Journal of Gynecologic Oncology最新文献

{"title":"The real-world practice of fertility preservation for patients with epithelial ovarian cancer in Asian regions.","authors":"Masato Yoshihara, Tingyan Shi, Navamol Lekskul, Angela Cho, Biswajit Dash, Siew Fei Ngu, Allen Gideon Tan, Sanghoon Lee, Pinyada Panyavaranant, Jennifer Ko, Very Great Eka Putra, Min-Hyun Baek, Rudrika Chandra, Yu Xue, Doris R Benavides, Syamel Muhammad, Geon-Woo Lee, Sarita Kumari, Romelyn Imperio-Onglao, Mohd Faizal Ahmad, Shohei Iyoshi, Ling Lim, Christine Shan-Chi Chiu, Reeta Mahey, Se Ik Kim, Virgilio M Novero, Emiri Miyamoto, Motohiro Chosokabe, Motoki Takenaka, Kensuke Sakai, Shiho Kuji, Kosuke Shigematsu, Jae-Weon Kim, Hiroaki Kajiyama, Nao Suzuki","doi":"10.3802/jgo.2027.38.e17","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e17","url":null,"abstract":"<p><strong>Objective: </strong>Fertility preservation (FP) is crucial for young women diagnosed with ovarian cancer (OvCa) due to the potential gonadal toxicity of chemotherapy. The Asian Society of Gynecologic Oncology (ASGO) Special Task Force on FP conducted a survey to evaluate FP practices across Asia, aiming to enhance cancer survivorship and fertility outcomes for adolescent and young adult (AYA) patients.</p><p><strong>Methods: </strong>The survey included responses from 10 Asian regions, focusing on FP indications, surgical and chemotherapy practices, and ovarian function monitoring. Data were collected from representative institutions, and the study was approved by the Ethics Committee of Nagoya University.</p><p><strong>Results: </strong>The findings showed significant variability in FP practices. Definitions of AYA patients varied across regions, affecting eligibility for FP interventions. Age limits for fertility-sparing surgery (FSS) ranged from 35 to 45 years across regions, with differing criteria for histological types and cancer stages. While all regions performed FSS, practices regarding surgery extent, chemotherapy management, and follow-up care were inconsistent. Seven regions had OvCa patient registries, but none maintained FP-specific registries. Regular ovarian function monitoring and the use of assisted reproductive technology were also unevenly implemented.</p><p><strong>Conclusion: </strong>The study highlights the need for standardized guidelines across Asia to harmonize oncologic safety with FP. Addressing these differences through collaborative efforts within ASGO is essential to improve patient outcomes and provide consistent care for AYA patients seeking FP during cancer treatment.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857186","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":"Screening of potential antibody-drug conjugate (ADC) targets in neuroendocrine carcinoma of the cervix: implications for targeted therapy.","authors":"Tianhui He, Xiaoxia Jiang, Jiangsha Li, Lin Wu, Xiaoliu Wu, Zheng Li","doi":"10.3802/jgo.2027.38.e14","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e14","url":null,"abstract":"<p><strong>Objective: </strong>Neuroendocrine carcinoma of the cervix (NECC) is a rare yet aggressive malignancy with a poor prognosis. Although antibody-drug conjugates (ADCs) have shown promise in multiple cancers, the expression profiles of relevant ADC targets in NECC remain unclear. This study aimed to systematically evaluate candidate ADC target expression in NECC and explore associations with clinicopathological features and prognosis.</p><p><strong>Methods: </strong>This study assessed the immunohistochemical expression of 9 ADC targets (including B7-H3, ROR1, DLL3, EGFR, Bcl-2, Nectin-4, TF, c-MET, and SEZ6) in a cohort. Expression levels were semi-quantitatively evaluated and correlated with clinicopathological variables and survival.</p><p><strong>Results: </strong>This study enrolled 173 NECC patients (median age 47 years). Recurrence and mortality rates were 44.5% and 25.4%, respectively. Immunohistochemical profiling was performed in 91 cases with available paraffin-embedded tissues. Near-universal expression of B7-H3 (97.8%) was observed, along with frequent expression of ROR1 (73.6%) and DLL3 (72.5%). Regarding clinicopathological correlations, high B7-H3 expression was associated with parametrial invasion (p=0.039), and EGFR positivity was linked to uterosacral ligament invasion (p=0.034). Among all markers analyzed, only EGFR positivity was significantly associated with increased recurrence risk (p=0.048). Multivariable analysis identified vaginal invasion (hazard ratio [HR]=2.15) and advanced International Federation of Gynecology and Obstetrics stage (HR=3.02) as independent predictors of recurrence (p<0.001).</p><p><strong>Conclusion: </strong>This study identifies B7-H3 as the premier ADC target in NECC, with ROR1 and DLL3 as additional promising targets. EGFR demonstrates dual utility for prognostic stratification and therapeutic intervention. These findings provide molecular evidence to guide the development of precision therapy for this aggressive malignancy.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794059","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":"Rising burden and deepening inequalities: a national study of high BMI-related uterine cancer in the United States using GBD and NHANES data.","authors":"Ju Huang, Xinhui Wu, Dingwen Xu, Huishen Yan, Zhe Yang, Zhongwei Jia","doi":"10.3802/jgo.2027.38.e12","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e12","url":null,"abstract":"<p><strong>Objective: </strong>Uterine cancer mortality is rising in the U.S. while other cancer deaths decline, posing a major public health challenge. High BMI is the strongest modifiable risk factor, but its full burden and associated inequalities remain poorly characterized.</p><p><strong>Methods: </strong>Using data from Global Burden of Disease 2023 and National Health and Nutrition Examination Survey (NHANES, 1999-2023), we assessed national and state-level trends in uterine cancer mortality (age-standardized mortality rate [ASMR]) and disability-adjusted life years (age-standardized disability-adjusted life year rate [ASDR]) from 1990-2023. We employed Joinpoint regression, frontier analysis, and AutoRegressive Integrated Moving Average forecasting. Individual-level BMI associations were evaluated using weighted multivariable logistic regression.</p><p><strong>Results: </strong>The ASMR and ASDR for high BMI-related uterine cancer in the U.S. significantly exceeded global averages, with the gap widening. The fastest increase occurred during 2009-2017. Significant geographic disparities were identified; West Virginia and Mississippi were consistent hotspots with high burden and rapid growth. A state's socio-demographic index was negatively correlated with the growth rate (estimated annual percentage change) of ASMR (ρ=-0.709) and ASDR (ρ=-0.726), indicating faster deterioration in socioeconomically disadvantaged regions. NHANES analysis confirmed a significant, dose-response relationship between BMI and uterine cancer risk (adjusted odds ratio per 1-unit BMI increase=1.03, 95% confidence interval=1.01-1.06), which strengthened over time. Subgroup analyses revealed stronger associations in obese individuals, non-Hispanic whites, and women aged ≥50 years.</p><p><strong>Conclusion: </strong>High BMI drives the rising and unequal uterine cancer burden in the U.S., underscoring the urgent need for interventions targeting both obesity and health inequities.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world safety and effectiveness of olaparib maintenance after first-relapse platinum-sensitive ovarian cancer in Japan: a multicenter historical cohort (JGOG3026).","authors":"Kosuke Yoshihara, Terumi Tanigawa, Shin Nishio, Hiroyuki Kanao, Yasunori Yoshino, Ayako Mochizuki, Sari Nakao, Tatsuo Kagimura, Hiroshi Tanabe, Hiroaki Kajiyama, Muneaki Shimada, Aikou Okamoto, Takayuki Enomoto","doi":"10.3802/jgo.2027.38.e5","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e5","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective of the study was to evaluate the safety and effectiveness of olaparib maintenance therapy in Japanese patients with platinum-sensitive first-relapsed ovarian cancer. The secondary objective was to survey the treatment given after the olaparib maintenance therapy.</p><p><strong>Methods: </strong>The JGOG3026 study was a nationwide, multicenter historical cohort study across 43 sites. Patients receiving olaparib maintenance therapy after platinum-based chemotherapy between January 2018 and July 2020 were included as modified intention-to-treat (mITT) 1. Those who received any post-olaparib therapy were extracted as mITT2. The primary endpoint was Grade ≥3 adverse event; secondary endpoints included progression-free survival (PFS), the time to first subsequent therapy (TFST), progression-free survival to the second progression (PFS2), and overall survival (OS).</p><p><strong>Results: </strong>In the mITT1 (n=413), any Grade ≥3 adverse events occurred in 41.6%; anemia was the most common (28.8%). Myelodysplastic syndrome occurred in 1.0% and no acute myeloid leukemia was observed during a mean follow-up of 34.1 months. The 24-month PFS and OS rates were 31.7% and 70.1%, respectively. Median PFS and OS were 12 months (95% confidence interval [CI]=9.9-13) and 39 months (95% CI=33-45). The 24-month TFST and PFS2 rates were 33.3% and 34.3%. In the mITT2 (n=284), chemotherapy after olaparib therapy was used in 97.2%, with an overall response rate of 22.5%.</p><p><strong>Conclusion: </strong>Olaparib maintenance therapy showed acceptable safety and effectiveness in Japanese clinical practice. Monitoring for secondary hematologic malignancies is needed after the start of olaparib maintenance therapy.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684810","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":"Limited prognostic impact of mismatch repair status in high-intermediate risk early-stage endometrial cancer receiving adjuvant radiotherapy: a retrospective cohort study.","authors":"Szu-Yu Huang, Hao Lin, Yu-Che Ou, Hung-Chun Fu, Ching-Chou Tsai, Ying-Yi Chen, Ying-Wen Wang, Szu-Wei Huang, Shao-Chi Wang, Chen-Hsuan Wu","doi":"10.3802/jgo.2027.38.e10","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e10","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether mismatch repair deficiency (dMMR) affects treatment outcomes in early-stage high-intermediate risk (HIR) endometrial cancer (EC) patients receiving adjuvant therapy.</p><p><strong>Methods: </strong>This retrospective study included patients with 2009 International Federation of Gynecology and Obstetrics stage I-II EC who underwent complete staging surgery from August 2006 to December 2022 at Kaohsiung Chang Gung Memorial Hospital. HIR stage I EC was defined using PORTEC and GOG-99 criteria. Stage II disease was considered low risk if meeting all criteria: endometrioid histology, grade 1-2, absence of lymphovascular invasion, and no lymph node involvement. Patients received adjuvant external beam radiation therapy (EBRT) or vaginal brachytherapy. Clinicopathological characteristics and 5-year disease-free survival (DFS) were analyzed.</p><p><strong>Results: </strong>Among the 137 included patients with a median follow-up of 55 months, MMR status was available for all cases, and 32.1% were classified as dMMR. In 115 patients receiving adjuvant radiation, dMMR was associated with higher parity (97.6% vs. 71.2%, p=0.001) and showed a trend toward higher ER expression (170.5 vs. 136.7, p=0.126). Five-year DFS was comparable between MMR-proficient (pMMR) and dMMR groups overall (90.3% vs. 88.6%, p=0.881), in radiation-only patients (91.9% vs. 90.2%, p=0.846), and EBRT-only patients (85.4% vs. 85.2%, p=0.908). Cox regression revealed no significant predictors of DFS including MMR status.</p><p><strong>Conclusion: </strong>MMR status did not impact survival outcomes in early-stage HIR EC patients receiving adjuvant therapy, suggesting limited prognostic value and questioning routine MMR testing cost-effectiveness in this subgroup.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684799","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":"Burden and temporal trends of cervical cancer in reproductive-age females from 1990 to 2021 and projections to 2035 in G20 countries: a systematic analysis of the Global Burden of Disease Study 2021.","authors":"Xiangwen Li, Siyu Pan, Pengfei Qu, Di Wu, Jian Song, Na Sun, Qiling Liu, Dandan Zhang, Rongqiang Zhang, Li Song","doi":"10.3802/jgo.2027.38.e13","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e13","url":null,"abstract":"<p><strong>Objective: </strong>Cervical cancer remains a critical global health threat. Despite its member states accounting for more than 85% of global gross domestic product (GDP), no comprehensive assessment of cervical cancer burden exists across the diverse Group of Twenty (G20) economies. This study aimed to characterize long-term cervical cancer burden trends and project future epidemiological trajectories among G20 reproductive-age females.</p><p><strong>Methods: </strong>Using Global Burden of Disease 2021 data, we analyzed cervical cancer disability-adjusted life years (DALYs) among females aged 15-49 years in G20 countries (1990-2021) via Joinpoint regression, health inequality indices, Das Gupta decomposition, and Bayesian age-period-cohort projection to 2035.</p><p><strong>Results: </strong>In 2021, cervical cancer generated 2.27 million DALYs among G20 reproductive-age females, with age-standardized rates ranging from 24.89 (Saudi Arabia) to 667.65 (South Africa) per 100,000. Overall rates declined (annual average percent change [AAPC]=-1.40%) (1990-2021), with China achieving a notable reduction (AAPC=-1.51%), but increased in Russia (AAPC=1.70%), Japan (AAPC=0.65%), Italy (AAPC=0.33%), and South Africa (AAPC=0.14%). Sociodemographic Index (SDI)-related inequality narrowed (1990: Slope Index of Inequality [SII]=-349.58, Concentration Index=-0.21; 2021: SII=-261.82, Concentration Index=-0.18), but persisted. Population growth (+23.99%) and age structure changes (+20.92%) drove DALY increases in the G20, offset by epidemiological improvements (-43.92%). Most G20 countries will see declining burden by 2035, while South Africa faces the largest increase.</p><p><strong>Conclusion: </strong>Differentiated, evidence-based strategies tailored to national burden characteristics, addressing demographic shifts, key health system gaps, and human papillomavirus genotype disparities, are critically needed to successfully achieve the World Health Organization 2030 global cervical cancer elimination targets.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684812","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":"Robotic versus conventional laparoscopic total hysterectomy in patients with endometrial cancer and frailty: analysis of the National Readmission Database, 2016-2020.","authors":"Huang-Pin Shen, Chih-Yu Chou, Hao-Jung Chang, Po-Hui Wang, Chih-Jen Tseng","doi":"10.3802/jgo.2027.38.e6","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e6","url":null,"abstract":"<p><strong>Objective: </strong>To compare perioperative outcomes after robotic-assisted vs. conventional laparoscopic total hysterectomy in frail women with endometrial cancer.</p><p><strong>Methods: </strong>This retrospective study included female patients aged ≥50 years with endometrial cancer and frailty who received either robotic-assisted or conventional laparoscopic total hysterectomy, extracting data from the Nationwide Readmissions Database from 2016 to 2020. Frailty was defined using the Hospital Frailty Risk Score. Patients with lymph node invasion, metastatic disease, missing key variables, or sample weight were excluded. Outcomes included perioperative complications, length of stay (LOS), and 30- and 90-day readmission. Logistic and linear regression analyses were performed to compare outcomes between surgical approaches.</p><p><strong>Results: </strong>In total, 1,212 patients with endometrial cancer and frailty were included. Robotic-assisted surgery was associated with significantly shorter LOS (adjusted beta=-0.34; 95% confidence interval [CI]=-0.46, -0.21; p<0.001), lower odds of sepsis (adjusted odds ratio [aOR]=0.57; 95% CI=0.34, 0.94; p=0.027) and surgical site infection (p=0.025), but higher odds of pneumonia (aOR=2.01; 95% CI=1.06, 3.84; p=0.033).</p><p><strong>Conclusion: </strong>Robotic-assisted hysterectomy in frail patients was associated with shorter LOS and fewer infection-related complications but a higher risk of pneumonia. Further studies are needed to optimize surgical decision-making in this population.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684790","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":"cfDNA-inferred putative clonal hematopoiesis during first-line platinum-to-PARP inhibitor maintenance in ovarian cancer.","authors":"Mika Okazawa-Sakai, Takao Fujisawa, Tatsuyuki Chiyoda, Hiroshi Yagi, Ichinosuke Hyodo, Shogen Boku, Yoh Hayasaki, Masanori Isobe, Daisuke Shintani, Kosei Hasegawa, Tomomi Egawa-Takata, Kimihiko Ito, Kei Ihira, Hidemichi Watari, Kazuhiro Takehara, Kiyoko Kato, Hiromichi Nakajima, Kenichi Harano, Yoshiaki Nakamura, Hideaki Bando, Takayuki Yoshino, Daisuke Aoki","doi":"10.3802/jgo.2027.38.e11","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e11","url":null,"abstract":"<p><strong>Objective: </strong>To describe cell-free DNA (cfDNA)-inferred putative clonal hematopoiesis (CH) candidates during first-line platinum-based chemotherapy followed by poly(ADP-ribose) polymerase inhibitor (PARPi) maintenance in ovarian cancer.</p><p><strong>Methods: </strong>In SCRUM-Japan MONSTAR-SCREEN-1, we analyzed clinically reported paired tumor tissue and plasma cfDNA profiling (324-gene assays). Baseline (B1) data were assessed in 35 treatment-naïve patients; longitudinal cfDNA was available at B1, after platinum without progression (B2), and during/after PARPi without progression (B3) in 8 patients. Putative CH candidates were defined as pathogenic variants (variant allele frequency <40%) in prespecified CH-related genes detected in plasma but not detected in matched tumor tissue at clinical reporting thresholds.</p><p><strong>Results: </strong>At B1, putative CH candidates were reported in 19/35 patients (54.3%), most commonly <i>DNMT3A</i>; positivity was associated with age ≥60 years. In the longitudinal cohort, tumor-derived <i>TP53</i> variants were below the assay reporting threshold at B3 in all patients, whereas putative CH <i>TP53</i> variants were reported in 0/8 patients at B1 and 6/8 patients at B3. DNA damage response gene candidates (<i>TP53</i>/<i>ATM</i>/<i>CHEK2</i>) more frequently became detectable above the reporting threshold during B2-B3 than during B1-B2, while epigenetic-gene candidates showed relatively stable detectability. No therapy-related myeloid neoplasm events were observed during follow-up.</p><p><strong>Conclusion: </strong>This paired tissue-plasma longitudinal analysis highlights an interpretive challenge in cfDNA testing during first-line platinum-to-PARPi maintenance therapy: putative CH candidates may become detectable as tumor-derived cfDNA declines. Given cfDNA-only inference without matched WBC sequencing and the small serial cohort, these observations are supportive of prior reports of CH dynamics but require validation in larger WBC-integrated cohorts.</p><p><strong>Trial registration: </strong>UMIN-CTR Clinical Trial Identifier: UMIN000036749.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684736","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 prognostic value of surgery in patients with locally advanced vulvar cancer: results from the SEER database and a Chinese multicenter registry.","authors":"Jiaqi Xu, Penglin Liu, Haifeng Qiu, Tingting Gong, Manlin Zhang, Jian Liu, Zhumei Cui, Ning Xie, Zhuang Li, Heyan Zhang, Zhongshao Chen, Jianye Wang, Yuehan Gao, Yuan Zhang, Li Song, Yang Sun, Zhuo Yang, Beihua Kong, Kun Song","doi":"10.3802/jgo.2027.38.e4","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e4","url":null,"abstract":"<p><strong>Objective: </strong>The therapeutic role of surgery in locally advanced vulvar cancer (LAVC) remains controversial based on current National Comprehensive Cancer Network and International Federation of Gynecology and Obstetrics (FIGO) guidelines. This multicenter study aimed to investigate the prognostic value of surgery in LAVC patients.</p><p><strong>Methods: </strong>LAVC patients (T2 stage with tumor >4 cm; and T3 stage) were enrolled from the Surveillance, Epidemiology, and End Results (SEER) database and the Chinese multicenter registry. The primary outcome was cancer-specific survival (CSS). The difference in CSS between the surgery group and non-surgery group was evaluated through Cox regression analyses and Kaplan-Meier analyses. To enhance the robustness of our findings, propensity score matching (PSM) and sensitivity analyses were also applied.</p><p><strong>Results: </strong>A total of 936 LAVC patients were included in the final analysis. Multivariable Cox regression analyses showed that surgery was associated with better CSS in LAVC patients, both in the SEER cohort (hazard ratio [HR]=0.55; 95% confidence interval [CI]=0.41-0.73; p<0.001) and the Chinese cohort (HR=0.31; 95% CI=0.14-0.71; p=0.006). Meanwhile, in the SEER cohort, the Kaplan-Meier analyses showed that the surgery group had better CSS than the non-surgery group both before (p<0.001) and after PSM cohorts (p=0.003). The Chinese cohort also demonstrated significantly improved CSS in the surgical group than the non-surgical group (p<0.001).</p><p><strong>Conclusion: </strong>Surgery was associated with better survival in patients with LAVC. Further prospective studies are warranted.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630629","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":"Outcome of advanced ovarian cancer patients who do not undergo cytoreductive surgery in the era of PARP inhibitors maintenance therapy: a propensity score-based analysis.","authors":"Junki Onishi, Suguru Odajima, Masashi Wakabayashi, Yuki Kochi, Hiromichi Nakajima, Kazuaki Takahashi, Kenichi Harano, Motoaki Saito, Hiroshi Tanabe, Nozomu Yanaihara, Hirokuni Takano, Kyosuke Yamada, Toru Mukohara, Aikou Okamoto","doi":"10.3802/jgo.2027.38.e7","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e7","url":null,"abstract":"<p><strong>Objective: </strong>Little is known about patients with advanced ovarian cancer (AOC) who do not undergo cytoreductive surgery but receive maintenance therapy with poly (ADP-ribose) polymerase inhibitors (PARPis). We aimed to investigate the efficacy of PARPi maintenance therapy in nonsurgical patients.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical records of patients newly diagnosed with stage III/IV ovarian cancer between April 2014 and March 2024 who did not undergo cytoreductive surgery and responded to first-line chemotherapy. The Kaplan-Meier method was used to estimate the survival outcomes. Adjustment for confounding using propensity score matching (PSM) was performed to compare progression-free survival (PFS) and overall survival (OS) between patients who received PARPi maintenance therapy and those who did not.</p><p><strong>Results: </strong>Eighty-six patients (11.5%) out of 751 newly diagnosed AOC patients were eligible; of these patients, 52 (60.5%) had received PARPi maintenance therapy, and 34 (39.5%) had not. The median PFS and OS for the PARPi maintenance group were 9.8 months (95% confidence interval [CI]=7.2-14.8 months) and 29.2 months (95% CI=21.9 months-not available), respectively. After PSM (27 matched pairs), PFS was prolonged in the PARPi maintenance group compared to the no PARPi maintenance group (log-rank test p<0.001; hazard ratio [HR]=0.34; 95% CI=0.18-0.64). Similarly, OS was prolonged in the PARPi maintenance group compared to the no PARPi maintenance group (p=0.019; HR=0.45; 95% CI=0.23-0.89).</p><p><strong>Conclusion: </strong>Patients with AOC who are not undergoing cytoreductive surgery may be a crucial population that benefits from PARPi maintenance therapy.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591035","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}