Journal of Gynecologic Oncology最新文献

{"title":"Performance of multi-parameter differential diagnostic models for ovarian cancer screening in women with adnexal masses.","authors":"Ningtao Cheng, Mengyan Tu, Chenchun Zhang, Tianchen Guo, Shenglong Wu, Sangsang Tang, Junfen Xu","doi":"10.3802/jgo.2026.37.e118","DOIUrl":"10.3802/jgo.2026.37.e118","url":null,"abstract":"<p><strong>Objective: </strong>To enhance ovarian cancer diagnosis by establishing multi-parameter differential diagnostic models, combining preoperative blood tests and ultrasonic examination.</p><p><strong>Methods: </strong>This was a retrospective cohort study. Adult women with adnexal lesions who underwent surgery between January 2013 and December 2019 were included in the study. We performed various blood tests (including routine blood work, biochemistry, thyroid hormone, reproductive hormones, and tumor markers) and ultrasonic examination on 2,929 participants. Based on these clinical features, diagnostic models were constructed and validated using the eXtreme Gradient Boosting (XGBoost) algorithm and logistic regression.</p><p><strong>Results: </strong>Among the 2,929 participants with adnexal masses, 2,117 participants had benign conditions (574 ovarian cysts, 1,376 ovarian tumors, and 167 ovarian endometriomas), 311 had borderline ovarian tumors, and 501 had invasive ovarian cancer (413 epithelial and 88 non-epithelial types). Initially, full-feature modeling achieves area under the curve (AUC) values of 1.00 and 0.97 for the diagnosis of epithelial ovarian cancer in the training and validation sets, respectively, using a set of 20 feature parameters. Similarly, a set of 30 feature parameters yield AUCs of 1.00 (training) and 0.97 (validation) for the diagnosis of invasive ovarian cancer. XGBoost outperformed other modeling algorithms in predictive values. The differential diagnostic models constructed from multiple feature parameters exhibited better calibration than the model based on a single parameter of cancer antigen 125.</p><p><strong>Conclusion: </strong>This study established effective multi-parameter differential diagnostic models to differentiate ovarian cancer from adnexal masses, demonstrating their potential to enhance diagnostic accuracy.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396964","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":"Evaluator-blinded, randomized, multi-center study to evaluate the efficacy and safety of Medicurtain^® in patients undergoing laparoscopic hysterectomy.","authors":"YeongTak Kim, JiYeong Choi, TaeJin Kim, YongIl Kwon, YeongJin Jeong","doi":"10.3802/jgo.2026.37.e128","DOIUrl":"10.3802/jgo.2026.37.e128","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the efficacy and safety of the surgical adhesion barrier Medicurtain^® in patients undergoing laparoscopic hysterectomy.</p><p><strong>Methods: </strong>The study was a multi-center, non-controlled, evaluator-blinded, randomized clinical trial. A total of 91 participants from 3 study sites were randomly assigned to the hyaluronic acid (HA)- hydroxyethyl starch (HES) barrier agent treatment test group (n=49) or the non-treatment control group (n=42). At Visit 3 (8 weeks±5 days), adhesion formation rates and grades were assessed via second-look laparoscopy, and adverse events (AEs) were evaluated. An independent investigator conducted all assessments.</p><p><strong>Results: </strong>At Visit 3, adhesion rates differed significantly between the 2 groups: 73.47% in the test group and 95.24% in the control group (p=0.005). In the intention-to-treat analysis, adhesion grades at Visit 3 were 1.10±0.87 in the treatment group and 1.45±0.74 in the control group, showing a statistically significant difference (p=0.045). Safety analysis revealed no adverse device effects during the follow-up period in either group and no dropouts due to AEs. Additionally, the test and control groups demonstrated no significant differences in other safety parameters, including vital signs, laboratory tests, physical examinations, and electrocardiogram findings.</p><p><strong>Conclusion: </strong>HA-HES barrier agent appears to be a potentially effective and safe adhesion barrier for laparoscopic procedures.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04672421.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396999","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":"Comparative performance of first-void urine and self-collected vaginal swabs against clinician-collected cervical samples using 2 HPV real-time assays in Indian women.","authors":"Rajeswari A, John Dickson Calvin Devadasan, Vinotha Thomas, Dhanya Susan Thomas, Anitha Thomas, Annie Prasanthi Vijjeswarapu, Shiny Nirupama, Karthick Nithyanandhan, Annarani Jose, Susanne A Pulimood, Leni George, Anne Jennifer Prabhu, Divya K, Rajesh Kannangai, Gnanadurai John Fletcher, Priya Abraham","doi":"10.3802/jgo.2026.37.e138","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e138","url":null,"abstract":"<p><strong>Objective: </strong>To enhance participation of women in cervical cancer (CC) screening, we compared high-risk human papillomavirus (HR-HPV) DNA testing of first-void urine (FVU) and self-collected vaginal swabs (SCVSs) to the gold standard clinician collected cervical specimens (CCCSs).</p><p><strong>Methods: </strong>In this cross-sectional study, consecutive consenting women (n=295) identified for CC screening mainly from Gynaecology-Oncology out-patient clinics were enrolled from May to October 2024. All were educated to provide self-samples (FVU, SCVS) followed by CCCS. All samples were tested for HR-HPV by 2 real-time polymerase chain reaction assays: Alinity m HR-HPV assay and Allplex™ II HPV HR assay. Awareness of CC, its screening, prevention and acceptability of self-sampling methods were assessed through a questionnaire.</p><p><strong>Results: </strong>All sample types showed identical concordance (93.9%)/discordance (6.1%) across both real-time assays. Using Alinity m, sensitivity and specificity of FVU vs. CCCS was similar to SCVS vs. CCCS, i.e., 83.3% (95% confidence interval [CI]=68.64%-93.03%) and 98% (95% CI=95.45%-99.36%) respectively. With Allplex, sensitivity and specificity of FVU vs. CCCS was 84.78% (95% CI=71.13%-93.66%) and 97.19% (95% CI=94.29%-98.86%) respectively; and that of SCVS vs. CCCS was 97.83% (95% CI=88.47%-99.94%) and 95.98% (95% CI=92.74%-98.06%) respectively. Majority were unaware of CC (86.4%), its screening (98.6%) or its prevention (96.9%). Majority of women (92%) preferred FVU for CC if screened at regular intervals.</p><p><strong>Conclusion: </strong>This study shows a favorable performance of FVU and SCVS in both assays. FVU is a scalable, non-invasive, acceptable and feasible alternative to CCCS, with the potential to intensify CC screening programs in low- and middle-income countries.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396945","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":"p16(INK4a) immunohistochemical expression is a strong predictor of treatment response and survival in patients with locally advanced squamous cell vulvar cancer undergoing upfront chemoradiotherapy.","authors":"Alex Federico, Simona Maria Fragomeni, Valentina Lancellotta, Sara Ammar, Angela Santoro, Alessia Piermattei, Giacomo Corrado, Gabriella Macchia, Luca Tagliaferri, Maria Antonietta Gambacorta, Gian Franco Zannoni, Anna Fagotti, Giovanni Scambia, Giorgia Garganese","doi":"10.3802/jgo.2026.37.e137","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e137","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the prognostic significance of tumor p16(INK4a) expression in predicting treatment response and survival in patients with locally advanced squamous cell vulvar cancer (LAVC) undergoing chemoradiotherapy (CRT).</p><p><strong>Methods: </strong>Retrospective data were collected from patients with stage II-IVB disease managed with definitive or neoadjuvant CRT between January 2016 and March 2024. Clinical response to CRT and survival outcomes according to tumor p16 expression were evaluated.</p><p><strong>Results: </strong>Among 61 patients, 39 (63.9%) had p16-negative (p16-) tumors, 22 (36.1%) had p16-positive (p16+) tumors. p16 positivity was linked to higher complete clinical response (cCR) rates (odds ratio [OR]=9.8; p<0.001) and, after adjusting for tumor size, lymph node status and radiation dose, was the only independent predictor of cCR (OR=7.0; p=0.003). The 3-year progression-free survival (PFS), locoregional control (LRC), and overall survival (OS) rates were 12.6%, 17.3%, and 19.5% for p16- tumors, 60.4% (p<0.001), 80.4% (p<0.001), and 64.9% (p<0.001) for p16+ tumors. Among patients who achieved a cCR, the 3-year PFS, LRC and OS were 14.3%, 14.3%, and 33.3% for p16- tumors, 69.6% (p=0.001), 85.7% (p<0.001), and 80.2% (p=0.008) for p16+ tumors. p16 positivity was independently associated with improved PFS (hazard ratio [HR]=0.15, p<0.001), LRC (HR=0.09, p<0.001), and OS (HR=0.16, p<0.001). Larger tumor size adversely affected all outcomes, while age, lymph node status, and RT dose were not significant predictors.</p><p><strong>Conclusion: </strong>p16(INK4a) expression predicts treatment response, locoregional disease control and survival in LAVC undergoing upfront CRT. These findings highlight the importance of integrating p16 expression into treatment protocols and future clinical trials.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338796","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":"Efficacy of secondary cytoreductive surgery for relapsed ovarian low-grade serous carcinoma: a multicenter analysis from French TMRG network.","authors":"Thomas Gaillard, Judicael Hotton, Enora Laas, Frederic Marchal, Cécile Loaec, Pierre-Emmanuel Colombo, Gwenael Ferron, Anne-Sophie Bats, Sébastien Gouy, Claire Bonneau, Floriane Jochum, Thomas Montassier, Frédéric Guyon, Florence Joly, Christophe Pomel, Dominique Berton-Ruigaud, Navid Mokarram-Dorri, Eric Lambaudie, Thibault de la Motte Rouge, Isabelle Ray-Cocquard, Fabrice Lecuru","doi":"10.3802/jgo.2026.37.e115","DOIUrl":"10.3802/jgo.2026.37.e115","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of secondary cytoreductive surgery (SCS) on overall survival (OS) and progression-free survival (PFS) in patients with recurrent low-grade serous ovarian cancer.</p><p><strong>Methods: </strong>A multicenter study was conducted, including 152 patients with recurrent low-grade serous ovarian cancer treated across 31 French centers from 2002 to 2024 from the Tumeurs Malignes Rares Gynécologiques network. Patients were analyzed based on SCS status, completeness of cytoreduction (CC0 vs. CC+), and clinical outcomes. Survival analyses were performed using Kaplan-Meier estimates and Cox proportional hazards models.</p><p><strong>Results: </strong>From 478 patients, a total of 152 patients with first recurrent low-grade serous ovarian cancer were included, with 39.5% undergoing SCS. Complete cytoreduction (CC0) was achieved in 92% of cases, with no difference in complication rates based on resection quality. After adjustment on confounding factors, SCS was independently associated with improved OS (adjusted hazard ratio on age [HRa]=0.28; 95% confidence interval [CI]=0.13-0.63; p<0.001) and showed better PFS also not statistically significant (HRa=0.57; 95% CI=0.32-1.03; p=0.06).</p><p><strong>Conclusion: </strong>SCS achieving complete resection significantly improves OS and appears to prolong PFS in recurrent low-grade serous ovarian cancer. Proper patient selection is critical to optimizing outcomes. These findings support the integration of SCS into the multidisciplinary management of recurrent low-grade serous ovarian cancer.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396966","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":"Understanding mortality trends in patients with uterine malignancies from 1999 to 2023 utilizing the CDC WONDER database.","authors":"Shannon Blee, Sun Young Guwn, Olivia Foley, Taylor Billion, Peter Silberstein, Abubakar Tauseef","doi":"10.3802/jgo.2026.37.e143","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e143","url":null,"abstract":"<p><strong>Objective: </strong>Uterine cancer incidence is increasing in the United States. This study aims to evaluate current malignant uterine neoplasm-related mortality in the US and investigate potential disparities that exist between differing demographic groups.</p><p><strong>Methods: </strong>Data was gathered from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database, and mortality trends due to malignant uterine neoplasms in patients aged 25 to 85+ years old in the US were analyzed from 1999 to 2023. Joinpoint regression was utilized for data analysis. Age-adjusted mortality rate (AAMR) and average annual percent change (AAPC) were examined. Data was stratified by race, age, region, urban vs. rural, and state.</p><p><strong>Results: </strong>Between 1999 and 2023, there were 262,431 malignant uterine neoplasm-related deaths in the US. Overall, mortality increased between 1999 and 2023 (AAPC, 1.15^*). Black/African American patients consistently had the highest AAMR among all other races, although all races experienced a significant increase in AAMR throughout the study period. The Northeast and Midwest experienced consistently higher AAMRs compared to other regions, while the South experienced the largest overall increase in AAMR (AAPC, 1.37^*). Urban and rural areas both experienced significant increases in malignant uterine neoplasm-related mortality (AAPCs 0.89^* and 0.76^*, respectively), while older age cohorts correlated with higher AAMR.</p><p><strong>Conclusion: </strong>Overall, disparities in malignant uterine neoplasms related mortality exist, and Black/African American and older patients are disproportionately affected. Therefore, more must be done to not only prevent but treat this disease, particularly in Black/African American and older patients.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338872","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":"Nationwide survey of hereditary breast and ovarian cancer-related clinical practice in gynecologic oncology in Japan: a joint study by the Japan Society of Gynecologic Oncology (JSGO) and the Japan Society of Obstetrics and Gynecology (JSOG).","authors":"Kenta Masuda, Katsutoshi Oda, Hidemichi Watari, Akira Hirasawa, Shinya Sato, Kenichi Harano, Satoru Nagase, Kazuhiro Takehara, Masaki Mandai, Yuko Sasajima, Tamotsu Sudo, Hiroyuki Yanai, Hitoshi Tsuda, Yusuke Kobayashi, Kei Kawana, Mikio Mikami, Kiyoko Kato, Daisuke Aoki, Aikou Okamoto","doi":"10.3802/jgo.2026.37.e122","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e122","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the current status of hereditary breast and ovarian cancer (HBOC)-related clinical practice in Japan, including genetic testing, risk-reducing surgery, and surveillance systems, and to identify institutional gaps and unmet needs.</p><p><strong>Methods: </strong>A nationwide questionnaire survey was conducted between February and April 2024 targeting 647 Japan Society of Obstetrics and Gynecology-affiliated training facilities and gynecologic oncology centers. Institutional-level data on genetic testing, homologous recombination deficiency (HRD) testing, risk-reducing salpingo-oophorectomy (RRSO), postoperative management, surveillance practices, and healthcare infrastructure were collected. Responses from 248 institutions (response rate, 38.3%) were analyzed descriptively.</p><p><strong>Results: </strong><i>BRCA1/2</i> genetic testing was performed in 83% of institutions, and HRD testing using the myChoice® CDx system in 87%. However, only 30% offered universal <i>BRCA1/2</i> testing for ovarian, fallopian tube, or peritoneal cancer, and testing indications varied widely. Genetic counseling resources were uneven, with 29% lacking on-site genetic specialists, driven mainly by institutional characteristics rather than geographic location. RRSO was performed in 50% of institutions, predominantly laparoscopically. While management of occult carcinoma after RRSO was largely consistent, postoperative management of serous tubal intraepithelial carcinoma (STIC) and positive peritoneal cytology varied substantially. Over 70% of institutions reported a need for expanded insurance coverage for genetic services and preventive care.</p><p><strong>Conclusion: </strong>Although HBOC-related genetic testing and preventive strategies are widely implemented in Japan, this nationwide survey revealed critical structural and evidence gaps, particularly in institutional capacity and the management of evidence-limited scenarios such as STIC, underscoring the need for system-level improvement.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of cervical cytology in HPV-independent cervical cancer: a comparative analysis with HPV-associated cases.","authors":"Chi-Son Chang, Jaewon Na, Jun-Hyeong Seo, Yoo-Young Lee, Tae-Joong Kim, Jeong-Won Lee, Byoung-Gie Kim, Chel Hun Choi","doi":"10.3802/jgo.2026.37.e130","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e130","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the diagnostic accuracy of cervical cytology (Pap test) in human papillomavirus (HPV)-independent (HPVI) cervical cancers compared to that in HPV-associated (HPVA) cancers, and investigated differences in clinical outcomes.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of 515 patients diagnosed with cervical cancer between 2000 and 2021. The patients were categorized as HPVA (n=439) or HPVI (n=76) cervical cancer groups based on pathology and HPV testing. Cytology results were reclassified into 3 clinical categories: negative, low-grade abnormal, and high-grade abnormal. Multivariable logistic regression analyses were performed adjusting for age, stage, tumor size, lymphovascular space invasion, and parametrial invasion. Subgroup analyses were conducted in adenocarcinoma and HPVA cohorts. Survival outcomes were evaluated using Kaplan-Meier analysis and compared using log-rank tests.</p><p><strong>Results: </strong>HPVI cancers showed a significantly higher rate of false-negative cytology results (39.5%) than HPVA cancers (18.0%, p<0.001). High-grade cytological abnormalities were less common in HPVI cases (52.6% vs. 69.2%). Similar trends were observed in adenocarcinoma-only cases, although the differences were not significant (39.5% vs. 22.8%, p=0.055). In multivariable analyses adjusting for clinicopathologic factors, HPVI status remained significantly associated with higher odds of negative cytology (adjusted odds ratio=3.04; 95% confidence interval=1.60-5.78). The Kaplan-Meier analysis demonstrated significantly worse progression-free and overall survival in patients with HPVI cancers (p<0.001).</p><p><strong>Conclusion: </strong>Cervical cytology demonstrated lower sensitivity for detecting HPVI cervical cancers, which are also associated with more aggressive clinical features and poorer outcomes. These findings support the need for tailored screening strategies for this underdetected cancer subtype.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148226024","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":"Prognostic outcomes in patients of low-grade endometrioid carcinoma confined to the adnexa who received no adjuvant therapy: a retrospective analysis.","authors":"Xiaoyan Zhao, Shuilian Yao, Nankun Leng, Fujing Sun, Xin Zhang, Yanmei Zhu","doi":"10.3802/jgo.2026.37.e112","DOIUrl":"10.3802/jgo.2026.37.e112","url":null,"abstract":"<p><strong>Objective: </strong>The International Federation of Gynecology and Obstetrics (FIGO) 2023 staging system for endometrial cancer (EC) recommends exempting stage IA3 patients from adjuvant therapy. Therefore, this study aims to evaluate the prognosis of low-grade endometrioid carcinoma (LGEC) confined to the adnexa without adjuvant treatment.</p><p><strong>Methods: </strong>A retrospective analysis of 439 LGEC with adnexal involvement and 739 aggressive-histotype EC with adnexal involvement patients from the Surveillance, Epidemiology, and End Results database was conducted. Patients were grouped by treatment received: radiotherapy only, chemotherapy only, combined therapy, and no adjuvant therapy. Kaplan-Meier analysis compared prognostic outcomes, and survival differences were evaluated using the log-rank test.</p><p><strong>Results: </strong>The 5-year overall survival (OS) for adnexal-involved, LGEC patients was significantly higher than that for adnexal-involved, aggressive-histotype EC patients (82.4% vs. 54.3%, p<0.05). Among LGEC patients, those in the no-adjuvant therapy group (n=87, 19.8%) had a 5-year OS of 70.6%, which was lower than that of the chemotherapy-only group (84.6%), the combined radiotherapy and chemotherapy group (88.7%), and the radiotherapy-only group (75.5%), with statistically significant differences among the groups (p<0.05). Even within the no-adjuvant therapy subgroup, LGEC with adnexal involvement patients demonstrated markedly better 5-year OS compared to their aggressive-histotype EC with adnexal involvement counterparts (70.6% vs. 34.3%, p<0.05).</p><p><strong>Conclusion: </strong>The IA3 substage newly introduced in the 2023 FIGO system provides clear prognostic stratification. While a 5-year OS of 70.6% was observed in adnexal-involved, LGEC patients without adjuvant therapy, prognosis varies by treatment, highlighting the need for individualized postoperative strategies based on pathological and clinical factors.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148225985","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 2023 FIGO Stage IA3: shifting the SEOC paradigm from pathogenic debate to clinical precision.","authors":"Wenli Gan, Ce Bian","doi":"10.3802/jgo.2026.37.e116","DOIUrl":"https://doi.org/10.3802/jgo.2026.37.e116","url":null,"abstract":"","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148226034","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}