sparing treatment of EC and EAH.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293790","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 necessity of adjuvant surgery for patients with high-risk chemorefractory or relapsed gestational choriocarcinoma with complete remission after anti-PD-1 therapy.","authors":"Jiayuan Zhao, Dan Wang, Yonglan He, Xirun Wan, Jun Zhao, Junjun Yang, Yang Xiang","doi":"10.3802/jgo.2025.36.e130","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e130","url":null,"abstract":"<p><strong>Objective: </strong>Anti-programmed cell death protein 1 (PD-1) therapy has demonstrated favorable therapeutic responses in patients with chemorefractory gestational trophoblastic neoplasia. The need for combined surgery to remove resistant foci in patients treated with anti-PD-1 therapy after complete remission (CR), however, has not been investigated. We therefore compared the prognosis of patients with high-risk chemorefractory or relapsed choriocarcinoma who underwent anti-PD-1 therapy with or without surgery.</p><p><strong>Methods: </strong>Patients with high-risk chemorefractory or relapsed choriocarcinoma who experienced CR following immunotherapy in conjunction with either surgical or non-surgical interventions were selected at Peking Union Medical College Hospital (PUMCH) between August 2018 and December 2023. Study endpoints included progression-free survival (PFS) and overall survival (OS). The results were analyzed using Mann-Whitney U tests and Kaplan-Meier analysis.</p><p><strong>Results: </strong>Forty-three patients who received andi-PD-1 therapy were enrolled in this study, including 18 patients with surgery and 25 without. Most of the foci in the surgery group were solitary (77.8%). The median maximum diameters of resistant foci before immunotherapy were 2.9 (0.7-7.3) cm and 1.4 (0.8-11.2) cm in the surgery and non-surgery groups, respectively (p=0.184). The 2-year PFS rate was both 91.5% in the non-surgery group and 90.9% in the surgery group. The 2-year and 3-year OS rates were 100.0% in both groups. There was no significant difference in PFS (p=0.849) or OS (p=0.371) between the 2 groups.</p><p><strong>Conclusion: </strong>These results suggest that surgical resection of drug-resistant lesions may not be necessary in patients with high-risk chemorefractory or relapsed choriocarcinoma who achieve CR after anti-PD-1 therapy.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293792","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":"Risk of ovarian cancer in women with pelvic inflammatory disease and homologous recombination repair gene mutations under 55: a population-based cohort study.","authors":"Chenzhao Feng, Wanwan Luo, Zanhong Wang, Xi Cao, Chunlin Dong, Fuxia Li, Rourou Xiao, Bin Yang, Gang Chen, Chaoyang Sun, Zhiqiang Han, Xingjie Hao, Beibei Wang","doi":"10.3802/jgo.2025.36.e126","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e126","url":null,"abstract":"<p><strong>Objective: </strong>To address the relation among pelvic inflammatory disease (PID), genetic vulnerability and ovarian cancer (OC) risk, we assessed the association between PID and OC risk, alongside the interplay with germline homologous recombination repair (gHR) mutation, utilizing the UK Biobank.</p><p><strong>Methods: </strong>We conducted a prospective cohort study in the UK Biobank by tracking OC incidences between individuals with and without a PID history. Identification of gHR mutations (<i>BRCA1</i>, <i>BRCA2</i>, <i>RAD51C</i>, <i>RAD51D</i>, <i>BRIP1</i>) carriers were accomplished through paired whole-exome sequencing data. We used Cox's regression models to evaluate the hazard ratios (HRs) for OC risks under PID.</p><p><strong>Results: </strong>In the large prospective cohort study, the adjusted HR for OC in patients with PID was 1.45 (95% confidence interval [CI]=0.90, 2.32) compared with those with non-PID. Intriguingly, age-stratified analysis unveiled a positive association between PID history and OC risk in those aged under 55 years (HR=1.92; 95% CI=1.02, 3.63). Moreover, individuals aged younger than 55 years harboring both a history of PID and gHR mutations exhibited the highest risk of OC (HR=7.40; 95% CI=1.03, 53.10).</p><p><strong>Conclusion: </strong>An association between PID and OC risk emerged, notably in the subgroup aged younger than 55 years old. Individuals with both a PID history and gHR mutations exhibited the highest risk of OC. These findings imply PID as a potential precursor for OC, underscoring the importance of early intervention, particularly in the younger population with gHR mutations.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293791","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":"Laparoscopy-assisted laterally extended endopelvic resection and sacrectomy (beyond laterally extended endopelvic resection) for platinum-sensitive recurrent ovarian cancer.","authors":"Hiroyuki Kanao, Sanshiro Okamoto, Shogo Nishino, Sachiho Netsu, Hidetaka Nomura, Mayu Yunokawa","doi":"10.3802/jgo.2025.36.e120","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e120","url":null,"abstract":"<p><p>Laterally extended endopelvic resection (LEER) is a surgical option for patients with laterally recurrent gynecological malignancies to preserve sciatic nerve function [1]. However, when a laterally recurrent tumor involves the sacrum, debulking surgery is generally abandoned because the surgical excision line is outside the standard LEER. Since its technical feasibility and oncological safety have been demonstrated, sacrectomy for recurrent rectal cancer is now considered the treatment of choice [2]. Theoretically, if complete resection is deemed possible, LEER and sacrectomy (beyond-LEER) may be the treatments of choice for recurrent gynecological malignancies. However, the technical feasibility of beyond-LEER has not been reported. In this video, we demonstrate the step-by-step procedure of laparoscopy-assisted beyond-LEER in a patient with platinum-sensitive recurrent ovarian cancer. The patient, with stage IVA ovarian cancer, was in complete remission after debulking surgery and chemotherapy. At the 13-month-platinum-free interval, a solitary recurrent tumor, involving the right internal iliac vessels and infiltrating the right sacral foramen (S3), was detected. Thus, second-line chemotherapy was initially introduced. During 6 months of chemotherapy, the tumor size remained unchanged and no other metastatic lesions were detected. Therefore, surgical resection was planned. Laparoscopy-assisted beyond-LEER was performed, and complete resection without tumor exposure was accomplished. No sign of recurrence 9 months post debulking surgery has been noted. This is the first report to demonstrate the technical feasibility of laparoscopy-assisted beyond-LEER. Table 1 presents a comparison with cases wherein open total pelvic exenteration with low-sacrectomy (TPES) was performed for recurrent rectal cancer. Forty-nine cases of open TPES demonstrated operation time, 11.5 hours; blood loss volume, 2,630 mL; and length of stay, 24.5 days [3]. These results are similar to the findings in our case: operation time, 11 hours; blood loss volume, 1,700 mL; and length of stay, 35 days. We suggest that the benefit of laparoscopy cannot be demonstrated because TPES is a different procedure compared with the beyond LEER. Kimura et al. [4] demonstrated that laparoscopic TPES for recurrent rectal cancer might have a benefit of reduced blood loss. The advantages of laparoscopy during our multidirectional procedure include not only the possibility of reducing blood loss but also the quick closure of abdominal wound and ease of keeping wound clean while changing patient's position during sacrectomy. However, due to the limited case and follow up periods, further studies are required to determine the efficacy of this novel surgery and real advantage of laparoscopy. The informed consent for use of this video was taken from the patient.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248246","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":"Pan-cancer analysis of ARNT2 and its oncogenic role in cervical cancer.","authors":"Dongdong Jin, Nannan Wang, Yang Xue, Yan Yang, Kaige Shi, He Wu, Jim Jinn-Chyuan Sheu, Ji-Hak Jeong, Zhenying Ban, Dandan Shen, Li Yang","doi":"10.3802/jgo.2025.36.e113","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e113","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to elucidate the role of aryl hydrocarbon receptor nuclear transporter 2 (ARNT2) in cervical cancer (CC) and explore the potential mechanism by which ARNT2 promotes the progression of CC through the protein phosphatase 2A (PP2A)/Akt signaling pathway.</p><p><strong>Methods: </strong>Bioinformatics tools were used to analyze the expression level of ARNT2 in cancer and its correlation with cancer prognosis. Western Blot and immunohistochemistry staining were used to detect the expression of ARNT2 protein in CC tissues and cells. ARNT2 was knocked down in SiHa and HeLa cells, respectively. Cell Counting Kit-8 assay and colony formation assay were used to detect changes in cell proliferation. Transwell assay and plate scratch assay were used to detect changes in cell migration and invasion. Western Blot assay was used to detect changes in the expression of PP2A/Akt signaling pathway after ARNT2 expression was downregulated. Finally, a CC xenograft tumor model was constructed to evaluate the effect of ARNT2 on SiHa cell tumorigenesis in vivo.</p><p><strong>Results: </strong>ARNT2 is highly expressed in tumor tissues and cell lines. ARNT2 knockdown can significantly inhibit the proliferation, invasion and migration of SiHa and HeLa cells in vitro and in xenograft models. Further studies have shown that ARNT2 may promote tumor formation by regulating the PP2A/Akt pathway.</p><p><strong>Conclusion: </strong>ARNT2 promotes the malignant biological behavior of CC cells through the PP2A/Akt signaling pathway, confirming its potential as a prognostic marker for CC.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248247","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":"Cost-effectiveness analysis of reflex p16/Ki-67 dual-stained cytology in HPV partial genotyping screening in Singapore.","authors":"Sun Kuie Tay, David Wastlund, Rebecca Shu Yu Sim, James Karichu, Qishi Zheng","doi":"10.3802/jgo.2025.36.e115","DOIUrl":"10.3802/jgo.2025.36.e115","url":null,"abstract":"<p><strong>Objective: </strong>Triage testing is an integral part of high-risk human papillomavirus (HPV)-based cervical screening programs. This study assesses, from a healthcare payer perspective in Singapore, the cost-effectiveness of p16/Ki-67 dual-stained cytology (DS) compared to current standard of care (SOC).</p><p><strong>Methods: </strong>A decision-analytic Markov microsimulation model with a lifetime horizon was built to simulate the outcomes from HPV screening in Singaporean women aged 30-65 years. The intervention (primary testing with HPV genotyping followed by DS reflex test) was compared to current SOC (HPV genotyping followed by cytology) according to Singaporean clinical management guidelines. The progression through health states and associated costs and health outcomes were based on local clinical care data in Singapore. Screening impact was assessed by cost saving, number of colposcopy and quality-adjusted life years (QALYs).</p><p><strong>Results: </strong>Compared to SOC, implementation of HPV genotyping + DS was estimated to decrease the number of screening test (-2.02 times per patient) and colposcopy (-0.16 times per patient), and reduce the overall costs to the Singaporean healthcare system by S$225.59 per patient (95% CI: S$199.05 to S$249.99). The total QALYs estimates for the 2 approaches were similar (-0.0003; 95% confidence interval=-0.0031 to 0.0022). Sensitivity analyses confirmed the robustness of expected cost-savings and that the full value of avoided colposcopies may be larger than projected in the current analysis.</p><p><strong>Conclusion: </strong>This economic modelling analysis projected that using DS instead of conventional cytology as the reflex test for positive test with non-HPV-16/18 subtypes significantly reduced the financial costs of cervical cancer screening in Singapore.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333247","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 technique for transdiaphragmatic latero-pericardial cardiophrenic lymph node excision using the minimally invasive surgical access procedure in patient with advanced stage ovarian cancer.","authors":"Candost Hanedan, Hande Nur Öncü, Tuba Zengin Aksel, Vakkas Korkmaz","doi":"10.3802/jgo.2025.36.e124","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e124","url":null,"abstract":"<p><p>This study reports the first case of transdiaphragmatic lateropericardial cardiophrenic lymph node excision using the GelPOINT™ mini access platform in a patient with advanced-stage ovarian cancer. A 69-year-old woman with high-grade serous epithelial ovarian cancer. Cardiophrenic lymph node dissection is vital in advanced ovarian cancer surgery, as enlarged nodes are linked to poor prognosis. No clear guidelines exist for operating on patients with enlarged cardiophrenic lymph nodes [1, 2]. These nodes are categorized by location relative to the heart: anterior, median (lateropericardial), and posterior [3]. Cardiophrenic lymph node resection can be performed using transdiaphragmatic, transxiphoid, or transthoracic approaches with video-assisted thoracoscopic surgery [4]. In cases with suspicious nodes on imaging, removing them is essential for optimal cytoreduction and accurate staging. In this case, preoperative computed tomography revealed suspicious cardiophrenic lymph nodes measuring 16×13 mm and 10×8 mm, located near the xiphoid process and lateral pericardium. A 30 mm diaphragm incision was made 60 mm from the xiphoid process. An Alexis O-wound retractor was used, and the GelPOINT™ mini platform was introduced with three ports, including one for the camera. A 30-degree optic scope was used to excise the node with LigaSure. When we needed smoke management, we used an aspirator. With this method, we were able to access distally located cardiophrenic lymph nodes with a small incision. Transdiaphragmatic excision of the cardiophrenic lymph node using the mini access platform can be performed effectively with a smaller incision, demonstrating the feasibility and safety of this minimally invasive technique in managing such cases.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180395","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}