Journal of Gynecologic Oncology最新文献

{"title":"Changes in the extensiveness of initial debulking surgery with increasing neoadjuvant chemotherapy use in advanced ovarian cancer: a nationwide population-based study.","authors":"Junhwan Kim, Byeong-Chan Oh, Sokbom Kang","doi":"10.3802/jgo.2027.38.e9","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e9","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate changes in initial debulking surgery extensiveness among advanced ovarian cancer (OC) patients alongside increasing neoadjuvant chemotherapy (NACT) use.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed patients with distant disease in the Surveillance, Epidemiology, and End Results summary stage who underwent initial debulking surgery between 2013 and 2019 using the Cancer Public Library Database in South Korea. We evaluated temporal trends in extensive surgery by surgical site and compared primary debulking surgery (PDS) versus interval debulking surgery (IDS) subgroups. Extensive surgery was defined as standard surgery plus ≥1 additional complex procedure(s) involving nongenital tract organs or extra-abdominal metastatic sites.</p><p><strong>Results: </strong>Among 5,500 patients, 23.6% received NACT. The IDS proportion increased during the study period (p for trend <0.01). The proportion of extensive surgery remained stable at 45.4%-49.2% (p for trend=0.54). Bowel surgery decreased from 73.5% to 65.2% (p for trend=0.02), whereas thoracic surgery increased from 31.8% to 44.2% (p for trend <0.01). Extensive surgery was more frequent in IDS versus PDS (p<0.01). In IDS compared to PDS, bowel surgery declined over time (p for trend=0.02) and was less frequent (59.6% vs. 74.4%, p<0.01), while thoracic (49.5% vs. 35.8%, p<0.01) and other extra-abdominal surgeries (5.0% vs. 2.9%, p<0.01) were more common.</p><p><strong>Conclusion: </strong>Increased NACT use was accompanied by constant overall extensive surgery, with greater bowel preservation and more frequent thoracic and other extra-abdominal surgeries in patients with advanced OC who underwent IDS.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592100","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":"A confirmatory trial of hysterectomy with minimal parametrectomy for stage IB1 cervical cancer involving a tumor diameter of 2 cm or less: a Japan Clinical Oncology Group study (JCOG1101).","authors":"Takahide Arimoto, Takahiro Kasamatsu, Ryunosuke Machida, Takafumi Toita, Hiroaki Kobayashi, Haruhiko Fukuda, Takashi Onda, Toru Nakanishi, Harushige Yokota, Shoji Kamiura, Kazuhiro Takehara, Hirokuni Takano, Toshiaki Saito, Ikuo Konishi, Satoshi Yamaguchi, Toshiaki Nakamura, Kimio Ushijima, Daisuke Aoki, Nobuo Yaegashi, Toyomi Satoh","doi":"10.3802/jgo.2027.38.e8","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e8","url":null,"abstract":"<p><strong>Objective: </strong>The standard surgery for stage IB uterine cervical cancer is radical hysterectomy (RH). However, RH is highly invasive, and there is a need to establish less invasive techniques.</p><p><strong>Methods: </strong>We conducted a prospective, single-arm trial to evaluate the efficacy and safety of modified radical hysterectomy (MRH)in patients with International Federation of Gynecology and Obstetrics 2008 stage IB1 cervical cancer involving a tumor diameter of ≤2 cm measured on magnetic resonance imaging. The protocol treatment consisted of MRH and adjuvant (chemo)radiotherapy if indicated. The primary endpoint was 5-year overall survival (OS). The expected OS was set at 95.8%; i.e., the OS of RH in our previous observational study.</p><p><strong>Results: </strong>Of 225 eligible patients, 193 (85.8%) had pT1b1 (Union for International Cancer Control 7th) disease, and 184 (81.8%) had a pathological maximum tumor diameter of ≤2 cm. Parametrial involvement, lymph node metastasis, stromal invasion involving ≥2/3 of the stroma, and surgical margins of <1 cm (including carcinoma in situ) were observed in 3 (1.3%), 16 (7.1%), 30 (13.3%), and 11 (4.9%) patients, respectively. The 5-year OS and relapse-free survival rates were 98.2% (90% confidence interval [CI]=96.0%-99.2%) and 94.7% (95% CI=90.8%-96.9%), respectively. The median time to the disappearance of residual urine after urethral catheter removal was 1 day. There were no treatment-related deaths. Grade 3/4 adverse events were observed in 17 patients (7.6%).</p><p><strong>Conclusion: </strong>MRH may be as effective as and less invasive than RH for stage IB1 uterine cervical cancer involving a tumor diameter of ≤2 cm.</p><p><strong>Trial registration: </strong>Japan Registry of Clinical Trials Identifier: jRCTs031180167.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592103","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":"Clinical effectiveness of laparoscopic versus open surgery for apparently early-stage endometrial cancer: Application of a treatment effect model.","authors":"Chuenkamon Charakorn, Sasivimol Rattanasiri, Arb-Aroon Lertkhachonsuk, Panida Mathaveechotikul, Gareth J McKay, John Attia, Ammarin Thakkinstian","doi":"10.3802/jgo.2027.38.e2","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e2","url":null,"abstract":"<p><strong>Objective: </strong>While the advantages of laparoscopic surgery (LPS) over open surgery (OPS) for endometrial cancer (EC) have been reported, most evidence comes from high-income countries with limited follow-up periods. To emulate a clinical trial using real-world cohort data to compare the clinical effectiveness, specifically recurrence and mortality rate, between LPS and OPS in patients with apparently early-stage EC.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at a tertiary care hospital in Thailand. Treatment effect models with inverse-probability-weighted regression adjustment were employed to balance patient characteristics between the LPS and OPS groups, and subsequently estimated the treatment effect of LPS relative to OPS.</p><p><strong>Results: </strong>From January 2011 to December 2022, 939 patients underwent surgery for EC. With a median follow-up time of 6.0 years (interquartile range=3.7-8.7), LPS significantly reduced the risk of recurrence and death compared to OPS, with a hazard ratio of 0.21 (95% confidence interval [CI]=0.09, 0.50) for recurrence and 0.42 (95% CI=0.24, 0.75) for death. LPS was significantly associated with longer operative time than OPS (mean difference [MD]=79.37 minutes; 95% CI=63.77-94.98) but showed clear advantages in other surgical outcomes, including reduced blood loss (MDs=-210.59 mL; 95% CI=-235.28, -185.89) and shorter hospital stays (MD=-17.25 hours; 95% CI=-25.67, -8.84).</p><p><strong>Conclusion: </strong>Real-world data from an upper-middle-income country indicated that LPS may provide superior oncologic outcomes, such as reduced recurrence and mortality rates, as well as improve surgical outcomes, including less blood loss and shorter hospital stays, despite a longer operative time.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497690","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":"Camrelizumab combined with chemotherapy as postoperative adjuvant therapy after radical surgery for cervical cancer patients with pathologically positive lymph nodes: a prospective multicenter phase II clinical trial.","authors":"Liqing Chen, Tingting Chen, Nalan Tu, Liya Dong, Yingli Zhang, Hui Wang, Yuanming Shen","doi":"10.3802/jgo.2027.38.e1","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e1","url":null,"abstract":"<p><strong>Background: </strong>Concurrent chemoradiotherapy is the standard adjuvant treatment for cervical cancer patients with pathologically confirmed lymph node metastases (International Federation of Gynecology and Obstetrics 2018 stage IIIC1p or IIIC2p) after radical surgery. Yet distant metastasis remains the predominant pattern of failure. In recent years, Immune checkpoint inhibitors combined with platinum-containing chemotherapy has been increasingly valued in the treatment of cervical cancer. Yet the role of postoperative chemo-immunotherapy in this setting remains unclear. There is no high-quality evidence-based evidence.</p><p><strong>Methods: </strong>This multicenter, prospective, single-arm phase II clinical trial is to evaluate the safety and preliminary efficacy of postoperative chemo-immunotherapy in cervical cancer patients with pathologically confirmed lymph node metastasis after radical hysterectomy, and to explore potential biomarkers associated with treatment response. Fifty-nine carefully selected cervical cancer patients with pathologically confirmed lymph node metastases and programmed death ligand-1 positivity (combined positive score ≥1) after radical surgery will be enrolled. Postoperative treatment is initiated 2-3 weeks after surgery. Each treatment cycle is administered every 21-28 days and consists of chemotherapy (paclitaxel 175 mg/m², cisplatin 75-80 mg/m²) combined with camrelizumab (200 mg). Patients with 3 or more positive lymph nodes or para-aortic lymph node metastases receive 6 cycles of combined chemo-immunotherapy, whereas other patients receive 3 cycles. The primary outcome is 3-year disease-free survival rate. The secondary outcomes are overall survival rate, adverse events and health-related cancer-specific quality of life.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT07167160.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497642","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":"Association between delayed confirmatory testing and cervical cancer detection among women with abnormal screening results.","authors":"Haiwon Yoo, Hyeongsu Kim, Jong Ha Hwang, Dong Hoon Suh, Young Ko, Sungwon Jung","doi":"10.3802/jgo.2027.38.e3","DOIUrl":"https://doi.org/10.3802/jgo.2027.38.e3","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between delayed confirmatory testing and cervical cancer detection among women with abnormal Pap smear results in the Korean national cervical cancer screening program.</p><p><strong>Methods: </strong>This retrospective cohort study used customized data from the National Health Insurance Service of Korea. Women aged ≥30 years who underwent cervical cancer screening in 2019/2020 were included. After excluding those with prior gynecologic conditions or inadequate screening history, participants were classified according to confirmatory testing within 2 years after abnormal screening results. Outcomes included claims-based detection of cervical cancer (C53) and carcinoma in situ (D06). Adjusted hazard ratios (HRs) were estimated using multivariable Cox proportional hazards models.</p><p><strong>Results: </strong>Among 10,331,369 participants, 64,762 were eligible (20,073 in Group 1 and 44,689 in Group 2). The 2-year detection rate of cervical cancer was 4.6% in Group 2 and 0.6% in Group 1. When including carcinoma in situ, rates were 19.5% and 5.6%, respectively. Delayed confirmatory testing was associated with higher detection rates, which may reflect delayed identification of pre-existing cases rather than a true increase in incidence (adjusted HR for C53+D06=1.45). Disparities by age, income, and region were observed.</p><p><strong>Conclusion: </strong>Delayed confirmatory testing was associated with higher cervical cancer detection; however, this likely reflects delayed identification of pre-existing cases rather than a causal increase in cancer occurrence. Improving follow-up systems may help reduce disparities in cancer detection.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497604","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":"Cross-country inequalities and frontier analysis in global burden of cervical cancer: cross-sectional studies.","authors":"Chenlu Fan, Chuanxi Fu","doi":"10.3802/jgo.2026.37.e45","DOIUrl":"10.3802/jgo.2026.37.e45","url":null,"abstract":"<p><strong>Objective: </strong>This research evaluated global health disparities of cervical cancer, and forecasted trends from 2022 to 2040.</p><p><strong>Methods: </strong>Cross-country inequalities [Slope Index of Inequality (SII) and the Concentration Index] are used to measure inequality. Frontier analysis evaluates the medical quality by calculating the difference between actual values and frontier values. Average annual percentage changes (AAPCs) were computed to discern trends from 2022 to 2040.</p><p><strong>Results: </strong>The global SII for the age-standardized death rate (ASDR) of cervical cancer was -9.14 per 100,000 in 1990 and -9.62 in 2021. For age-standardized disability-adjusted life years (DALY) rate, the Concentration Index was -0.22 in 1990 and -0.30 in 2021. Frontier analysis calculated the difference between the actual value and the frontier value, indicating that countries with the most significant potential for reducing the disease burden of cervical cancer are Kiribati, Lesotho, Zimbabwe, Eswatini, and Eritrea. The global age standardized incidence rate (ASIR) and ASDR for cervical cancer are expected to decline by 2040, with an AAPC of -0.34 (95% confidence interval [CI]=-0.35 to -0.34) and -0.99 (95% CI=-0.99 to -0.99), respectively. However, in Eastern Europe, Central Latin America, Tropical Latin America, and Sub-Saharan Africa, the ASIR for cervical cancer is projected to continue rising through 2040. Unsafe sex is a contributing factor to cervical cancer deaths.</p><p><strong>Conclusion: </strong>Cross-national inequalities show that from 1990 to 2021, the trend of cervical cancer inequality has intensified and is concentrated in low socio-demographic index regions. Healthcare services in countries like Kiribati, Lesotho, and Zimbabwe need significant improvement.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e45"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944609","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":"Treatment patterns and survival outcomes according to histologic subtype in malignant ovarian germ cell tumors: a nationwide real-world cohort study.","authors":"Jaekyung Bae, Byeong-Chan Oh, Uisuk Kim, Junyoung Shin, Sokbom Kang","doi":"10.3802/jgo.2026.37.e60","DOIUrl":"10.3802/jgo.2026.37.e60","url":null,"abstract":"<p><strong>Objective: </strong>To investigate real-world treatment patterns and survival outcomes by histologic subtype in patients with malignant ovarian germ cell tumors (MOGCTs) in Korea.</p><p><strong>Methods: </strong>Using the Cancer Public Library Database, a retrospective cohort study was conducted including adult patients newly diagnosed with MOGCTs between 2013 and 2018. Patients were categorized into 3 histologic subtypes: dysgerminoma, non-dysgerminomatous germ cell tumors (ND-GCTs; yolk sac tumor, embryonal carcinoma, and mixed germ cell tumor [GCT]), and malignant teratomatous germ cell tumors (immature teratoma and teratocarcinoma). Initial treatment patterns, including surgery and chemotherapy, were examined. Overall survival (OS) was assessed by histologic subtype using the Kaplan-Meier method. In localized-stage patients, OS and time to first subsequent therapy or death (TFST) were estimated by adjuvant chemotherapy use, with subgroup analysis by histology.</p><p><strong>Results: </strong>A total of 332 patients were included (27.7% dysgerminomas, 33.4% ND-GCTs, 38.9% malignant teratomatous GCTs). In localized disease, surgery alone was common in dysgerminomas (57.6%), while adjuvant chemotherapy was frequently used in ND-GCTs (88.5%) and malignant teratomatous GCTs (60.0%). Adjuvant chemotherapy was associated with longer TFST overall (p<0.01), but no OS benefit (p=0.22). In subgroup analysis, adjuvant chemotherapy was associated with longer TFST in ND-GCTs (p<0.01) and malignant teratomatous GCTs (p=0.04), but not in dysgerminomas. No significant differences in OS were observed in any group.</p><p><strong>Conclusion: </strong>This study highlights distinct treatment patterns and outcomes by histologic subtype in MOGCTs. These findings support the value of large population-based data in guiding treatment decisions for rare ovarian tumor subtypes.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e60"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348257","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":"Cervical neuroendocrine carcinoma with non-neuroendocrine components has a poorer prognosis than pure neuroendocrine carcinoma.","authors":"Sun Min Park, Chel Hun Choi, Kidong Kim, Hyojin Kim, Se Ik Kim, Chae Hyeong Lee","doi":"10.3802/jgo.2026.37.e80","DOIUrl":"10.3802/jgo.2026.37.e80","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether neuroendocrine carcinoma of the cervix (NECC) with coexisting non-neuroendocrine tumor components (mixed subtype) is associated with a worse prognosis compared to the pure subtype.</p><p><strong>Methods: </strong>A total of 121 patients diagnosed with NECC at 4 participating hospitals in the Republic of Korea between August 1997 and November 2023 were included. All diagnoses were confirmed through surgical specimens obtained via conization or hysterectomy. Clinical and pathological variables were collected through medical record review. The association between tumor heterogeneity (pure vs. mixed subtype) and progression-free survival (PFS) was analyzed using a Cox proportional hazards model.</p><p><strong>Results: </strong>The majority of patients was diagnosed at stage I (62%), had small cell histology (63%), and presented with the pure subtype (66%). Most patients (n=106) underwent surgery with or without adjuvant therapy as initial treatment. In univariate analysis, there was no significant difference in PFS between the pure and mixed subtypes (p=0.952). However, after adjusting for covariates, the mixed subtype was significantly associated with worse PFS compared to the pure subtype (adjusted hazard ratio=3.16; 95% confidence interval=1.58-6.35; p=0.001).</p><p><strong>Conclusion: </strong>NECC with non-neuroendocrine components is associated with significantly worse prognosis than the pure subtype.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e80"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463441","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":"Tubal epithelial alterations: evolving concepts.","authors":"Kei Koyama, Daichi Maeda, Akiteru Goto","doi":"10.3802/jgo.2026.37.e121","DOIUrl":"10.3802/jgo.2026.37.e121","url":null,"abstract":"<p><p>The fallopian tube has emerged as a central organ in the pathogenesis of ovarian cancer, particularly high-grade serous carcinoma (HGSC). Detailed histopathological and molecular analyses have revealed a diverse spectrum of tubal epithelial alterations with varying malignant potentials. This review outlines key lesions including secretory cell outgrowth (SCOUT), p53 signature, serous tubal intraepithelial lesion (STIL), serous tubal intraepithelial carcinoma (STIC), β-catenin signatures, endometrioid tubal intraepithelial neoplasia, and papillary tubal hyperplasia (PTH). The p53 signature, STIL, and STIC are changes originating from secretory cells with underlying <i>TP53</i> alterations. However, recent findings suggest that these lesions do not necessarily represent a continuous sequence in terms of risk of progression to HGSC. Advances in molecular biology have enabled the estimation of malignant potential of individual lesions. SCOUTs, particularly Type II are thought to be precursors of endometrioid carcinoma. While SCOUTs are frequently observed in the general population, endometrioid carcinoma of the fallopian tube remains extremely rare. PTH has traditionally been regarded as a reactive phenomenon; however morphological and molecular overlaps with low-grade serous carcinoma have recently been suggested. These findings underscore the complexity and heterogeneity of tubal epithelial alterations and suggest that not all lesions follow a linear tumorigenic sequence. Continued integration of morphological, molecular, and spatial analyses will be essential for refining our understanding of tubal pathology and its contribution to gynecological carcinogenesis.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e121"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199246","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":"Comparative outcomes of adjuvant chemotherapy alone versus combined chemotherapy and radiation therapy in patients with stage III endometrial cancer: a propensity score matching study.","authors":"Khemanat Khemworapong, Janjira Petsuksiri, Atthapon Jaishuen, Pittaya Dankulchai, Kullathorn Thephamongkol, Jiraporn Setakornnukul","doi":"10.3802/jgo.2026.37.e77","DOIUrl":"10.3802/jgo.2026.37.e77","url":null,"abstract":"<p><strong>Objective: </strong>We compared the outcomes of adjuvant chemotherapy (CT) alone vs. adjuvant CT combined with radiation therapy (CRT) in patients with stage III endometrial cancer. All patients received 6 cycles of CT before radiation therapy (RT) were initiated. We also explored specific patient subgroups that might benefit from the addition of RT.</p><p><strong>Methods: </strong>Between 2007 and 2019, we analyzed 118 patients after propensity score matching, with 59 patients in each group (CT alone vs. CRT). The primary endpoint was pelvic recurrence; the secondary endpoints were progression-free survival (PFS). We conducted exploratory subgroup analyses stratifying patients by stage, histological grade, lymphovascular space invasion (LVSI), and cervical involvement to assess whether these factors influenced outcomes between the 2 treatments.</p><p><strong>Results: </strong>Patients receiving CRT had significantly lower 5-year pelvic recurrence rates than those receiving CT alone (1.8% vs. 17.9%; hazard ratio [HR]=0.09 [0.01-0.71]; p=0.004). There was no significant difference in 5-year PFS between the 2 groups overall (67.6% vs. 72.3%; HR=0.75 [0.39-1.46]; p=0.393). However, in high-risk _{subclass III} patients (stage IIIC, grade 3 endometrioid or non-endometrioid carcinoma, LVSI, and cervical involvement), CRT significantly improved 5-year PFS (62.5% vs. 90.9%; p=0.049) and 5-year pelvic recurrence rates (0% vs. 54.6%; p=0.008). No differences in distant recurrence or overall survival were identified.</p><p><strong>Conclusion: </strong>Compared with CT alone, CRT improved pelvic control overall and significantly improved pelvic control and PFS in high-risk _{subclass III} patients. Therefore, RT may be considered for these subclasses to optimize treatment outcomes.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e77"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377724","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}