Journal of Gynecologic Oncology最新文献

{"title":"Genotype distribution and risk factors for human papillomavirus infection.","authors":"Yanqing Shen, Zuwei Zhang, Shaole Shi, Caixia Zhang, Channi Wang, Ye Chen","doi":"10.3802/jgo.2026.37.e7","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e7","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the patterns of human papillomavirus (HPV) genotype distribution and identify high-risk factors for HPV infection, focusing on their etiological significance and potential public health implications.</p><p><strong>Methods: </strong>This study enrolled 496 women from the Gynecology Outpatient Department of Wuhan Central Hospital between September 2021 and September 2024. Data were collected through medical records and questionnaire surveys to analyze the distribution characteristics of HPV infection. High-risk factors were evaluated using multivariate binary logistic regression analysis.</p><p><strong>Results: </strong>HPV infection exhibited the highest infection rate among women ≤25 years (63.5%) and ≥49 years (55.0%), with the most common types of high-risk HPV being HPV52, 16, and 58. Protective factors included frequent condom use (odds ratio [OR]=0.580) and HPV vaccination (OR=0.564). High-risk factors included diabetes (OR=6.620), anxiety (OR=2.126), and low work intensity (OR=1.670).</p><p><strong>Conclusion: </strong>This study demonstrated diabetes, anxiety, and low work intensity as significant risk factors for HPV infection, providing valuable etiological insights. Psychological assessments and diabetes management should be integrated into public health strategies for HPV prevention. Furthermore, multidisciplinary collaboration among gynecologists, psychologists, and endocrinologists, is also recommended to prevention and care efforts.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and biological characteristics associated with of loss-of-heterozygosity in endometrial cancer.","authors":"Felix Blanc-Durand, Etienne Rouleau, Patricia Pautier, Natalie Ngoi, Yi Wan Lim, Siew Eng Lim, Alexandra Leary, David Sp Tan","doi":"10.3802/jgo.2026.37.e10","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e10","url":null,"abstract":"<p><strong>Objective: </strong>Genomic instability has been identified in a subgroup of endometrial cancers (ECs) that are predominantly <i>TP53</i> mutated (<i>TP53mut</i>). We report the features associated with loss-of-heterozygosity (LOH) in EC.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of EC patients from France and Singapore. All patients underwent comprehensive molecular profiling using the tumor based FoundationOne CDX panel. The degree of LOH was correlated with molecular and clinicopathologic findings. LOH-high, intermediate and low were defined as ≥14%, 4%-14%, and <4%, respectively.</p><p><strong>Results: </strong>One hundred twelve patients were identified, including 66% Asian and 34% Caucasian. Fifty nine percent had International Federation of Gynecology and Obstetrics III/IV diseases, 34% low-grade endometrioid, 19% high-grade endometrioid, and 15% serous. The 63% and 50% of tumors expressed estrogen receptor (ER) and progesterone receptor (PR). One percent had a <i>POLE</i> mutation, 18% were microsatellite instability (MSI)-, 40% <i>TP53mut</i> and 41% non-specific molecular profiles. The 17% of patients were classified LOH-high, 37% LOH-intermediate and 46% LOH-low. LOH-high was significantly associated with serous and carcinosarcomas, ER/PR negative tumors, <i>TP53</i> mutations, <i>BRCA1</i> mutations and <i>TERC</i> amplification whereas LOH-low with low-grade endometrioid, MSI, <i>ARID1A</i>, <i>PIK3CA</i>, <i>CTNNB1</i>, and <i>PTEN</i> mutations. The median overall survival was 42.2, 55.2, and 100.8 months in the LOH-high, intermediate, and low respectively (p=0.034). Among <i>TP53mut</i> EC, LOH-low patients had significantly poorer outcomes (p<0.001).</p><p><strong>Conclusion: </strong>In this large multiethnic cohort, 17% of EC exhibited high LOH and correlated with hormone-receptor-negative tumors and poorer survival rates. LOH may serve as a tool for identifying EC cases with high genomic instability that could potentially benefit from PARP inhibitors.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707717","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":"Current status of carboplatin desensitization therapy for gynecologic malignancies.","authors":"Hiroshi Nishio, Koji Matsumoto, Hiroaki Komatsu, Mitsunori Morita, Takayuki Nagasawa, Jiro Suzuki, Shin Nishio, Mitsuya Ishikawa, Toyomi Satoh","doi":"10.3802/jgo.2026.37.e11","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e11","url":null,"abstract":"<p><p>Platinum-based chemotherapies are widely used in the treatment of gynecologic malignancies and are standard treatment for initial treatment and recurrent diseases. Due to the widespread use of platinum-based regimens, the management of platinum hypersensitivity reactions (HSRs) is an important issue for physicians treating gynecologic malignancies. Patients receiving multiple lines of platinum therapy, with long intervals between platinum lines and history of allergic reaction, and status of germline <i>BRCA</i> mutation are at an increased risk of platinum HSRs. The development of desensitization protocols to allow patients with platinum hypersensitivity to receive further therapy is mandatory. Each institution should work with its' multidisciplinary team to select a protocol that best suits individual practice setting and patient population to maximize patients care.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707718","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":"Postoperative conventional versus hypofractionated intensity-modulated radiation therapy with concurrent chemotherapy in cervical cancer: a prospective multicenter randomized phase III trial (POHIM_P3 trial).","authors":"Won Kyung Cho, Won Park, Jong Hoon Lee, Hyun-Cheol Kang, Meesun Yoon, Keun-Yong Eom, Yeon-Sil Kim, Sangjoon Park, Young Seok Kim, Yeon Joo Kim, Euncheol Choi, Dong-Yun Kim","doi":"10.3802/jgo.2026.37.e4","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e4","url":null,"abstract":"<p><strong>Background: </strong>For patients with high-risk factors such as pelvic lymph node metastasis, positive surgical margins, or parametrial involvement, concurrent chemoradiotherapy (CCRT) with whole-pelvic radiotherapy significantly improves survival outcomes. Hypofractionated radiation therapy, which delivers higher radiation doses over fewer sessions, enhances tumor control but raises concerns about increased normal tissue toxicity. A recent Korean phase II study (POHIM-CCRT) evaluated the safety of hypofractionated intensity-modulated radiation therapy (IMRT), delivering 40 Gy in 16 fractions with weekly cisplatin following radical surgery. The results showed minimal acute toxicity. Based on these findings, the present study was designed to assess the oncologic efficacy of hypofractionated CCRT compared to conventional treatment strategies in high-risk cervical cancer patients after radical surgery.</p><p><strong>Methods: </strong>The POHIM-P3 trial is a phase 3, randomized, multicenter study designed for women with cervical cancer requiring adjuvant CCRT after radical hysterectomy. Participants in the experimental arm receive hypofractionated IMRT to whole pelvis, delivering a total dose of 40 Gy in 16 fractions, and the control arm receive conventional radiotherapy with a total dose of 45-50.4 Gy in 25-28 fractions in combination with weekly cisplatin. The primary endpoint of the study is the 3-year disease-free survival and the secondary endpoints included acute and late side-effects, local control rates, and overall survival rates.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT06509724.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659372","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 multimodal intervention program to improve sexual health and self-perceived quality of life in patients treated for cervical cancer: a randomized prospective study (PROVIDENCE trial).","authors":"Blanca Gil-Ibañez, Núria Carreras-Dieguez, Gregorio López, Beatriz Sánchez-Hoyo, Beatrice Conti Nuño, Reyes Oliver-Perez, Camil Castelo-Branco, Tiermes Marina, Aureli Torné, Alvaro Tejerizo, Berta Diaz-Feijoo","doi":"10.3802/jgo.2025.36.e56","DOIUrl":"10.3802/jgo.2025.36.e56","url":null,"abstract":"<p><strong>Background: </strong>Patients with cervical cancer treatment experience an impairment of sexual function and quality of life. This issue is usually underreported and undertreated, and evidence-based interventions are lacking. Prevention of sexual dysfunction is a crucial pillar in improving the quality of life of these patients. The primary objective of this trial is to evaluate the impact of a multimodal intervention, encompassing prevention of vaginal dysfunction and patient education, on sexual function and quality of life in cervical cancer survivors utilizing patient-reported outcome measurements.</p><p><strong>Methods: </strong>Multi-institutional, randomized clinical trial where patients will be randomized 1:2 at diagnosis of initial or locally advanced cervical cancer to control arm or intervention arm. After treatment, control arm patients will undergo standard follow-up by their referring physician. The multimodal intervention for patients in the intervention group includes application of vaginal estrogens plus hyaluronic-acid cream along with use of vaginal vibrator, systematic evaluation of the need of systemic hormone replacement therapy and treatment if needed, and access to online content about sexuality, nutrition, sports and lifestyle habits. Through 4 appointments (at diagnosis, 1, 6, and 12 months after treatment), sexual health, vaginal trophism and self-perceived quality of life of patients in both arms will be assessed with validated questionnaires as female sexual function index (FSFI), European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire 30, and Cx-24, Cervantes Scale, vaginal health index and vaginal thickness assessed by ultrasound. The major inclusion criteria will be patients aged ≥18 years with the International Federation of Gynecology and Obstetrics stage I-III cervical cancer treated with surgery and/or radiotherapy. The primary endpoint will be FSFI score 12 months after treatment, which will be compared between groups. Uni- and multivariate analysis will be performed to identify factors influencing sexual function recovery after treatment. The sample size will be of 120 eligible patients, who will be randomized to detect an improvement of 5.2 points in FSFI score. Complete accrual is estimated in March 2026. To date, the present study has no external funding.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT06031493.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e56"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382596","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":"Analysis of fertility-preserving treatment outcomes in patients with POLE-mutated endometrioid carcinoma.","authors":"Zhuoyu Zhai, Yiqin Wang, He Li, Nan Kang, Yuanyuan Liu, Jianliu Wang","doi":"10.3802/jgo.2025.36.e101","DOIUrl":"10.3802/jgo.2025.36.e101","url":null,"abstract":"<p><p>To explore the clinical outcomes of fertility-sparing treatment (FST) in patients with POLE-mutated endometrioid carcinoma (EEC). A total of 9 EEC patients who received FST and were classified to the POLE-mutated subtype in Peking University People's Hospital from April 2020 to October 2023, were retrospectively collected. Clinical and pathological data were analyzed to describe the outcomes of FST in patients with POLE-mutated EEC. A total of 9 patients with EEC including 6 cases with well-differentiated (G1) and 3 cases with moderately-differentiated (G2). The average age was 34.8±2.1 years. POLE mutation sites were P286R (5 cases), V411L (2 cases), L424I (1 cases), and S459F (1 cases), respectively. The median follow-up time was 16 months (9-41 months). The complete response (CR) rate was 88.9% (8/9), with a median time to CR of 5.5 months (3-18 months). The partial response (PR) rate was 11.1% (1/9). The relapse rate was 50.0% (4/8), with a median recurrence time of 9.5 months (5-25 months). Of these, 75% (3/4) underwent secondary FST, with all achieving CR again (3/3). Three of 5 who were out-of-indication patients achieved CR by individual therapy. FST in patients with POLE-mutated EEC achieve a CR rate of 88.9% in this study, the largest number of retrievable reports. In certain patients who are out-of-indication, individualized treatment may also result in remission. However, unlike surgical patients, some patients experience disease recurrence and whether POLE-mutated EEC is sensitive to conventional therapy in FST is controversial given its pathogenesis.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e101"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005851","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":"Platinum free interval and clinical benefit of the second-line chemotherapy in recurrent uterine and ovarian carcinosarcoma: a retrospective cohort analysis.","authors":"Julie Berthet, Amel Kime, Bruno Borghese, Sixtine De Percin, Antoine Gaudet-Chardonnet, Jerome Alexandre, Guillaume Beinse","doi":"10.3802/jgo.2025.36.e64","DOIUrl":"10.3802/jgo.2025.36.e64","url":null,"abstract":"<p><strong>Objective: </strong>Uterine and ovarian carcinosarcomas (OCSs) are rare and aggressive neoplasms. We assessed whether progression free survival after initial treatment (PFS1) was associated with the clinical benefit of chemotherapy after progression, estimated as overall survival (OS) after progression/relapse.</p><p><strong>Methods: </strong>All consecutive patients treated with chemotherapy for stage I-IV uterine/OCS in Cochin University Hospital between 2010 and 2022 were included in this retrospective cohort. Association between PFS1 and OS after progressive disease (PD) was determined by Cox regression. Optimal PFS1 threshold for OS after PD prediction was determined by a time-dependent receiver operating characteristic-curve analysis.</p><p><strong>Results: </strong>Forty patients treated for endometrial (n=32) or OCS (n=8) were included. Median PFS1 and OS after PD were 16 months 95% confidence interval (95% CI=11-not available [NA]) and 6 months (95% CI=2-15). In patients who relapsed/progressed (n=20), OS after PD was anticipated by PFS1 (Pearson r=0.61; area under the curve=0.79; 95% CI=0.6-1). At the threshold of PFS1 ≤/>9 months (n=6/n=7), median OS post PD were 2 months (0.1-NA) and 15 months (6-NA), for patients treated with platinum/anthracycline based chemotherapy in second line. Patients receiving best supportive care alone (n=7) had a median OS post PD of 8 months (1.3-NA).</p><p><strong>Conclusion: </strong>Our results highlight that a subgroup of carcinosarcomas patients exhibits a durable benefit from chemotherapy in the relapse settings, and suggest the use of PFS1, as a proxy of platinum-sensitivity, to select patients who might derive higher clinical benefit of a 2nd line of chemotherapy.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e64"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023209","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":"Relacorilant plus nab-paclitaxel for recurrent, platinum-resistant ovarian cancer: a cost-effectiveness study.","authors":"Yidong Zhou, Fei Tong, Bowen Jin, Junjie Pan, Ning Ren, Lanqi Ren, Qiaoping Xu","doi":"10.3802/jgo.2025.36.e63","DOIUrl":"10.3802/jgo.2025.36.e63","url":null,"abstract":"<p><strong>Objective: </strong>The phase 2, open-label, randomized, 3-arm study (NCT03776812) found that intermittently dosed relacorilant + nab-paclitaxel improved progression-free survival, duration of response, and overall survival compared with nab-paclitaxel monotherapy with minimal additional toxicity. This study analyzed the cost-effectiveness of intermittent relacorilant + nab-paclitaxel (IN), continuous relacorilant + nab-paclitaxel (CN) and nab-paclitaxel monotherapy (N) from the payer's perspective over a 5-year time horizon.</p><p><strong>Methods: </strong>The health outcome is expressed in quality-adjusted life years (QALYs). IN, CN and N were evaluated using QALYs and incremental cost-effectiveness ratio (ICER). The data for this model come from the NCT03776812 trial and other published literature. The impact of the variables is studied using a one-way deterministic sensitivity analysis and a probabilistic sensitivity analysis based on a second-order Monte Carlo simulation.</p><p><strong>Results: </strong>N was the least costly strategy, at $ 4606.05, followed by IN ($22,597.75) and CN ($44,276.86). Based on a willingness-to-pay threshold of $100,000/QALY, IN was cost-effective compared with N, with an ICER of $21,418.69 per QALY gained for N, whereas CN was ruled out by extended dominance (less effective, more costly), compared with N. The incremental benefits of IN compared to CN and N were 0.72 QALYs and 0.84 QALYs.</p><p><strong>Conclusion: </strong>From a US health care system perspective, IN may be cost-effective compared to CN for patients with recurrent platinum-resistant ovarian cancer, and IN is also better than CN and N in terms of efficacy. Therefore, IN is a high-quality regimen for clinicians to treat patients with recurrent platinum-resistant ovarian cancer.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03776812.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e63"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573089","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":"Poor accuracy of endometrial sampling in patients with uterine carcinosarcomas: a nationwide analysis.","authors":"Eveline N B Pham, Caroline B van den Berg, Rachel van Es, Helena C van Doorn, Floris H Groenendijk, Heleen J van Beekhuizen","doi":"10.3802/jgo.2025.36.e52","DOIUrl":"10.3802/jgo.2025.36.e52","url":null,"abstract":"<p><strong>Objective: </strong>To determine the accuracy of aspiration biopsy (AB), hysteroscopic biopsy (HB), and dilatation & curettage (D&C) in detecting uterine carcinosarcoma (UCS).</p><p><strong>Methods: </strong>Pathology reports were retrieved from the Dutch Nationwide Pathology Databank PALGA for patients with a certain or suggested diagnosis of UCS in pre- and/or postoperative histology between 2001 and 2021. Patients without available pre- or postoperative pathology reports were excluded. The accuracy measures sensitivity, positive predictive value (PPV), accuracy, and concordance using Cohen's kappa were calculated for AB, D&C, and HB, using postoperative histology as the reference. This was analyzed for 2 scenarios: Analysis A compared samples with a certain or suggested diagnosis of UCS vs. no mention of UCS. Analysis B compared samples with a certain diagnosis of UCS vs those without UCS.</p><p><strong>Results: </strong>The study included 1,481 patients, totaling 1,685 samples. Sensitivity was similar for AB and HB (52.4% and 50.5%, respectively, for analysis A; 45.1% and 42.2% for analysis B). D&C showed the highest sensitivity (70.8% and 64.9% for analysis A and B, respectively). AB had the highest PPV (85.3% and 90.9% for analysis A and B, respectively), HB had the lowest PPV (79.7% and 80.9%, respectively). Accuracy was highest for D&C (44.4%) compared to AB (32.8%) and HB (29.5%). All Cohen's kappa values were below 0.20, indicating poor correlation between preoperative and postoperative diagnoses.</p><p><strong>Conclusion: </strong>The study reveals low accuracy measures across all conventional endometrial sampling techniques, highlighting the need for research to identify markers or tools to diagnose UCS.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e52"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032949","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":"Intra- and postoperative complications associated with diaphragmatic surgery for advanced ovarian cancer.","authors":"Kyoko Nishikimi, Shinichi Tate, Ayumu Matsuoka, Satoyo Otsuka, Makio Shozu, Kaori Koga","doi":"10.3802/jgo.2025.36.e66","DOIUrl":"10.3802/jgo.2025.36.e66","url":null,"abstract":"<p><strong>Objective: </strong>Diaphragmatic resection is frequently required to achieve optimal cytoreduction with no residual disease in patients with advanced ovarian cancer. Pleural effusion and pneumothorax are known short-term postoperative complications of diaphragmatic resection; however, few studies have reported intraoperative and long-term postoperative complications of this procedure. We investigated the intraoperative, as well as short- and long-term postoperative complications of diaphragmatic resection.</p><p><strong>Methods: </strong>Of the patients with stage III/IV ovarian cancer, who were initially treated at our hospital between 2008 and 2020, 267 patients who underwent diaphragmatic resection were included in this study. We recorded details regarding the type of diaphragmatic resection, type of closure, and intraoperative, as well as short- and long-term postoperative complications.</p><p><strong>Results: </strong>Of the 264 patients who underwent right-sided diaphragmatic resection, 235 underwent full-thickness resection and 29 underwent peritoneal stripping. Of the 118 patients who underwent left-sided diaphragmatic resection, 23 underwent full-thickness resection and 95 underwent peritoneal stripping. Intraoperative complications occurred in 5 patients (massive bleeding from the right hepatic vein [n=1], massive bleeding during excision of the liver adherent to the diaphragm [n=1], and lung injury [n=3]). Short-term complications included pleural effusion that necessitated drainage in 2 and pneumothorax after drain removal in 1 patient. Long-term complications included right diaphragmatic hernia in 1, left diaphragmatic hernia in 2, and pancreaticopleural fistula in 1 patient.</p><p><strong>Conclusion: </strong>Diaphragmatic resection was associated with a low incidence of intra- and postoperative complications, which highlights the safety of this approach for management of advanced ovarian cancer.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e66"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523424","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}