Journal of Gynecologic Oncology最新文献

{"title":"Oncological safety of minimally invasive surgery in borderline ovarian tumor and ovarian cancer: a retrospective comparative study.","authors":"Natsuki Osawa, Kenro Chikazawa, Ken Imai, Hiroyoshi Ko, Tomoyuki Kuwata, Ryo Konno","doi":"10.3802/jgo.2025.36.e46","DOIUrl":"10.3802/jgo.2025.36.e46","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the oncological safety of laparoscopic surgery for patients with benign tumors who underwent laparoscopic surgery at our facility and were subsequently diagnosed with borderline ovarian tumors or ovarian cancer.</p><p><strong>Methods: </strong>We conducted a retrospective review of 45 patients initially diagnosed with benign ovarian tumors who underwent laparoscopic surgery at our institution from January 2009 to April 2024.</p><p><strong>Results: </strong>Postoperative pathological examination identified 32 cases of borderline ovarian tumors and 13 cases of ovarian cancer. Laparoscopic cystectomy was performed in 14 (43.8%) borderline cases and 4 (30.8%) ovarian cancer cases. Out of 14 patients with borderline ovarian tumors who underwent cystectomy, 8 subsequently underwent staging laparotomy, whereas 6 underwent only ovarian tumor cystectomy. In contrast, none of the patients with ovarian cancer completed treatment with only ovarian tumor cystectomy. Recurrent disease was observed in 9.4% of borderline tumor cases, all of which were successfully managed with further surgery. In the ovarian cancer group, recurrence occurred in 31% of patients, with 3 resulting in tumor-related mortality.</p><p><strong>Conclusion: </strong>Laparoscopic surgery for borderline ovarian tumors is suggested to be oncologically safe, with low recurrence rate and no adverse impact on survival. However, for ovarian cancer, particularly in cases with peritoneal dissemination, rapid disease progression remains a concern. While this study suggests that laparoscopic surgery may be a viable option for borderline ovarian tumors, further research is needed to validate these findings, particularly for ovarian cancer.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e46"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687182","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":"Pharmacokinetics, toxicities, and tissue concentrations of belotecan sprayed by rotational intraperitoneal pressurized aerosol chemotherapy in a pig model.","authors":"Seungmee Lee, Seoyoon Lee, Yoo-Kyung Song, Se-Mi Kim, Yoon Jeong Choi, Seung Jun Lee, San-Hui Lee, Hee Seung Kim","doi":"10.3802/jgo.2025.36.e37","DOIUrl":"10.3802/jgo.2025.36.e37","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated the pharmacokinetics, tissue concentrations, and toxicities of belotecan during rotational intraperitoneal pressurized aerosol chemotherapy (RIPAC) in pigs.</p><p><strong>Methods: </strong>We sprayed belotecan in 10% and 30% of doses for intravenous chemotherapy in six pigs (cohort 1, n=3, 0.50 mg/m²; cohort 2, n=3, 1.5 mg/m²). We evaluated the time-dependent plasma concentrations of belotecan before RIPAC to 120 hours for the pharmacokinetics, tissue concentrations in twelve peritoneal regions, and hepatic and renal functions before RIPAC to 120 hours in the 2 cohorts.</p><p><strong>Results: </strong>Mean values of the peak plasma concentration (C_max), the time to C_max, the time taken for C_max to drop in half, and the area under the curve from time zero to the time of last quantifiable concentration were 905 and 3,700 ng/mL, 1.42 and 1.50 hours, 3.64 and 5.60 hours, and 2,260 and 17,900 pg·hr/mL in cohorts 1 and 2, respectively. Mean values of tissue concentrations were 1.5 to 15.3 times higher in cohort 1 than in cohort 2 despite the similar ratio of tissue to plasma concentration, and tissue concentrations in the two cohorts were higher in the parietal peritoneum than in the visceral peritoneum. However, hepatic and renal functions were not different before RIPAC to 120 hours in the two cohorts.</p><p><strong>Conclusion: </strong>RIPAC using belotecan of 0.5 mg/m² and 1.5 mg/m² may be feasible with fewer hepatic and renal toxicities in pigs. Thus, belotecan of 1.5 mg/m² may be considered as the starting dose for RIPAC in a phase 1 trial.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e37"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687186","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":"Application value of personalized 3D printing vaginal model for the Image-guided adaptive brachytherapy of cervical cancer.","authors":"Zhantuo Cai, Qiuyan Wu, Xinglong Yang, Qinghua Qin, Yiqian Zhang, Zhouyu Li, Mingyi Li","doi":"10.3802/jgo.2025.36.e48","DOIUrl":"10.3802/jgo.2025.36.e48","url":null,"abstract":"<p><strong>Objective: </strong>To explore the application value of using 3-dimensional (3D) printing (3DP) technology to create individualized vaginal molds for brachytherapy (BT) in high-dose-rate 3D cervical cancer through reverse engineering of needle placement.</p><p><strong>Methods: </strong>Prospectively, 11 patients with cervical cancer were treated with 3DP-intracavitary/interstitial (IC/IS) BT using 3DP to create individualized vaginal molds. All patients were performed BT after completion of external beam radiotherapy (EBRT). Each patient was treated with BT 5 times, the prescription dose was 600 cGy/F, which was performed once or twice a week, 2 of them were freehand IC/IS BT, and 3 were 3DP-IC/IS BT. The relevant planning parameters (bladder, rectum, sigmoid colon, and small intestine) and target conformity index (CI) for high-risk clinical target volume (HR-CTV) and organs at risk (OARs) were compared between the groups.</p><p><strong>Results: </strong>There were significant advantages in the 3DP-IC/IS BT group compared with the freehand IC/IS BT group: HR-CTV D₉₀ (629.40±19.34 vs. 613.03±15.93 cGy, p=0.002), D₉₅ (580.74±18.31 vs. 567.44±23.94 cGy, p=0.032), bladder D_2cc (431.11±23.27 vs. 458.07±23.27 cGy, p<0.001), bladder D_1cc and bladder D_0.1cc. There was no statistically significant difference (p>0.05) between the 2 groups in rectal D_2cc (352.30±42.42 vs. 361.29±42.42 cGy, p=0.470), sigmoid colon D_2cc (236.73±78.95 vs. 246.50±58.17 cGy, p=0.621), CI (0.79±0.04 vs. 0.79±0.039 p=0.773), HR-CTV V₁₀₀, V₂₀₀, D₉₈, D₁₀₀ and other OARs parameters (p>0.05).</p><p><strong>Conclusion: </strong>Compared with IC/IS BT, 3DP-IC/IS BT has apparent advantages with simple operation and high safety. In addition, individualized mold helps to improve the tumor target area's radiation dose while meeting the dose-limiting requirements for organs at risk and reduces the clinical proficiency requirements for operating physicians.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e48"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895146","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":"Prognostic impact of peritoneal cytology on treating endometrial cancer using data from the Japan Society of Obstetrics and Gynecology cancer registry.","authors":"Kensuke Sakai, Wataru Yamagami, Fumiaki Takahashi, Hideki Tokunaga, Eiko Yamamoto, Yoshihito Yokoyama, Kiyoshi Yoshino, Kei Kawana, Satoru Nagase","doi":"10.3802/jgo.2025.36.e41","DOIUrl":"10.3802/jgo.2025.36.e41","url":null,"abstract":"<p><strong>Objective: </strong>The prognostic value and clinical usage of peritoneal cytology in endometrial cancer are uncertain. This study aimed to determine whether positive cytology is associated with the prognosis for endometrial cancer.</p><p><strong>Methods: </strong>A Japanese nationwide retrospective registry study was conducted between 2012 and 2019. Clinicopathological data were analyzed for patients who were registered in the Japan Society of Obstetrics and Gynecology (JSOG) gynecological tumor registry and underwent initial treatment for endometrial cancer.</p><p><strong>Results: </strong>In total, 83,027 patients who met the inclusion criteria were identified. Data on peritoneal cytology status and overall survival (OS) were available for 74,984 and 36,995 patients, respectively. Positive peritoneal cytology was found in 11,536 (15.4%) patients. A higher proportion of patients who had positive peritoneal cytology were related to advanced stages, high-grade histology, deep myometrial invasion, lymph node (LN) metastasis, and poor risk of recurrence. After controlling for age, stage, myometrial invasion, LN metastasis, distant metastasis, and risk of recurrence, positive peritoneal cytology was associated with poor prognosis (p<0.001). Multivariate Cox regression analysis revealed that clinicopathological factors (i.e., age, International Federation of Gynecology and Obstetrics stage, histological type, myometrial invasion, LN metastasis, distant metastasis, and peritoneal cytology), including positive peritoneal cytology, were also significant prognostic factors for OS.</p><p><strong>Conclusion: </strong>Positive peritoneal cytology was a prognostic factor for endometrial cancer for the JSOG gynecological tumor registry.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e41"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558035","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":"Clinicopathological features and patterns of treatment of patients with endometrial cancer in Brazil.","authors":"Martina Parenza Arenhardt, Giovanna Vieira Giannecchini, Luiz Claudio Santos Thuler, Andreia Cristina de Melo","doi":"10.3802/jgo.2025.36.e102","DOIUrl":"10.3802/jgo.2025.36.e102","url":null,"abstract":"","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e102"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780217","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":"International cost-effectiveness analysis of chemoradiotherapy plus pembrolizumab for locally advanced cervical cancer.","authors":"Kun Liu, Youwen Zhu, Hong Zhu","doi":"10.3802/jgo.2025.36.e106","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e106","url":null,"abstract":"<p><strong>Objective: </strong>Pembrolizumab administration can improve concurrent chemoradiotherapy (CCRT) efficacy in newly diagnosed, high-risk, locally advanced cervical cancer (LACC). Given the importance of balancing the costs of innovative therapeutics against their efficacy, this study was developed to assess the cost-effectiveness from the perspective of payers in Americas, Europe, and Asia.</p><p><strong>Methods: </strong>The main survival and other relevant parameters of 1,060 LACC patients from the KEYNOTE-A18 trial were collected to establish a lifetime 3-state Markov model to evaluate the cost and effectiveness of pembrolizumab-CCRT and placebo-CCRT. Primary outcome measures included total cost, life-years (LYs), quality-adjusted LYs (QALYs), incremental cost-effectiveness ratio (ICER), incremental net monetary benefit, and incremental net health benefits (INHBs) at countries' traditional willingness-to-pay (WTP) thresholds. Model stability was also examined through sensitivity analyses.</p><p><strong>Results: </strong>The USA, Italy, and China are selected as representative countries for each of the 3 continents, assuming that their WTP thresholds were $150,000, $43,749, and $37,766 per QALY. The increased efficacy and costs of pembrolizumab-CCRT versus placebo-CCRT were 2.52 QALYs (3.11 LYs) and $346,479, 2.30 QALYs (2.81 LYs) and $236,776, 1.79 QALYs (2.12 LYs) and $29,027, calculating the ICER for the 3 countries as $137,500/QALY ($111,499/LY), $102,758/QALY ($84,192/LY), and $16,217/QALY ($13,726/LY), respectively. The respective INHBs were 0.21 QALY, -3.11 QALY, and 1.02 QALY, and pembrolizumab-CCRT was exhibited cost-effectiveness opportunities of 62.68%, 12.53%, and 75.23% at the selected WTP threshold, respectively.</p><p><strong>Conclusion: </strong>At current prices, pembrolizumab-CCRT represents a cost-effective alternative for patients with LACC in the USA and China, but not in Italy.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575606","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":"Pregnancy complications and outcomes in patients with early endometrial cancer or atypical hyperplasia after fertility-sparing treatment.","authors":"Yali Cheng, Youting Dong, Bingyi Yang, Weiwei Shan, Yu Xue, Xiaojun Chen","doi":"10.3802/jgo.2025.36.e111","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e111","url":null,"abstract":"<p><strong>Objective: </strong>To explore the characteristics of pregnancy outcomes in patients with early-stage endometrioid endometrial cancer (EEC) and endometrial atypical hyperplasia (EAH) after successful fertility-sparing treatment.</p><p><strong>Methods: </strong>This was a retrospective, single-center analysis of 481 patients with EEC/EAH who desired to conceive after successful fertility-sparing treatment from January 2015 to June 2023. Pregnancy outcomes across reproductive methods were compared.</p><p><strong>Results: </strong>The pregnancy rate was 58.24% and the live birth rate was 48.65% in patients with EAH/EEC after successful fertility-preserving treatment. An age ≥35 years, BMI ≥25 kg/m², and hypertension were independent risk factors for failure of pregnancy. Higher pregnancy (65.77% and 63.64%) and live birth (53.08% and 48.86%) rates were achieved in the in vitro fertilization and embryo transfer (IVF-ET) and ovulation induction group than in the natural conception group (47.68% and 35.10%, respectively). The incidence of threatened abortion (56.52%), cervical insufficiency (5.58%), and placenta accrete/increta (11.15%) appeared to be numerically higher in patients with EAH/EEC than in epidemiological data. More than 5 times of hysteroscopic evaluation was an independent risk factor for placenta accreta/increta.</p><p><strong>Conclusion: </strong>Assisted reproductive technology including IVF-ET and ovulation induction might be preferred for patients with EEC/EAH after successful fertility-sparing treatment to achieve a relatively better pregnancy outcome, though IVF-ET has a higher incidence risk of threatened abortion, preterm birth and placenta accreta/increta. Obstetricians should be prepared for the treatment of threatened abortion, cervical insufficiency, and placenta accreta/increta in patients with EEC/EAH once they become pregnant, especially in those receiving more than 5 times of hysteroscopic evaluation.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575607","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":"Characteristics of endometrial cancer progressed to extrauterine lesions following fertility preserving medroxyprogesterone acetate therapy for young endometrial cancer patients.","authors":"Shoko Kitazawa, Kensuke Sakai, Miho Kawaida, Tatsuyuki Chiyoda, Hiroshi Nishio, Kouji Banno, Nobuyuki Susumu, Wataru Yamagami","doi":"10.3802/jgo.2025.36.e104","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e104","url":null,"abstract":"<p><strong>Objective: </strong>Medroxyprogesterone acetate (MPA) is an effective fertility-preserving treatment for early endometrial cancer and atypical endometrial hyperplasia (AEH), and rarely leads to the development of extrauterine lesions (ELs). We aimed to clarify the characteristics of patients who developed ELs post-MPA therapy.</p><p><strong>Methods: </strong>We analyzed the clinicopathological factors and prognoses of 319 patients with endometrioid carcinoma grade 1 (EMG1) and AEH treated with MPA at our institution. All patients underwent imaging before MPA treatment to rule out ELs.</p><p><strong>Results: </strong>Seven patients (2.2%) with EMG1 showed EL after MPA treatment. Two patients developed EL during the initial treatment, 2 during repeated treatment, and 3 during follow-up. Two patients had peritoneal dissemination, 3 had regional lymph node metastasis, 1 had distant metastasis at the Virchow lymph node, and 1 had ovarian metastasis. ELs were diagnosed using imaging tests in 6 patients and elevated tumor markers in 3 (overlapping) patients. One patient was diagnosed with ELs pathologically after hysterectomy. Upon EL diagnosis, patients underwent standard treatment, including hysterectomy and chemotherapy, that was followed by a diagnosis of EMG1 for 5, EMG2 for 1, and EMG3 for 1 patient. One patient died 15 months after start of therapy and another died 119 months post-treatment initiation, while the others have been survived.</p><p><strong>Conclusion: </strong>Only 2.2% of all patients developed ELs post-MPA treatment, but some cases were fatal. It is essential to conduct imaging tests and screen for tumor markers during and after MPA treatment regularly and also when cancer progression is suspected.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967249","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":"Oncologic outcome of metachronous oligometastatic recurrence in advanced cervical cancer patients after primary radio-chemotherapy.","authors":"Thomas Bartl, Tim Dorittke, Cristina Ciocsirescu, Johannes Knoth, Maximilian Schmid, Christoph Grimm, Alina Sturdza","doi":"10.3802/jgo.2025.36.e99","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e99","url":null,"abstract":"<p><strong>Objective: </strong>Systemic chemotherapy in recurrent cervical cancer is a palliative treatment approach with limited oncologic outcome. As emerging evidence supports favorable prognosis following radical local treatment strategies for oligometastatic recurrence in gynecologic malignancies, there is an unmet clinical need to define prognostic implications of surgical metastasectomy in recurrent cervical cancer.</p><p><strong>Methods: </strong>Data of 139 consecutive cervical cancer patients, who underwent primary external-beam radiotherapy with concomitant chemotherapy, followed by magnetic resonance image-guided adaptive brachytherapy between 2015 and 2019, was analyzed. Oncologic outcomes of recurrence patterns, defined according to the European Society for Radiotherapy and Oncology (ESTRO) and the American Society for Radiation Oncology (ASTRO) consensus, was assessed according to the type of recurrence therapy.</p><p><strong>Results: </strong>Of 54 patients (38.8%) with metachronous disease recurrence, 21 (38.8%) classified as metastatic and 22 (40.7%) as oligometastatic. Oligometastatic recurrence was associated with improved progression-free survival after recurrence (PFS2; hazard ratio [HR]=2.95; 95% confidence interval [CI]=1.23-7.08; p=0.015) and disease-specific survival after recurrence (HR=3.28; 95% CI=1.40-7.70; p=0.006) irrespective of the type of recurrence therapy. An exploratory subgroup analysis of oligometastatic patients undergoing surgical resection ± adjuvant therapy (n=12) suggested reduced risk of second disease recurrence (odds ratio=0.15; 95% CI=0.02-0.92; p=0.020) and improved PFS2 (HR=0.24; 95% CI=0.06-0.99; p=0.048) as compared to palliative systemic treatment (n=7).</p><p><strong>Conclusion: </strong>A relevant number of recurrences qualifies as oligometastatic according to the ESTRO-ASTRO consensus, which associate with improved prognosis irrespective of the type of recurrence therapy. Patients experiencing oligometastatic recurrence should be carefully evaluated for potentially curative treatment approaches.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020439","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":"Role of adjuvant chemotherapy in stage IC ovarian granulosa cell tumors: a systematic review and meta-analysis.","authors":"Tianyu Zhang, Jie Yang, Xinyue Zhang, Jiaxin Yang","doi":"10.3802/jgo.2025.36.e100","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e100","url":null,"abstract":"<p><p>This systematic review and meta-analysis aimed to assess the impact of postoperative adjuvant chemotherapy on recurrence and mortality in stage IC granulosa cell tumors (GCTs). We searched the PubMed, Embase, and Cochrane Library for studies published up to December 1, 2024, comparing the oncological outcomes of adjuvant chemotherapy with observation in stage IC GCTs. Seventy studies were identified, with 12 included in the meta-analysis. Among 695 patients, 255 (36.7%) received postoperative adjuvant chemotherapy and 440 (63.3%) received observation. The overall recurrence and mortality rates were 18.7% and 7.6%, respectively. No significant differences were observed in survival outcomes between the adjuvant chemotherapy and observation groups, including recurrence rate (odds ratio [OR]=1.32; 95% confidence interval [CI]=0.67-2.58; p=0.424; I²=33%), mortality rate (OR=0.83; 95% CI=0.44-1.57; p=0.560; I²=0%), 5-year disease free survival (OR=0.88; 95% CI=0.18-4.18; p=0.868; I²=54%) and 5-year overall survival (OR=1.28; 95% CI=0.60-2.74; p=0.519; I²=0%). Subgroup analysis revealed no significant difference in recurrence rate between adjuvant chemotherapy and observation for both adult and juvenile GCTs, or between patients who underwent fertility-sparing surgery and those who did not. Additionally, no difference was found in recurrence rate between 'bleomycin, etoposide, and cisplatin' or 'etoposide and cisplatin' and 'paclitaxel combined with carboplatin or cisplatin' regimens. Postoperative adjuvant chemotherapy did not provide additional benefits in disease recurrence or survival outcomes compared to observation in stage IC GCTs. Trial Registration: PROSPERO Identifier: CRD42024559478.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013474","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}