Journal of Gynecologic Oncology最新文献

{"title":"Non-cancer causes of death following cervical cancer diagnosis: a SEER database study.","authors":"Shanshan Wang, Jingxin Ding, Xiaoqin Chen, Mengli Zhao, Zhongrong Gao, Xiaojing Yang, Hua Jiang, Keqin Hua, Jie Fu","doi":"10.3802/jgo.2027.38.e39","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e39","url":null,"abstract":"<p><strong>Objective: </strong>To quantify non-cancer mortality after cervical cancer diagnosis and examine how these risks vary over time, by disease stage, race, and registry-recorded treatment patterns.</p><p><strong>Methods: </strong>We analyzed 65,852 women diagnosed with cervical cancer in Surveillance, Epidemiology, and End Results-17 (2000-2021). Standardized mortality ratios (SMRs) compared observed deaths with age-, race-, sex-, and calendar-period-specific mortality in the U.S. general population. Fine-Gray models retained every death other than the target cause as a competing event.</p><p><strong>Results: </strong>Of 24,857 deaths, 19,975 (80.4%) were cancer-related and 4,882 (19.6%) were non-cancer-related. The overall non-cancer SMR was 1.65 (95% confidence interval [CI]=1.60-1.70). After International Federation of Gynecology and Obstetrics stage- and race-exact propensity score matching (4,506 pairs; maximum absolute standardized mean difference, 0.079), registry-inferred combined radiotherapy plus chemotherapy without surgery was not associated with overall non-cancer death (subdistribution hazard ratio [sHR]=1.01; 95% CI=0.88-1.16); the infectious-disease (sHR=1.72; 95% CI=0.75-3.95) and septicemia estimates (sHR=1.60; 95% CI=0.69-3.72; 23 events) were imprecise. Among 31,617 patients surviving beyond 5 years, the conditional non-cancer SMR remained elevated (1.44; 95% CI=1.38-1.49).</p><p><strong>Conclusion: </strong>Non-cancer mortality remains elevated among cervical cancer survivors, including beyond the 5-year landmark. Treatment-group contrasts are strongly affected by disease stage, treatment-selection mechanisms, and unmeasured clinical factors; they should therefore be interpreted as hypothesis-generating rather than causal. Survivorship care should integrate cardiovascular, infectious, renal, respiratory, and metabolic risk management.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149268774","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":"Impact of platinum-free interval on the efficacy of lenvatinib plus pembrolizumab in advanced or recurrent endometrial cancer.","authors":"Rintaro Hamada, Toshiyuki Seki, Masami Kono, Miwako Shimazaki, Junki Onishi, Yuki Koike, Takafumi Kuroda, Jiro Suzuki, Kazuaki Takahashi, Masataka Takenaka, Yasushi Iida, Motoaki Saito, Satoshi Takakura, Hirokuni Takano, Kyosuke Yamada, Aikou Okamoto","doi":"10.3802/jgo.2027.38.e31","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e31","url":null,"abstract":"<p><strong>Objective: </strong>Following platinum-based therapy, recurrent endometrial cancer (EC) is treated with lenvatinib plus pembrolizumab (LP). The platinum re-administration response is predicted by the platinum-free interval (PFI), but the PFI and LP efficacy relationship remains unclear. We investigated the association between PFI and LP efficacy in patients receiving LP for recurrent EC.</p><p><strong>Methods: </strong>We retrospectively reviewed 96 patients with recurrent EC treated with LP between December 2021 and March 2025 at our institutions. A PFI ≥6 months was defined as a longer PFI. The primary outcomes were progression-free survival (PFS) and overall survival (OS). PFI, mismatch repair (MMR) status, p53 status, International Federation of Gynecology and Obstetrics (FIGO) 2023 stage (I/II vs. III/IV), histological type (endometrioid vs. non-endometrioid), and number of prior treatment regimens (1 vs. ≥2) underwent multivariable Cox regression analyses.</p><p><strong>Results: </strong>Of the 96 patients, 65 and 31 had PFI <6 months and ≥6 months, respectively. Molecular profiling identified 10 MMR-deficient tumors and 86 MMR-proficient tumors. Endometrioid histology, advanced FIGO stage (III/IV), and ≥2 previous treatment regimen proportions were 38.5% vs. 71.0%, 64.6% vs. 58.1%, and 24.6% vs. 32.3%, respectively, in the patients with shorter vs. longer PFI. Longer-PFI patients had significantly longer median PFS (7.5 vs. 14.2 months; p=0.025) and OS (21.7 vs. 32.9 months; p=0.003). Multivariable analysis determined that a longer PFI was independently associated with improved PFS (hazard ratio [HR]=0.54; 95% confidence interval [CI]=0.31-0.94; p=0.029) and OS (HR=0.37; 95% CI=0.17-0.81; p=0.012).</p><p><strong>Conclusion: </strong>LP therapy following platinum-based chemotherapy was more effective in longer-PFI patients.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149268727","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":"Radical versus simple trachelectomy for fertility preservation in early-stage cervical cancer: a retrospective cohort study based on propensity score inverse probability of treatment weighting.","authors":"Wenjing Wang, Zejian Lin, Jihong Liu","doi":"10.3802/jgo.2027.38.e29","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e29","url":null,"abstract":"<p><strong>Objective: </strong>To compare oncologic, perioperative, and reproductive outcomes between simple trachelectomy (ST) and radical trachelectomy (RT) in patients with International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IB1-IB2 cervical cancer.</p><p><strong>Methods: </strong>We conducted a single-center retrospective cohort study including FIGO 2018 stage IB1-IB2 cervical cancer patients with negative lymph nodes and margins who underwent RT or ST between January 2010 and December 2023. Propensity score-based inverse probability of treatment weighting was used to balance baseline covariates. Primary outcome was progression-free survival (PFS). Secondary outcomes included operative time, intraoperative blood loss, postoperative hospitalization, antibiotic-therapy days, and postoperative laboratory changes, and pregnancy/obstetric outcomes among patients who intended to conceive.</p><p><strong>Results: </strong>Among 45 patients (RT, n=23; ST, n=22), measured covariate balance was substantially improved after weighting. Median follow-up was 47 months, with two recurrences in the ST group. No statistically significant difference in PFS was detected between groups after weighting (p=0.148). ST was associated with shorter operative time (p<0.001), less intraoperative blood loss (p<0.001), fewer antibiotic-therapy days (p<0.001), smaller increases in white blood cell count (p=0.036) and C-reactive protein (p<0.001), and less albumin decline (p=0.018). Among 15 patients with pregnancy intention, successful pregnancies were observed in 1/6 (16.7%) in the RT group and 3/9 (33.3%) in the ST group.</p><p><strong>Conclusion: </strong>No statistically significant difference in PFS was detected between ST and RT in this limited cohort. ST was associated with lower perioperative burden, while reproductive findings were descriptive and hypothesis-generating. Larger prospective or multicenter studies with standardized selection criteria and fertility follow-up are needed, particularly for IB2 disease.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149268747","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":"Comment of 'Subsequent primary cancer incidence in cervical cancer survivors: insights from a comprehensive cohort study utilizing combined Japanese population-based cancer registries'.","authors":"Sercan Ön","doi":"10.3802/jgo.2026.37.e133","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e133","url":null,"abstract":"","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061944","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":"Molecular subtyping: the missing piece in the FIGO 2023 IA3 downgrading of low-grade endometrioid carcinoma with adnexal involvement.","authors":"Aliza Arif, Sasha Zaki, Sangeen Khan","doi":"10.3802/jgo.2026.37.e142","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e142","url":null,"abstract":"","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061889","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":"Pediatric non-gestational choriocarcinoma: a call for disease-specific treatment protocols.","authors":"Aliza Arif, Shahzaib Ali, Isheeka Lohana, Shanza Abbas","doi":"10.3802/jgo.2026.37.e146","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e146","url":null,"abstract":"","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061897","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":"Real-world evidence and molecular subtyping in low-grade endometrioid carcinoma with adnexal involvement: a response to the commentary.","authors":"Jiyan Shang, Tianming Li, Yanmei Zhu","doi":"10.3802/jgo.2026.37.e145","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e145","url":null,"abstract":"","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061885","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":"Effectiveness of first-line niraparib maintenance in Korean patients with advanced ovarian cancer: a multicenter retrospective cohort study.","authors":"Ok-Ju Kang, Myong Cheol Lim, Keun Ho Lee, Jae-Weon Kim, Byoung-Gie Kim, Yong Jae Lee, So-Jin Shin, Ki Hyung Kim, Dae Hoon Jeong, Jeong-Yeol Park","doi":"10.3802/jgo.2027.38.e34","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e34","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the real-world effectiveness of first-line niraparib maintenance therapy in Korean patients with advanced epithelial ovarian cancer (EOC) and assess outcomes across clinical and molecular subgroups.</p><p><strong>Methods: </strong>This multicenter retrospective study included patients with newly diagnosed International Federation of Gynecology and Obstetrics stage III-IV EOC who completed first-line platinum-based chemotherapy between December 2019 and October 2022 at nine tertiary institutions in South Korea. Patients were classified according to receipt of niraparib maintenance or no maintenance therapy. Propensity score matching was performed based on age, neoadjuvant chemotherapy, and <i>BRCA</i> mutation status. Progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan-Meier analysis and Cox proportional hazards models.</p><p><strong>Results: </strong>A total of 554 patients were included (niraparib, n=248; no maintenance, n=306). In the unmatched cohort, niraparib was associated with significantly longer PFS (p<0.001) and OS (p=0.001). After 1:1 matching, 189 pairs were analyzed. The 3-year PFS rate was higher in the niraparib group (43.1% vs 25.7%; p<0.001), as was the 3-year OS rate (86.3% vs 74.7%; p=0.005). PFS benefit was observed in both <i>BRCA</i>-mutated and <i>BRCA</i> wild-type subgroups. OS improvement was evident in the <i>BRCA</i> wild-type subgroup, with minimal post-progression crossover.</p><p><strong>Conclusion: </strong>First-line niraparib maintenance was associated with improved PFS regardless of <i>BRCA</i> status and with improved OS, particularly in <i>BRCA</i> wild-type patients.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT06086665.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061921","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":"Changes and clinical impact of HER3 and <i>ERBB3</i> expression in primary and recurrent ovarian cancer.","authors":"Kota Yokosu, Riu Yamashita, Satoshi Fujii, Hiroshi Tanabe, Toru Mukohara, Saori Sato, Maki Kobayashi, Keiko Oshima, Hiroko Kimura, Hiroyuki Takahashi, Motoaki Saito, Kyosuke Yamada, Hirokuni Takano, Aikou Okamoto, Kenichi Harano","doi":"10.3802/jgo.2027.38.e30","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e30","url":null,"abstract":"<p><strong>Objective: </strong>Human epidermal growth factor receptor (HER) 3, encoded by the <i>ERBB3</i> gene, transduces signals most effectively when dimerized with HER2. Although HER3 protein expression has been considered a poor prognostic factor in ovarian cancer, limited data exist on changes in HER3 protein expression and <i>ERBB3</i> messenger RNA (mRNA) expression during recurrence. This study evaluated HER3/ERBB3 expression before and after recurrence and its association with prognosis using paired samples. We also evaluated HER2/ERBB2 expression.</p><p><strong>Methods: </strong>We retrospectively analyzed 56 epithelial ovarian, fallopian tube, and primary peritoneal cancer patients who underwent primary cytoreduction and platinum-based chemotherapy at initial treatment and secondary cytoreduction at recurrence. HER2/HER3 protein expression was assessed by immunohistochemical staining. <i>ERBB2</i>/<i>ERBB3</i> mRNA expression was quantified using the nCounter® Analysis System.</p><p><strong>Results: </strong>The median age was 52 years. International Federation of Gynecology and Obstetrics stages I-IV included 16, 12, 22, and 6 patients, respectively. Histological subtypes included high-grade serous carcinoma (n=19), clear cell carcinoma (n=14), and other histological subtypes (n=23). The proportion of HER2-high and HER3-high tumors increased from 14.5% to 22.2% and from 62.5% to 72.2%, respectively, at recurrence, without statistical significance. Conversely, both <i>ERBB2</i> and <i>ERBB3</i> were significantly downregulated during recurrence. At initial treatment, HER3 did not correlate with prognosis, whereas <i>ERBB3</i> was independently associated with favorable recurrence-free and overall survival. At recurrence, neither HER3 nor <i>ERBB3</i> was prognostically significant.</p><p><strong>Conclusion: </strong><i>ERBB3</i> expression at initial treatment was associated with prognosis and significantly downregulated during recurrence. These findings suggest biological changes in HER3/<i>ERBB3</i> associated with recurrence.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982983","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":"Correlation of bevacizumab relative dose intensity with first-line treatment outcomes in advanced epithelial ovarian cancer.","authors":"Liming Zhang, Meilin Chen, Zhen Yang, Meiling Gong, Ruilian Yu","doi":"10.3802/jgo.2027.38.e28","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e28","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between bevacizumab relative dose intensity (RDI) and first-line treatment outcomes in advanced epithelial ovarian cancer.</p><p><strong>Methods: </strong>We retrospectively analyzed 72 patients treated with first-line bevacizumab plus paclitaxel-platinum chemotherapy between January 2019 and September 2024. Patients were categorized using X-tile-derived RDI cutoffs as low (≤0.61), intermediate (>0.61 to <0.93), or high (≥0.93). Objective response rate (ORR), progression-free survival (PFS), and adverse events were compared, and Cox proportional hazards regression was used to assess factors associated with PFS.</p><p><strong>Results: </strong>ORRs were 40.0%, 75.0%, and 80.0% in the low-, intermediate-, and high-RDI groups, respectively (p=0.011). Median PFS was 12.6, 21.2, and 23.5 months, respectively (log-rank p=0.037), with the greatest difference between the low- and high-RDI groups (p=0.018). In multivariable analysis, high versus low RDI was associated with a lower risk of progression (hazard ratio=0.463; 95% confidence interval=0.235-0.913; p=0.026). Overall adverse-event incidence did not differ significantly among groups; however, grade 3-4 neutropenia and thromboembolic events were significantly more frequent in the high- than low-RDI group.</p><p><strong>Conclusion: </strong>Lower bevacizumab RDI was associated with poorer response and shorter PFS. Given the retrospective single-center design, the optimal RDI threshold requires validation in larger prospective studies.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982952","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}