Journal of Gynecologic Oncology最新文献

{"title":"Impact of the diagnosis-surgery interval on survival outcomes and development of a nomogram for predicting survival in early-stage cervical cancer: a Surveillance, Epidemiology, and End Results database analysis.","authors":"Tita Vanichbuncha, Kittinun Leetanaporn, Jitti Hanprasertpong","doi":"10.3802/jgo.2026.37.e108","DOIUrl":"10.3802/jgo.2026.37.e108","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated the association between the diagnosis-surgery interval on survival in early-stage cervical cancer (CC) and developed a nomogram for survival prediction.</p><p><strong>Methods: </strong>We analyzed Surveillance, Epidemiology, and End Results data (2000-2019) of 7,827 patients with stage I-II CC who underwent radical or extended hysterectomy as primary treatment. Associations among the diagnosis-surgery interval, prognostic factors, overall survival (OS), and cancer-specific survival (CSS) were examined. A nomogram constructed using a multivariate Cox model was assessed using the concordance index (C-index) and a calibration curve.</p><p><strong>Results: </strong>Most patients had stage I (95.15%) squamous cell carcinoma (62.21%), tumor size ≤2 cm (39.86%), without lymph node (LN) involvement (86.07%). Adjuvant radiation and chemotherapy were administered to 28.03% and 18.72% of the patients, respectively. The median diagnosis-surgery interval was 1 month (range: 0-17 months). Older age, non-Hispanic black race, higher stage, higher grade, larger tumor size, LN involvement, adjuvant radiation, and surgical delay (>1 month) were associated with worse OS and CSS (p=0.009 and p=0.022, respectively). Adenosquamous carcinoma was associated with poor CSS. The nomogram predicted survival, with areas under the curve of 76.07% and 80.19% for 5-year OS and CSS, respectively. Calibration curves and C-index values (0.735 for OS and 0.777 for CSS) confirmed the nomogram's accuracy in predicting 3-, 5-, and 10-year OS and CSS in early-stage CC.</p><p><strong>Conclusion: </strong>Surgical delays of >1 month were associated with worse survival in early-stage CC. The developed nomogram incorporates multiple prognostic factors to enhance personalized risk assessment and survival prediction.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e108"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005597","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":"Reply to \"Comments on 'Therapeutic efficacy of laser vaporization and conization for high-grade cervical intraepithelial neoplasia'\".","authors":"Miseon Nakazawa, Mizue Teramoto, Tsuyoshi Saito","doi":"10.3802/jgo.2026.37.e141","DOIUrl":"10.3802/jgo.2026.37.e141","url":null,"abstract":"","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e141"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794075","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":"Comments on 'Therapeutic efficacy of laser vaporization and conization for high-grade cervical intraepithelial neoplasia'.","authors":"Emaan Fatima, Sidra Aman Ullah, Manahil Nasrullah, Inshrah Suhail","doi":"10.3802/jgo.2026.37.e140","DOIUrl":"10.3802/jgo.2026.37.e140","url":null,"abstract":"","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e140"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982973","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":"Erratum: Mutations in homologous recombination repair genes in patients with metastatic endometrial cancer: association with clinical characteristics and prognosis.","authors":"Ling Zhong, Ying Lin, Chunxiao Li, Haili Qian, Minghong Shen","doi":"10.3802/jgo.2026.37.e144","DOIUrl":"10.3802/jgo.2026.37.e144","url":null,"abstract":"<p><p>This corrects the article on p. e62 in vol. 36, PMID: 39950607.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":"37 5","pages":"e144"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137030","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":"One more opportunity in early-stage cervical cancer: the role of photodynamic therapy in managing positive surgical margins.","authors":"Alexander Dushkin, Tatyana Grishacheva, Stanislav Afanasiev, Irina Dushkina, Akmaral Khangeldi, Alexander Karaulov, Maxim Afanasyev","doi":"10.3802/jgo.2026.37.e91","DOIUrl":"10.3802/jgo.2026.37.e91","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate recurrence of squamous intraepithelial lesions (SILs) and human papillomavirus (HPV) infection after photodynamic therapy (PDT) in patients with early-stage cervical cancer (CC) and positive surgical margins.</p><p><strong>Methods: </strong>We retrospectively analyzed 46 patients aged 25 to 52 years with stage IA-IB invasive CC treated with PDT. Chlorin e6-based photosensitizers were used to irradiate both the cervical canal and surface with standardized doses. Patients were stratified by residual tumor status (R_1-2 vs. R₀/SIL⁺). Outcomes were assessed by HPV testing, cytology and pelvic magnetic resonance imaging. The primary endpoint was relapse-free survival (RFS) with complete response (CR) defined by HPV negativity and absence of cytological or radiological abnormalities.</p><p><strong>Results: </strong>At 12 months, all patients achieved CR with complete HPV clearance and no residual lesions. At 48 months, overall RFS rate was 74.0% (95% confidence interval [CI]=49.5-87.9). SILs recurrence occurred in 3.7% of patients. Outcomes were slightly better in the R_1-2 group than in the R₀/SIL⁺ group without significant differences. Four patients (8.7%) subsequently had vaginal deliveries. In multivariable analysis, older age was associated with higher relapse risk (hazard ratio [HR]=1.27; 95% CI=1-1.6; p=0.047) as was a greater number of lifetime sexual partners (HR=1.08; 95% CI=1.01-1.15; p=0.019).</p><p><strong>Conclusion: </strong>PDT demonstrates promising efficacy as a minimally invasive, fertility-preserving treatment for early-stage CC with positive surgical margins. The high rate of HPV eradication and durable RFS support its evaluation as an adjunct or alternative to repeat surgery in selected patients.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e91"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574261","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":"Outcomes of node-positive cervical cancer treated with neoadjuvant chemotherapy followed by radical surgery: a single-center approach to a challenging disease.","authors":"Innocenza Palaia, Giorgia Perniola, Noemi Tonti, Federica Tomao, Angelina Pernazza, Giacomo Barchiesi, Lucia Manganaro, Francesca De Felice, Angela Musella, Giulia Paoni Saccone, Federica Tanzi, Sofia Mancini, Annarita Vestri, Danilo Alunni Fegatelli, Pierluigi Benedetti Panici, Ludovico Muzii, Violante Di Donato","doi":"10.3802/jgo.2026.37.e87","DOIUrl":"10.3802/jgo.2026.37.e87","url":null,"abstract":"<p><strong>Objective: </strong>Chemoradiotherapy with brachytherapy (CCRT-B) is the standard treatment for locally advanced cervical cancer (LACC), but prognosis remains poor for patients with lymph node involvement (International Federation of Gynecology and Obstetrics [FIGO] stage IIIC1-2) and bulky disease. This study aimed to evaluate recurrence patterns, salvage therapies, and survival outcomes in patients with FIGO IIIC1-2 cervical cancer (CC) treated with platinum-based neoadjuvant chemotherapy (NACT) followed by radical surgery (RS), and to explore NACT + RS as a potential alternative to CCRT-B.</p><p><strong>Methods: </strong>This retrospective study included 97 patients with FIGO IIIC1-2 CC treated between 2012 and 2022 at Policlinico Umberto I, Rome. All patients received 3 cycles of platinum-based NACT followed by radical hysterectomy, bilateral salpingo-oophorectomy, and systematic pelvic lymphadenectomy, with para-aortic lymphadenectomy performed if indicated. Adjuvant radiotherapy was given in cases of positive vaginal or parametrial margins; chemotherapy or chemoradiotherapy was administered in patients with lymph node positivity after surgery.</p><p><strong>Results: </strong>With a median follow-up of 51 months, 33% of patients died from the disease, 5% from other causes, 58% were alive without disease, and 4% were alive with disease. The 2- and 5-year overall survival (OS) rates were 80.1% and 61.1%, respectively. Progression-free survival was 69.5% at 2 years and 58.5% at 5 years. Median OS after recurrence was 1.01 years. Recurrences occurred primarily in pelvic lymph nodes (22%) and central pelvis (9%).</p><p><strong>Conclusions: </strong>NACT followed by RS offers similar survival outcomes to CCRT-B in node-positive LACC and may be a viable alternative in specialized and well surgical-trained centers.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT06752135.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e87"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645538","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":"Optimizing outcomes in minimally invasive radical hysterectomy: the protective role of a vaginal pipe.","authors":"Seongmin Kim, Hyunkyoung Seo, Seon-Mi Lee, Sanghoon Lee, Jae-Yun Song, Jae-Kwan Lee, Nak-Woo Lee","doi":"10.3802/jgo.2027.38.e22","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e22","url":null,"abstract":"<p><strong>Objective: </strong>Following the 2018 LACC trial, minimizing intraoperative tumor spillage during minimally invasive radical hysterectomy (MIRH) became critical in early-stage cervical cancer. This study investigated whether a vaginal pipe reduces tumor spillage and recurrence during MIRH.</p><p><strong>Methods: </strong>We retrospectively reviewed International Federation of Gynecology and Obstetrics 2018 stage IA1-IIA2 cervical cancer patients undergoing radical hysterectomy (2014-2022). Of 216 patients, 35 underwent abdominal radical hysterectomy and 181 underwent MIRH, subdivided by vaginal pipe usage: vaginal pipe group (MIRH-Y, n=77) and non-use group (MIRH-N, n=104).</p><p><strong>Results: </strong>Baseline characteristics differed only in age (p=0.004) and tumor size (p=0.003). No significant differences were found in 2-year disease-free survival (DFS, p=0.578) or 5-year overall survival (p=0.532). Recurrence occurred in 3 (3.9%) patients in MIRH-Y vs. 12 (11.5%) in MIRH-N. In multivariate Cox regression adjusting for age and tumor size, vaginal pipe use showed a marginal trend toward reduced recurrence (adjusted hazard ratio [HR]=0.31; 95% confidence interval [CI]=0.09-1.09; p=0.068), consistent with inverse probability of treatment weighting (IPTW) analysis (HR=0.36; 95% CI=0.13-1.04; p=0.058). Patients with tumors ≤2 cm showed favorable DFS in the MIRH-Y group (p=0.037), whereas no differences were observed in tumors >2 cm.</p><p><strong>Conclusion: </strong>In this exploratory analysis, vaginal pipe use during MIRH was associated with a non-significant trend toward lower recurrence, with a statistically significant DFS difference only in tumors ≤2 cm. Because these associations did not reach statistical significance, these hypothesis-generating findings warrant prospective confirmation before the device can be recommended as a routine surgical adjunct.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of mRNA-based and next-generation sequencing HPV assays in a population-based cervical cancer screening program in China.","authors":"Hua Zhang, Hang Zhou, Mengting Li, Tuohetiguli Mutailipu, Tingyuan Li, Yuan Yang, Ruoji Pi, Yu Dai, Chunlin Wang, Xingsheng Cai, Wen Chen","doi":"10.3802/jgo.2026.37.e103","DOIUrl":"10.3802/jgo.2026.37.e103","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate and compare the diagnostic performance of the Food and Drug Administration-approved APTIMA^® human papillomavirus (HPV) assay (E6/E7 mRNA-based) and the Mygene HPV-STI Assay (MHSA) in detecting cervical intraepithelial neoplasia (CIN) 2+ and CIN3+ lesions among Chinese women in a screening setting.</p><p><strong>Methods: </strong>A total of 3,166 women were enrolled from Wuxiang County, Shanxi Province, China, and followed for 3 years. APTIMA and MHSA were performed using cervical cytology specimens. Histopathology served as the reference standard. Diagnostic accuracy (sensitivity, specificity, and predictive values), assay concordance, and receiver operating characteristic (ROC) analyses were conducted for baseline and longitudinal detection of CIN2+/CIN3+.</p><p><strong>Results: </strong>Among 2,683 women with complete follow-up, the prevalence of high-risk-HPV was 17.22% by APTIMA and 20.16% by MHSA. Substantial concordance was observed (κ=0.798). APTIMA showed higher specificity than MHSA when combined with cytology (CIN2+: 88.42% vs. 87.96%, p=0.038; CIN3+: 87.28% vs. 86.87%, p=0.063), while sensitivity and predictive values were comparable. The MHSA demonstrated broader HPV genotyping, while APTIMA yielded slightly superior performance in post-test probability for CIN3+ over 3 years. ROC analysis confirmed comparable diagnostic discrimination.</p><p><strong>Conclusion: </strong>Both assays offer high clinical accuracy within 3 years. While APTIMA remains the validated standard, the MHSA may serve as a promising next-generation sequencing-based alternative, particularly in expanded genotyping.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e103"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005529","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":"Reply to \"Comment on 'Gram-positive targeting antibiotics are associated with progression and death in women with platinum-sensitive recurrent high-grade epithelial ovarian cancer'\".","authors":"Julia Chalif, Roberto Vargas, Laura M Chambers","doi":"10.3802/jgo.2026.37.e132","DOIUrl":"10.3802/jgo.2026.37.e132","url":null,"abstract":"","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e132"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794044","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":"Reconciling modest median progression-free survival and larger overall survival gains in platinum-resistant ovarian cancer.","authors":"Hyunji Lim, Se Ik Kim, Jae-Weon Kim, Dong Hoon Suh","doi":"10.3802/jgo.2026.37.e134","DOIUrl":"10.3802/jgo.2026.37.e134","url":null,"abstract":"","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e134"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684808","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}