Journal of Gynecologic Oncology最新文献

{"title":"Prognostic impact of the number of resected pelvic nodes in endometrial cancer: Japanese Gynecologic Oncology Group Study JGOG2043 post hoc analysis.","authors":"Yosuke Konno, Michinori Mayama, Kazuhiro Takehara, Yoshihito Yokoyama, Jiro Suzuki, Nobuyuki Susumu, Kenichi Harano, Satoshi Nakagawa, Toru Nakanishi, Wataru Yamagami, Kosuke Yoshihara, Hiroyuki Nomura, Aikou Okamoto, Daisuke Aoki, Hidemichi Watari","doi":"10.3802/jgo.2025.36.e3","DOIUrl":"10.3802/jgo.2025.36.e3","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine whether the number of resected pelvic lymph nodes (PLNs) affects the prognosis of endometrial cancer (EC) patients at post-operative risk of recurrence.</p><p><strong>Methods: </strong>JGOG2043 was a randomized controlled trial to assess the efficacy of three chemotherapeutic regimens as adjuvant therapy in EC patients with post-operative recurrent risk. A retrospective analysis was conducted on 250 patients who underwent pelvic lymphadenectomy alone in JGOG2043. The number of resected and positive nodes and other clinicopathologic risk factors for survival were retrieved.</p><p><strong>Results: </strong>There were 83 patients in the group with less than 20 PLNs removed (group A), while 167 patients had 20 or more PLNs removed (group B). There was no significant difference in patients' backgrounds between the two groups, and the rate of lymph node metastasis was not significantly different. There was a trend toward fewer pelvic recurrences in group B compared with group A (3.5% vs. 9.6%; p=0.050). Although Kaplan-Meier analysis showed no statistically significant difference in survival rates between the two groups (5-year overall survival [OS]=90.3% vs. 84.3%; p=0.199), multivariate analysis revealed that resection of 20 or more nodes is one of the independent prognostic factors (hazard ratio=0.49; 95% confidence interval=0.24-0.99; p=0.048), as well as surgical stage, high-risk histology, and advanced age for OS.</p><p><strong>Conclusion: </strong>Resection of 20 or more PLNs was associated with improved pelvic control and better survival outcomes in EC patients at risk of recurrence who underwent pelvic lymphadenectomy alone and were treated with adjuvant chemotherapy.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e3"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300703","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":"Cancer-field surgery for endometrial cancer by robotic peritoneal mesometrial resection and targeted compartmental lymphadenectomy (PMMR+TCL).","authors":"Paul Buderath, Tra My Dang, Rainer Kimmig","doi":"10.3802/jgo.2025.36.e13","DOIUrl":"10.3802/jgo.2025.36.e13","url":null,"abstract":"<p><strong>Objective: </strong>Cancer-field surgery by peritoneal mesometrial resection and targeted compartmental lymphadenectomy (PMMR+TCL) for the treatment of endometrial cancer (EC) aims at optimal locoregional tumor control without the need for adjuvant radiotherapy. In a previous publication we could demonstrate the feasibility of the method and presented encouraging first oncologic data.</p><p><strong>Methods: </strong>Following up our 2021 publication, we present data on the treatment of EC by PMMR+TCL in much larger cohort and with longer follow-up.</p><p><strong>Results: </strong>One hundred and thirty-five patients with EC International Federation of Gynecology and Obstetrics (FIGO) I-IV (75.6% FIGO I) underwent cancer field surgery via PMMR+TCL for EC in the years 2016-2023. Mean follow-up in our cohort was 27.5 months (0, 83; 19.7). The procedure was feasible and safe with favorable intra-and postoperative complication rates. Even though 50.4% of patients had an indication for postoperative radiotherapy following national and international guidelines, the rate of postoperative irradiation administered was 10.4%. The overall recurrence rate was 8.1% and we observed 2 (1.5%) isolated locoregional recurrences.</p><p><strong>Conclusion: </strong>Our results confirm the feasibility and safety of PMMR+TCL in EC patients. Oncologic data are very encouraging and hint at a superior locoregional control without adjuvant irradiation. Larger studies with longer follow-up will be needed to confirm these results.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e13"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468533","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":"Phase II randomized study of dostarlimab alone or with bevacizumab versus non-platinum chemotherapy in recurrent gynecological clear cell carcinoma (DOVE/APGOT-OV7/ENGOT-ov80).","authors":"Jung-Yun Lee, David Tan, Isabelle Ray-Coquard, Jung Bok Lee, Byoung Gie Kim, Els Van Nieuwenhuysen, Ruby Yun-Ju Huang, Ka Yu Tse, Antonio González-Martin, Clare Scott, Kosei Hasegawa, Katie Wilkinson, Eun Yeong Yang, Stephanie Lheureux, Rebecca Kristeleit","doi":"10.3802/jgo.2025.36.e51","DOIUrl":"10.3802/jgo.2025.36.e51","url":null,"abstract":"<p><strong>Background: </strong>Recurrent gynecological clear cell carcinoma (rGCCC) has a low objective response rate (ORR) to chemotherapy. Previous preclinical and clinical data suggest a potential synergy between immune checkpoint inhibitors and bevacizumab in rGCCC. Dostarlimab, a humanized monoclonal antibody targeting programmed cell death protein 1 (PD-1), combined with the anti-angiogenic bevacizumab, presents a novel therapeutic approach. This study will investigate the efficacy of dostarlimab +/- bevacizumab in rGCCC.</p><p><strong>Methods: </strong>DOVE is a global, multicenter, international, open-label, randomized phase 2 study of dostarlimab +/- bevacizumab with standard chemotherapy in rGCCC. We will enroll 198 patients with rGCCC and assign them to one of three groups in a 1:1:1 ratio: arm A (dostarlimab monotherapy), B (dostarlimab + bevacizumab), and C (investigator's choice of chemotherapy [weekly paclitaxel, pegylated liposomal doxorubicin, doxorubicin, or gemcitabine]). Patients with disease progression in arm A or C will be allowed to cross over to arm B. Stratification factors include prior bevacizumab use, prior lines of therapy (1 vs. >1), and primary site (ovarian vs. non-ovarian). Key inclusion criteria are histologically proven recurrent or persistent clear cell carcinoma of the ovary, endometrium, cervix, vagina, or vulva; up to five prior lines of therapy; disease progression within 12 months after platinum-based chemotherapy; and measurable disease. Key exclusion criteria are prior treatment with an anti-PD-1, anti-programmed death-ligand 1, or anti-programmed death-ligand 2 agent. The primary endpoint is progression-free survival determined by investigators. Secondary endpoints are ORR, disease control rate, clinical benefit rate, progression-free survival 2, overall survival, and toxicity. Exploratory objectives include immune biomarkers.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT06023862.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e51"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877061","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":"Nomogram for predicting pathology upstaging in patients with EIN: is sentinel lymph node assessment useful in these patients?","authors":"Fengyi Liang, Weijuan Xin, Shaoliang Yang, Haiyan Wang","doi":"10.3802/jgo.2025.36.e1","DOIUrl":"10.3802/jgo.2025.36.e1","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to identify the risk factors for postoperative pathological escalation of endometrial cancer in patients with a pathologic diagnosis of endometrial intraepithelial neoplasia (EIN) before surgery. Some of the clues from the preoperative assessment were used to build a nomogram to predict the likely pathological escalation after surgery, and to explore the feasibility of sentinel lymph node biopsy in these patients with possible pathological escalation.</p><p><strong>Methods: </strong>This was a retrospective analysis of patients who underwent surgical treatment for EIN diagnosed before surgery between 2018 and 2023 in The Obstetrics and Gynecology Hospital of Fudan University. parameters including clinical, radiological and histopathological factors were analyzed by univariate and multivariate logistic regression to determine the correlation with pathology upstaging. A nomogram based on the multivariate results was developed to predict the probability of pathology upstaging. A total of 729 patients were included, divided into training set and validation set. 484 patients were used to build the model. This nomogram was subsequently validated using 245 patients.</p><p><strong>Results: </strong>Upstaging to endometrial carcinoma occurred in 115 (23.8 percent) of 484 women treated between 2018 and 2023 in training set. A lager endometrial thickness (at least 15 mm), menopause, hypertension, HE4, and endometrial blood were significantly associated with upstaging. A nomogram developed using these factors demonstrated good predictive performance (area under the receiver operating characteristic curve (AUC)=0.6808; 95% confidence interval [CI]=0.6246-0.7369). The nomogram showed similar predictive performance in the validation data set, based on another 245 women (AUC=0.7821; 95% CI=0.7076-0.8567).</p><p><strong>Conclusion: </strong>This study developed a novel nomogram based on the 5 most important factors, which can accurately predict invasive cancer. It is common for women with preoperative diagnosis of EIN to experience pathological progression to endometrial cancer. For some patients with postoperative pathological escalation, we found lymph node metastasis. This nomogram may be useful to help doctor decide whether to perform sentinel lymph node biopsy for surgical staging in these EIN patients. According to the nomogram, simultaneous sentinel lymph node biopsy in patients with high probability of postoperative pathological upgrading can provide better guidance for postoperative adjuvant treatment of endometrial cancer and avoid the occurrence of secondary surgery.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e1"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317497","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":"Clinical practice guidelines for ovarian cancer: an update to the Korean Society of Gynecologic Oncology guidelines.","authors":"Banghyun Lee, Suk-Joon Chang, Byung Su Kwon, Joo-Hyuk Son, Myong Cheol Lim, Yun Hwan Kim, Shin-Wha Lee, Chel Hun Choi, Kyung Jin Eoh, Jung-Yun Lee, Yoo-Young Lee, Dong Hoon Suh, Yong Beom Kim","doi":"10.3802/jgo.2025.36.e69","DOIUrl":"10.3802/jgo.2025.36.e69","url":null,"abstract":"<p><p>We updated the Korean Society of Gynecologic Oncology (KSGO) practice guideline for the management of ovarian cancer as version 5.1. The ovarian cancer guideline team of the KSGO published announced the fifth version (version 5.0) of its clinical practice guidelines for the management of ovarian cancer in December 2023. In version 5.0, the selection of the key questions and the systematic reviews were based on the data available up to December 2022. Therefore, we updated the guidelines version 5.0 with newly accumulated clinical data and added 5 new key questions reflecting the latest insights in the field of ovarian cancer between 2023 and 2024. For each question, recommendation was provided together with corresponding level of evidence and grade of recommendation, all established through expert consensus.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":"36 1","pages":"e69"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122937","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":"Prevalence of high-risk human papillomavirus genotypes among women in Uzbekistan, 2021-2023.","authors":"Iroda Pulatovna Sharipova, Erkin Isakovich Musabaev, Shakhlo Sobirovna Sadirova, Dildora Tolibjonovna Suyarkulova, Shavkat Ekrinovich Tashev, Shakhnoza Khayrullaevna Akhmedova, Nozimakhon Rakhmatullaxodjaevna Turabova, Saidkhon Makhmudkhonovich Sharapov, Rano Ibrahimovna Kasimova, Ravshan Abdullaevich Rakhimov, Guljakhon Toyirovna Yuldashova, Kyutaeg Lee, Gayoung Chun, Hyunwon Kim","doi":"10.3802/jgo.2025.36.e7","DOIUrl":"10.3802/jgo.2025.36.e7","url":null,"abstract":"<p><strong>Objective: </strong>Cervical cancer remains a significant global health concern. Extensive research has established a critical link between human papillomavirus (HPV) infection and the development of cervical cancer. As a result, high-risk HPV (Hr-HPV) testing has emerged as a promising screening method. This study aimed to retrospectively analyze the prevalence of Hr-HPV genotypes among women in three regions of Uzbekistan.</p><p><strong>Methods: </strong>Between 2021 and 2023, the Research Institute of Virology of Uzbekistan and the Korea Foundation for International Healthcare conducted a comprehensive population-based study in Tashkent, Andijan, and Samarkand. The study targeted 43,921 women aged 20 and above, utilizing real-time polymerase chain reaction to investigate the prevalence of 12 Hr-HPV genotypes. The analysis included an examination of the distribution of these genotypes based on age, region, and various demographic factors.</p><p><strong>Results: </strong>The overall prevalence of Hr-HPV among women aged 20 and above in Uzbekistan was 7.4%. Regional variations were observed and Hr-HPV prevalence was higher in individuals in their 20s than in other age groups in all 3 regions (p<0.001). The proportion of HPV 16 and 18 was 32.5% and 6.4% in the single infections, 41.9% and 14.7% in the double infections, and 59.3% and 20.0% in the multiple infections. There were also significant differences in prevalence across demographic factors, such as marital status, parity, current smoking, and contraceptive method (p<0.005).</p><p><strong>Conclusion: </strong>The findings emphasize the importance of early screening and educational initiatives, particularly targeting young and co-infected women. This foundational data aims to improve women's health strategies in Uzbekistan.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":"36 1","pages":"e7"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122972","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":"Early prediction and risk stratification of ovarian cancer based on clinical data using machine learning approaches.","authors":"Ting Gui, Dongyan Cao, Jiaxin Yang, Zhenhao Wei, Jiatong Xie, Wei Wang, Yang Xiang, Peng Peng","doi":"10.3802/jgo.2025.36.e53","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e53","url":null,"abstract":"<p><strong>Objective: </strong>Our study was aimed to construct a predictive model to advance ovarian cancer diagnosis by machine learning.</p><p><strong>Methods: </strong>A retrospective analysis of patients with pelvic/adnexal/ovarian mass was performed. Potential features related to ovarian cancer were obtained as many as possible. The optimal machine learning algorithm was selected among six candidates through 5-fold cross validation. Top 20 features having the most powerful predictive significance were ranked by Shapley Additive Interpretation (Shap) method. Clinical validation was further performed to confirm whether our model could advance diagnosis of ovarian cancer.</p><p><strong>Results: </strong>A total of 9,799 patients were collected. The inclusion criteria included age >18 years old, the first diagnosis being pelvic/adnexal/ovarian mass of undetermined significance, and pathological report indispensable. Four hundred and thirty-eight dimensional features were obtained after filtration. LightGBM showed the best performance with accuracy 88%. Among the top 20 features, 55% belonged to laboratory test report, 35% came from imaging examination report, and 10% were attributed to basic demographics and main symptom. Age, CA125, and risk of ovarian malignancy algorithm were the top three. Our predictive model performed stably in testing and clinical validation datasets, and was found to advance the diagnosis of ovarian cancer about 17 days before clinical pathological examination.</p><p><strong>Conclusion: </strong>LightGBM was the optimal algorithm for our predictive model with accuracy of 88%. Laboratory test and imaging examination played essential roles in diagnosing ovarian cancer. Our model could advance the diagnosis of ovarian cancer before clinical pathological examination.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950006","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":"Adjuvant hormone therapy and overall survival among low-grade and apparent early-stage endometrial stromal sarcoma patients.","authors":"Kristin L Bixel, Caitlin E Meade, Morgan Brown, Ashley S Felix","doi":"10.3802/jgo.2025.36.e50","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e50","url":null,"abstract":"<p><strong>Objective: </strong>Surgery is the mainstay of treatment for low-grade endometrial stromal sarcoma (LG-ESS). While adjuvant hormone therapy is recommended for patients with advanced/recurrent disease, no consensus regarding its use among early-stage patients exists. We aimed to identify correlates of adjuvant hormone therapy use and associations of adjuvant hormone therapy and overall survival (OS) in stage I LG-ESS patients.</p><p><strong>Methods: </strong>Retrospective cohort study of patients with stage I LG-ESS who underwent hysterectomy from 2004-2019 using data from the National Cancer Database. Categorical data were compared using χ² tests. Kaplan-Meier estimates and log-rank tests were used to compare OS according to adjuvant hormone use. Hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between adjuvant hormone use and OS were estimated using Cox proportional hazards regression.</p><p><strong>Results: </strong>Of 2,386 patients included, 20.2% were treated with adjuvant hormonal therapy. Use of hormone therapy increased over time, with rates approximately doubling from 2004 to 2019 (12.6% to 24.6%). Age, tumor size, lymphovascular space invasion and adjuvant radiation were associated with adjuvant hormone therapy use. There was no association between adjuvant hormone therapy and OS (log-rank p=0.73; HR=1.05; 95% CI 0.76-1.46) for patients with LG-ESS.</p><p><strong>Conclusion: </strong>Use of adjuvant hormone therapy for stage I LG-ESS has increased over time though is not associated with OS in this cohort of patients. Additional evaluation is needed to understand the impact of adjuvant hormone therapy on recurrence rates, progression rates, and quality of life to fully understand its value.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895143","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":"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":"https://doi.org/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":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared decision-making in patients with gynecological cancer and healthcare professionals: a cross-sectional observational study in Japan.","authors":"Masakazu Abe, Hironobu Hashimoto, Azusa Soejima, Yumiko Nishimura, Ami Ike, Michiko Sugawara, Muneaki Shimada","doi":"10.3802/jgo.2025.36.e47","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e47","url":null,"abstract":"<p><strong>Objective: </strong>This cross-sectional study aimed to understand the actual situation of shared decision-making (SDM) and identify the challenges of implementing SDM among Japanese gynecologic cancer patients and healthcare professionals (HCPs).</p><p><strong>Methods: </strong>Adult Japanese women undergoing chemotherapy for endometrial or ovarian/fallopian tube cancer and HCPs who prescribed/administered treatment were enrolled. Data were collected via a web-based questionnaire. Primary endpoints were the actual and desired status of SDM for patients by preferred role (active, collaborative, passive), and important aspects in drug selection for patients and HCPs. SDM treatment preferences were determined using the Control Preferences Scale.</p><p><strong>Results: </strong>Respondents comprised 154 patients (77 for endometrial and 77 for ovarian/fallopian tube cancer), 153 physicians, 166 nurses, and 154 pharmacists. Among patients, 53.9% desired an active role in decision-making, and 55.8% participated; 25.3% desired a collaborative role, and 14.3% participated; and 20.8% desired a passive role, and 29.9% participated. Most patients with a collaborative role in decision-making (86.4%) were \"very satisfied\" or \"somewhat satisfied\" with their communication with physicians, compared with 60.4% and 73.9% of respondents with active and passive roles in decision-making, respectively. In daily practice, 23.5%, 47.6%, and 19.5% of physicians, nurses, and pharmacists, respectively, confirmed \"awareness\" of SDM. Regarding treatment expectations, patients ranked \"complete elimination of cancer,\" and HCPs ranked \"live longer\" as the most important.</p><p><strong>Conclusion: </strong>Most patients desire involvement in their treatment decisions. Additionally, treatment expectations differ between patients and HCPs. Increasing SDM awareness, implementing it systematically, and addressing patients' needs for collaborative roles in decision-making is essential.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687243","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}