Journal of Gynecologic Oncology最新文献

{"title":"Cost-effectiveness analysis of reflex p16/Ki-67 dual-stained cytology in HPV partial genotyping screening in Singapore.","authors":"Sun Kuie Tay, David Wastlund, Rebecca Shu Yu Sim, James Karichu, Qishi Zheng","doi":"10.3802/jgo.2025.36.e115","DOIUrl":"10.3802/jgo.2025.36.e115","url":null,"abstract":"<p><strong>Objective: </strong>Triage testing is an integral part of high-risk human papillomavirus (HPV)-based cervical screening programs. This study assesses, from a healthcare payer perspective in Singapore, the cost-effectiveness of p16/Ki-67 dual-stained cytology (DS) compared to current standard of care (SOC).</p><p><strong>Methods: </strong>A decision-analytic Markov microsimulation model with a lifetime horizon was built to simulate the outcomes from HPV screening in Singaporean women aged 30-65 years. The intervention (primary testing with HPV genotyping followed by DS reflex test) was compared to current SOC (HPV genotyping followed by cytology) according to Singaporean clinical management guidelines. The progression through health states and associated costs and health outcomes were based on local clinical care data in Singapore. Screening impact was assessed by cost saving, number of colposcopy and quality-adjusted life years (QALYs).</p><p><strong>Results: </strong>Compared to SOC, implementation of HPV genotyping + DS was estimated to decrease the number of screening test (-2.02 times per patient) and colposcopy (-0.16 times per patient), and reduce the overall costs to the Singaporean healthcare system by S$225.59 per patient (95% CI: S$199.05 to S$249.99). The total QALYs estimates for the 2 approaches were similar (-0.0003; 95% confidence interval=-0.0031 to 0.0022). Sensitivity analyses confirmed the robustness of expected cost-savings and that the full value of avoided colposcopies may be larger than projected in the current analysis.</p><p><strong>Conclusion: </strong>This economic modelling analysis projected that using DS instead of conventional cytology as the reflex test for positive test with non-HPV-16/18 subtypes significantly reduced the financial costs of cervical cancer screening in Singapore.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333247","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":"Atezolizumab, bevacizumab, and platinum chemotherapy in cervical cancer: results of Japanese population from BEATcc.","authors":"Munetaka Takekuma, Shin Nishio, Satoshi Yamaguchi, Mayu Yunokawa, Hiroshi Nishio, Koji Nishino, Akira Kurosaki, Shinichiro Minobe, Guillermo Villacampa, Ana Oaknin, Aikou Okamoto","doi":"10.3802/jgo.2025.36.e116","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e116","url":null,"abstract":"<p><strong>Objective: </strong>This study analyzed the efficacy of add-on atezolizumab to standard first-line bevacizumab-containing therapy in 56 Japanese patients with metastatic and recurrent cervical cancer treated across 8 sites under the Japanese Gynecologic Oncology Group between October 2018 and August 2021 in the BEATcc trial.</p><p><strong>Methods: </strong>Patients were randomized to standard arm (standard therapy: cisplatin 50 mg/m² or carboplatin area under the curve of 5, paclitaxel 175 mg/m², and bevacizumab 15 mg/kg) or experimental arm (standard therapy with atezolizumab 1,200 mg).</p><p><strong>Results: </strong>Of 56 patients, 30 were in experimental arm vs. 26, standard arm (age: 53.2±12.9 vs. 54.7±12.2 years). Median progression-free survival was 15.8 months (95% confidence interval [CI]=10.4-26.1) in experimental arm vs. 11.1 months (8.4-16.5) in standard arm (hazard ratio [HR]=0.51; 95% CI=0.26-1.01). Median overall survival was 34.1 months (23.2-38.6) in the experimental arm vs. 31.6 months (16.4-36.5), standard arm (HR=0.53; 95% CI=0.23-1.21). Objective response rate was 86.7% in experimental arm vs. 84.6%, standard arm. Complete response and partial response, respectively, were 23.3% and 63.3% in experimental arm and 26.9% and 57.7% in standard arm. Grade ≥3 adverse events occurred in 80.0%, experimental arm and 88.5%, standard arm. Gastrointestinal/genitourinary fistula incidence was lower in Japanese patients (1 patient receiving atezolizumab), likely due to stricter inclusion criteria.</p><p><strong>Conclusion: </strong>Overall, add-on atezolizumab enhances the efficacy of bevacizumab and chemotherapy in Japanese patients as those in overall BEATcc population and could be considered a new first-line treatment option for metastatic, persistent, or recurrent cervical cancer in Japan.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03556839.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086275","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 novel technique for transdiaphragmatic latero-pericardial cardiophrenic lymph node excision using the minimally invasive surgical access procedure in patient with advanced stage ovarian cancer.","authors":"Candost Hanedan, Hande Nur Öncü, Tuba Zengin Aksel, Vakkas Korkmaz","doi":"10.3802/jgo.2025.36.e124","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e124","url":null,"abstract":"<p><p>This study reports the first case of transdiaphragmatic lateropericardial cardiophrenic lymph node excision using the GelPOINT™ mini access platform in a patient with advanced-stage ovarian cancer. A 69-year-old woman with high-grade serous epithelial ovarian cancer. Cardiophrenic lymph node dissection is vital in advanced ovarian cancer surgery, as enlarged nodes are linked to poor prognosis. No clear guidelines exist for operating on patients with enlarged cardiophrenic lymph nodes [1, 2]. These nodes are categorized by location relative to the heart: anterior, median (lateropericardial), and posterior [3]. Cardiophrenic lymph node resection can be performed using transdiaphragmatic, transxiphoid, or transthoracic approaches with video-assisted thoracoscopic surgery [4]. In cases with suspicious nodes on imaging, removing them is essential for optimal cytoreduction and accurate staging. In this case, preoperative computed tomography revealed suspicious cardiophrenic lymph nodes measuring 16×13 mm and 10×8 mm, located near the xiphoid process and lateral pericardium. A 30 mm diaphragm incision was made 60 mm from the xiphoid process. An Alexis O-wound retractor was used, and the GelPOINT™ mini platform was introduced with three ports, including one for the camera. A 30-degree optic scope was used to excise the node with LigaSure. When we needed smoke management, we used an aspirator. With this method, we were able to access distally located cardiophrenic lymph nodes with a small incision. Transdiaphragmatic excision of the cardiophrenic lymph node using the mini access platform can be performed effectively with a smaller incision, demonstrating the feasibility and safety of this minimally invasive technique in managing such cases.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180395","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":"Modifying surgical extents in patients with preoperatively presumed early-stage endometrial cancer based on ProMisE classification: a retrospective, single-center study.","authors":"Ji Hyun Lee, Eunhyang Park, Eun Ji Nam, Sunghoon Kim, Sang Wun Kim, Young Tae Kim, Jung-Yun Lee","doi":"10.3802/jgo.2025.36.e112","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e112","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore differences in disease extent based on the Proactive Molecular Risk Classifier for Endometrial Cancer (ProMisE) classification and to establish personalized staging surgery strategies in patients with preoperatively presumed uterus-confined endometrial cancer.</p><p><strong>Methods: </strong>In this retrospective, single-center study, we reviewed the medical records of patients with endometrial cancer. These patients were classified according to the ProMisE classification based on tissue samples obtained from dilation and curettage or staging surgeries, and the disease extent was analyzed based on pathologic reports.</p><p><strong>Results: </strong>A total of 345 patients were clinically estimated to be in stage 1/2 before staging surgery, with immunohistochemistry (IHC) results available. This cohort included 332 patients (96.2%) with clinical stage 1 and 13 patients (3.8%) with stage 2 based on the 2009 FIGO staging system. Among these, 81 patients (23.5%) were assigned to an mismatch repair deficient group (MMRd), 33 (9.6%) to an abnormal p53 group, and 123 (71.1%) to a no specific molecular profile (NSMP) group. Overall, 13 patients had nodal metastasis, with a higher rate observed in the abnormal p53 group (1.2%, 12.1%, and 2.2% for the MMRd, abnormal p53, and NSMP groups, respectively, p=0.013). One patient (0.3%) had parametrial metastasis and four (1.1%) had peritoneal metastasis.</p><p><strong>Conclusion: </strong>Patients with abnormal p53 IHC results exhibited a higher likelihood of lymph node metastasis, even when initially presumed to be at an early stage. For the abnormal p53 group, proactive lymphadenectomy surgery appears beneficial for accurate staging and establishing a subsequent treatment plan.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127411","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":"Molecular subtypes and quantitative analysis of PD-L1 and tumor-associated immune cells in uterine carcinosarcoma.","authors":"Lili Sun, Xiaozhuo Gao, Zehua Zhao, Yanmei Zhu","doi":"10.3802/jgo.2025.36.e114","DOIUrl":"https://doi.org/10.3802/jgo.2025.36.e114","url":null,"abstract":"<p><strong>Objective: </strong>In the present study, molecular subtypes were determined, programmed death-ligand 1 (PD-L1) and tumor-associated immune cells (TAICs) were quantitatively detected, and their effect on prognosis in uterine carcinosarcoma (UCS) was analyzed.</p><p><strong>Methods: </strong>The study included 65 UCS cases. Direct sequencing of POLE exonuclease domain and immunohistochemistry of mismatch repair (MMR) deficiency proteins and p53 were used to stratify molecular subtypes. QuPath was used for quantitative immunohistochemical detection of PD-L1 and TAICs. The chi square test was used to determine the association between molecular subtypes and expression of PD-L1 and TAICs. The Kaplan-Meier method and Cox proportional hazards regression were used for plotting and survival analysis.</p><p><strong>Results: </strong>In 65 UCS cases, 1 case (1.5%) was POLE ultramutated (POLEmut) subtype, 11 cases (16.9%) were deficient MMR (dMMR) subtype, 32 cases (49.3%) were p53 mutant (p53mut) subtype, and 21 cases (32.3%) were nonspecific molecular profile (NSMP) subtype. The positive density of PD-L1 in tumor (p=0.022), CD8 in stroma (p=0.036), and CD163 in stroma (p=0.025) were significantly associated with molecular subtypes. The patients with POLEmut and dMMR subtypes had a relatively better prognosis trend than patients with NSMP and p53mut subtypes. The patients with high positive density of PD-L1 in tumor had significantly better prognosis; however, high positive density of CD163 in stroma showed significantly worse prognosis.</p><p><strong>Conclusion: </strong>UCS could be classified into four molecular subtypes associated with prognosis. PD-L1 and M2 macrophages could effectively predict the prognosis of patients with UCS.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127506","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":"Different surgical methods for FIGO stage IVB cervical cancer patients receiving chemotherapy: a population-based study.","authors":"Haoran Li, Jiao Wu, Qing Xu, Yixin Chen, Xi Cheng","doi":"10.3802/jgo.2025.36.e42","DOIUrl":"10.3802/jgo.2025.36.e42","url":null,"abstract":"<p><strong>Objective: </strong>To assess survival differences between non-extensive surgery (NES) and extensive surgery (ES) in International Federation of Gynecology and Obstetrics (FIGO) stage IVB cervical cancer patients receiving chemotherapy from a population-based database, the Surveillance, Epidemiology and End Results.</p><p><strong>Methods: </strong>Propensity matching was conducted to minimize heterogeneity. Survival analysis was performed by the Kaplan-Meier method, log-rank test, and Cox proportional hazards model.</p><p><strong>Results: </strong>A total of 154 patients met screening criteria, among whom 84 patients (84/154) underwent NES while 70 patients (70/154) underwent ES. After matching, no survival advantage was observed in ES group compared with NES group (p=0.066; hazard ratio [HR]=1.54; 95% confidence interval [CI]=0.97-2.42). Stratified analyses suggested ES prolonged overall survival in patients with histology other than squamous cell carcinoma and adenocarcinoma (p=0.028; HR=0.36; 95% CI=0.15-0.89) and American Joint Committee on Cancer (AJCC) T stage T1 (p=0.009; HR=0.18; 95% CI=0.05-0.66). Despite no survival benefit after regional lymph node surgery (p=0.629; HR=0.88; 95% CI=0.53-1.47), subgroup analyses demonstrated that patients younger than 50 (p=0.006; HR=0.21; 95% CI=0.07-0.64), with AJCC T stage T1 (p=0.002; HR=0.09; 95% CI=0.02-0.42), T3 (p=0.001; HR=0.02; 95% CI=0.00-0.21), hematogenous metastasis (p=0.036; HR=0.27; 95% CI=0.08-0.92) and without surgery of other sites (p<i>=</i>0.040; HR=0.01; 95% CI=0.00-0.79) might achieve longer survival after regional lymph node surgery.</p><p><strong>Conclusion: </strong>In conclusion, ES or regional lymph node surgery may provide survival advantage for certain subgroup of FIGO IVB cervical cancer patients receiving chemotherapy. However, it deserves large scale prospective clinical trials to confirm.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e42"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558034","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":"Functions, interactions and prognostic role of <i>POLE</i>: a bioinformatics analysis.","authors":"Jonathan Carvajal-Veloza, Fredy Galindo-Morales, Luz Dary Gutierrez-Castañeda","doi":"10.3802/jgo.2025.36.e45","DOIUrl":"10.3802/jgo.2025.36.e45","url":null,"abstract":"<p><strong>Objective: </strong>To describe <i>POLE</i> characteristics and reported mutations in endometrial cancer (EC) and analyze the impact of these mutations on the structure and function of the protein, as well as their relationship with the survival and prognosis of the disease.</p><p><strong>Methods: </strong>We retrieved reported mutations for <i>POLE</i> in EC from Catalogue of Somatic Mutations in Cancer database. We analyzed the most frequent mutations possible impact in the protein using HOPE server. We built a protein-protein network using Network Analyst, Cytoscape, and Network Analyzer plugin for topological analysis, enrichment analysis was performed using Gene Ontology: Biological processes. Clinical data was retrieved from cBioPortal database to compare overall survival between mutated <i>POLE</i> (<i>POLE</i>mut) and wild-type <i>POLE</i>. Relation of mutational status of <i>POLE</i> in EC and immune cell infiltration was analyzed using CIBERSORT algorithm in TIMER2.0 server.</p><p><strong>Results: </strong>Thirty mutations in POLE were retrieved, most reported mutations were p.P286R, p.V411L and p.A456P, these mutations were likely to be pathogenic. Network analysis of POLE showed interaction of this protein in biological processes such as DNA repair, the cell proliferation cycle, and mechanisms of resistance to platinum. Immune infiltration analysis showed that T cell CD8+, T cell memory activated CD4+, T cell follicular helper, T cell gamma delta and macrophage M1 were more infiltrated in EC <i>POLE</i>mut tumors.</p><p><strong>Conclusion: </strong>Mutations in POLE might affect DNA polymerase epsilon function. These mutations also affect interactions with other proteins like proteins involved in different DNA repairing mechanisms. <i>POLE</i> mutations may lead to platinum resistance, but they can also trigger an immune response that improves prognosis.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e45"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687258","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 trial comparing the use of Orcellex^® Brush versus Cervex-Brush^® on vaginal vault smear cytology adequacy rate in patients treated with radiotherapy for cervical cancer.","authors":"Yick Ling So, Mung Yuen He, Sze Ki Hui, Ellen Lok-Man Yu","doi":"10.3802/jgo.2025.36.e43","DOIUrl":"10.3802/jgo.2025.36.e43","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate and compare the Cervex-Brush^® and Orcellex^® Brush as sampling devices for vaginal vault smear cytology in cervical cancer patients treated primarily with radiotherapy.</p><p><strong>Methods: </strong>A randomized crossover trial was conducted at a gynecological oncology center in Hong Kong to compare the Cervex-Brush^® and Orcellex^® Brush in terms of their vault smear adequacy rate in cervical cancer patients who underwent radiotherapy.</p><p><strong>Results: </strong>One hundred sixty cervical cancer patients treated with primary radiotherapy and undergoing follow-up surveillance by vaginal vault cytology were recruited. The smear adequacy rate was 90.6% for Cervex-Brush^® and 91.9% for Orcellex^® Brush. The rates of low cellularity for both brushes were similar (76.8% for Cervex-Brush^® vs. 76.1% for Orcellex^® Brush). The detection rates of abnormal smears were also not significantly different (2.8% for Cervex-Brush^® vs. 4.2% for Orcellex^® Brush). The 2 brushes were also not significantly different in terms of pain score and degree of bleeding. It was further observed that the second smear collection was more painful and patients who were on hormonal replacement therapy demonstrated less bleeding.</p><p><strong>Conclusion: </strong>There was no difference between the Orcellex^® brush and the Cervex-Brush^® in terms of smear adequacy rate, rate of high cellularity and the detection of abnormal smears. There was also no significant difference between the 2 brushes in terms of pain and the degree of bleeding. Therefore, the Orcellex^® Brush can be considered a suitable alternative sampling device for vault smear collection in patients who have undergone radiotherapy for cervical cancer.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04461574.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e43"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501876","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":"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":"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":"e50"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099043/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut microbiome associated with PARP inhibitor efficacy in patients with ovarian cancer.","authors":"Mika Okazawa-Sakai, Shunsuke A Sakai, Ichinosuke Hyodo, Satoshi Horasawa, Kentaro Sawada, Takao Fujisawa, Yasuko Yamamoto, Shogen Boku, Yoh Hayasaki, Masanori Isobe, Daisuke Shintani, Kosei Hasegawa, Tomomi Egawa-Takata, Kimihiko Ito, Kei Ihira, Hidemichi Watari, Kazuhiro Takehara, Hiroshi Yagi, Kiyoko Kato, Tatsuyuki Chiyoda, Kenichi Harano, Yoshiaki Nakamura, Riu Yamashita, Takayuki Yoshino, Daisuke Aoki","doi":"10.3802/jgo.2025.36.e38","DOIUrl":"10.3802/jgo.2025.36.e38","url":null,"abstract":"<p><strong>Objective: </strong>To investigate an association between the gut microbiome and efficacy of poly(ADP-ribose) polymerase inhibitors (PARPi) in ovarian cancer.</p><p><strong>Methods: </strong>This study conducted fecal microbiome analysis (16S rRNA gene sequencing) and circulating tumor DNA (ctDNA) profiling for ovarian cancer patients who underwent PARPi maintenance therapy. Fecal and blood samples were collected at the baseline and the progressive disease (PD) or last follow-up. The relative abundance of gut microbes and progression-free survival (PFS) were analyzed using linear discriminant analysis of effect size and the Cox proportional hazard model according to <i>BRCA1</i>/<i>2</i> mutation (<i>BRCA1</i>/<i>2</i>mut) status detected by ctDNA sequencing.</p><p><strong>Results: </strong>Baseline samples were available from 23 <i>BRCA1</i>/<i>2</i>mut-positive patients and 33 <i>BRCA1/2</i>mut-negative patients. The microbes enriched in the baseline samples with long PFS were <i>Bifidobacterium</i>, <i>Roseburia</i>, <i>Dialister</i>, <i>Butyricicoccus</i>, and <i>Bilophila</i> for <i>BRCA1/2</i>mut-positive patients and <i>Phascolarctobacterium</i> for <i>BRCA1/2</i>mut-negative patients. In multivariate analyses dividing patients by the median values of relative abundances, no bacteria were associated with PFS in <i>BRCA1/2</i>mut-positive patients, whereas high <i>Phascolarctobacterium</i> abundances (≥1.11%) was significantly associated with longer PFS in <i>BRCA1/2</i>mut-negative patients (median 14.0 vs. 5.9 months, hazard ratio=0.28; 95% confidence interval=0.11-0.69; p=0.014). In the last samples, the relative abundances of <i>Phascolarctobacterium</i> were significantly higher in patients without PD (n=5) than those with PD (n=15) (median 1.25% vs. 0.06%; p=0.016).</p><p><strong>Conclusion: </strong>High fecal composition of <i>Phascolarctobacterium</i> was associated with prolonged PFS in patients with <i>BRCA1/2</i>mut-negative ovarian cancer receiving PARPi therapy. Our results would provide new insights for future research.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e38"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501880","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}