Journal of Gynecologic Oncology最新文献

{"title":"LKB1 attenuates the transport activity of GLUT1 by regulating the alternative splicing of PKM1/PKM2 in cervical cancer.","authors":"Mingzhe Wu, Yaoxing Guo, Jinghua Yang, Enhua Wang, Hong-Tao Xu, Guang-Ping Wu, Huanyu Zhao","doi":"10.3802/jgo.2026.37.e117","DOIUrl":"10.3802/jgo.2026.37.e117","url":null,"abstract":"<p><strong>Objective: </strong>Liver kinase B1 (LKB1) is a tumor suppressor that negatively regulates glucose transporter 1 (GLUT1) in Peutz-Jeghers Syndrome, but its mechanism in cervical cancer is unclear.</p><p><strong>Methods: </strong>LKB1 expression was detected in cervical cancer specimens by real-time polymerase chain reaction. The double directional genetic manipulation, Nuclear and Cytoplasmic Protein separation technique and immunofluorescence were performed to detect the regulatory relationships among LKB1, pyruvate kinase isozyme type M2 (PKM2), hypoxia-inducible factor 1α (HIF-1α), and GLUT1 in cervical cancer cells, and Plasma Membrane and Cytoplasmic Protein separation technique and glucose uptake assay were used to verify the transport activity of GLUT1. LKB1-overexpression and -knockdown cervical cancer cell lines were generated in vitro.</p><p><strong>Results: </strong>LKB1 messenger RNA level was lower in cervical cancer tissues than in matched paracancerous tissues. LKB1 was highly expressed in the cytoplasm of C33A, but was absent in its nucleus. And LKB1 was absent in SiHa. LKB1 regulated the alternative splicing of PKM1/PKM2. LKB1 overexpression significantly downregulated the PKM2pS37 expression in the nucleus and cytoplasm, the HIF-1α expression in the nucleus, and the GLUT1 expression in the plasma membrane. PKM2 knockdown reduced the nuclear accumulation of HIF-1α. Moreover, PKM2/HIF-1α knockdown reduced the glucose uptake of GLUT1. LKB1 negatively regulated the interaction between PKM2 and HIF-1α via AMPK signaling so as to inhibit the malignant phenotype of cervical cancer cells.</p><p><strong>Conclusion: </strong>LKB1 attenuates GLUT1 transport activity by inhibiting the PKM2/HIF-1α pathway, supporting the important roles of PKM2 and HIF-1α in the pathogenesis of cervical cancer.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e117"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338843","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":"Homologous recombination deficiency in high-grade serous ovarian carcinoma: clinical pathological characteristics, impact of neoadjuvant chemotherapy, and prognostic implications.","authors":"Yunjie Ge, Yangyang He, Shili Yu, Hongwen Gao, Ping-Li Sun","doi":"10.3802/jgo.2026.37.e73","DOIUrl":"10.3802/jgo.2026.37.e73","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinicopathological and prognostic significance of homologous recombination deficiency (HRD) in high-grade serous ovarian carcinoma (HGSC) and evaluate the impact of neoadjuvant chemotherapy (NACT) on HRD detection.</p><p><strong>Methods: </strong>HRD status was assessed in 126 surgically resected HGSC samples (30 post-NACT, 96 primary surgery) using the AmoyDx^® HRD Complete Panel. HRD positivity was defined as a pathogenic/likely pathogenic BRCA1/2 mutation and/or genomic scar score (GSS) ≥45. Correlations with clinicopathological variables, histological subtypes (classic vs. solid, endometrial-like, and transitional [SET] patterns), and survival were analyzed.</p><p><strong>Results: </strong>HRD positivity was detected in 76 (60.3%) cases, with BRCA1/2 mutations in 26.2%. HRD-positive tumors showed larger size (p=0.034) and more SET patterns (p=0.001). Notably, among BRCA1/2 wild-type patients, the NACT group showed significantly lower HRD positivity (22.2% vs. 56.1%; p=0.003) and decreased median GSS (19.5 vs. 55.2; p<0.001) than the primary surgery group. Multivariate analysis identified HRD positivity (hazard ratio [HR]=0.488; p=0.023) and first-line maintenance therapy (HR=0.435; p=0.008) predicted better progression-free survival (PFS), while lymph node metastasis predicted worse PFS (HR=2.674; p=0.001). R0 resection improved both PFS (HR=0.410; p=0.006) and overall survival (HR=0.074; p=0.013).</p><p><strong>Conclusion: </strong>HRD status is a prognostic biomarker in HGSC. Its correlation with SET patterns supports histology as an initial screening tool. Importantly, NACT is correlated with reduced detectable HRD positivity and lower GSS, underscoring the need for HRD testing before chemotherapy to ensure accurate assessment and guide treatment.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e73"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348251","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":"PARP inhibitor maintenance takes advantages in advanced epithelial ovarian cancer but May show a negative impact while recurrence occurs: a multi-center retrospective study in Taiwan.","authors":"Wei-Ting Chao, Yu-Wen Sung, Kuan-Ju Huang, Lian-Shung Yeh, Bor-Ching Sheu, Wen-Chun Chang, Shang-Hsuan Peng, Po-Han Lin, Peng-Hui Wang","doi":"10.3802/jgo.2026.37.e75","DOIUrl":"10.3802/jgo.2026.37.e75","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess prognosis related to poly (ADP-ribose) polymerase inhibitor (PARPi) maintenance therapy (MT) in newly diagnosed patients with advanced-stage epithelial ovarian cancer (adsOC, primary setting). Additionally, it evaluated the effect on recurrent patients after the front- or second-line PARPi MT (recurrence setting).</p><p><strong>Methods: </strong>This multicenter retrospective study analyzed adsOC patients undergoing standard of care therapy (cytoreductive surgery and chemotherapy), regardless whether PARPi MT was followed or not from December 2011 to May 2023. The prognostic factors affecting survival outcomes (progression-free survival [PFS] and overall survival [OS]) in primary and recurrence settings were analyzed.</p><p><strong>Results: </strong>A total of 218 patients were analyzed, including 25% with <i>BRCA</i>m, 13% with homologous recombination deficiency (<i>HRD</i>), and 62% with homologous recombination proficiency (<i>HRP</i>). The median follow-up was 35.5 months. In primary setting, International Federation of Gynecology and Obstetrics IIIC/IV, Eastern Cooperative Oncology Group (ECOG) >1, neoadjuvant chemotherapy, non-high-grade serous carcinoma (HGSOC) or non-endometrioid, <i>HRP</i> and absence of PARPi MT were associated with worse outcome. In recurrence setting, ECOG >1, platinum-resistance, non-HGSOC or non-endometrioid, non-<i>BRCA</i>m and previous PARPi MT were associated with poor prognosis. Rechallenge of PARPi in recurrent patients did not show statistically different outcome compared to those without PARPi.</p><p><strong>Conclusion: </strong>Besides, the best survival occurring in adsOC patients with <i>BRCA</i>m, <i>HRD</i> patients treated with PARPi MT also experienced significantly prolonged PFS and OS. However, prior frontline PARPi MT was associated with poorer OS if the recurrence occurred. Treatment for recurrence status with PARPi MT did not show survival benefits.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e75"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377711","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 application value of the updated FIGO 2023 classification compared with FIGO 2009 for endometrial cancer staging in a Chinese cohort.","authors":"Xiaoyan Zhao, Lili Sun, Fujing Sun, Yushui Liu, Xin Zhang, Yanmei Zhu","doi":"10.3802/jgo.2026.37.e76","DOIUrl":"10.3802/jgo.2026.37.e76","url":null,"abstract":"<p><strong>Objective: </strong>To compare the predictive performance of the International Federation of Gynecology and Obstetrics (FIGO) 2009 and FIGO 2023 staging systems for endometrial cancer (EC) and to assess whether FIGO 2023 system better predicts patient prognosis.</p><p><strong>Methods: </strong>A retrospective analysis of 640 EC patients was conducted, with staging according to the 2009 and 2023 FIGO systems. Kaplan-Meier survival analysis, hazard ratios (HRs), Harrell's concordance index (C-index), and Akaike's Information Criterion (AIC) were used to assess model performance.</p><p><strong>Results: </strong>A change to a higher substage occurred in 148 patients (23.1%), whereas 12 patients (1.9%) were down-staged, based on the FIGO 2009 staging system. Among early-stage patients, 9 and 62 were reclassified from early-stage (I and II) to IAm_POLEmut and IICm_p53abn, respectively, according to the molecular subtypes POLEmut and p53abn, and showed distinctly different prognoses (5-year overall survival [OS]: 100% vs. 75.3%). The 5-year OS and disease-free survival (DFS) rates were better for stage IA3 than for stage IIIA1 (OS: 91.7% vs. 71.6%, DFS: 91.7% vs. 71.3%). Among patients with advanced EC, those with the p53abn molecular subtype had the worst prognoses (5-year OS: 41.6%). Compared to FIGO 2009, FIGO 2023 showed significantly higher HRs for OS and DFS (p<0.001), higher C-index values (0.751 vs. 0.711, 0.750 vs. 0.709), and lower AIC values (1,316.919 vs. 1,338.928, 1,315.444 vs. 1,337.864).</p><p><strong>Conclusion: </strong>The FIGO 2023 system provided a better model fit and higher predictive accuracy than the FIGO 2009 system. Molecular subtyping was crucial for prognoses of patients with advanced EC (stage III/IV).</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e76"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348221","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 and prognostic insights into Trousseau's syndrome in gynecologic malignancies: a multicenter study.","authors":"Hemian Zhang, Masayuki Futagami, Rie Miura, Tatsuhiko Shigeto, Makito Mizunuma, Maika Oishi, Yuki Osawa, Yukiko Matsumura, Tsukasa Baba, Tadahiro Shoji, Masahiro Kagabu, Yukiyo Kumazawa, Kenichi Makino, Tsuyoshi Ohta, Satoru Nagase, Muneaki Shimada, Shogo Shigeta, Hideki Tokunaga, Shu Soeda, Shigenori Furukawa, Yoshihito Yokoyama","doi":"10.3802/jgo.2026.37.e63","DOIUrl":"10.3802/jgo.2026.37.e63","url":null,"abstract":"<p><strong>Objective: </strong>Trousseau's syndrome lacks standardized diagnostic criteria, and its rarity has hindered large-scale investigations. This study aims to elucidate the diagnostic landscape of Trousseau's syndrome in gynecological malignancies within a multicenter framework and to identify prognostic determinants.</p><p><strong>Methods: </strong>A retrospective multicenter study was conducted, encompassing patients diagnosed with Trousseau's syndrome secondary to gynecologic malignancies across 6 Japanese institutions affiliated with the Tohoku Gynecologic Cancer Unit from 2003 to 2018. Institutional diagnostic criteria were consolidated, and clinical characteristics, treatment approaches, and prognostic factors were systematically analyzed.</p><p><strong>Results: </strong>A total of 88 patients were included, the majority presenting with multiple infarctions involving cerebral infarction and hypercoagulability. However, some cases were diagnosed based on isolated cerebral infarction, highlighting variability in diagnostic criteria. Prognostic factors significantly associated with survival included D-dimer levels (p=0.030), treatment of the primary malignancy after infarction (p<0.001), International Federation of Gynecology and Obstetrics stage (p<0.001), performance status (p=0.006), and the timing of Trousseau's syndrome onset (p<0.001) in univariate analysis. Multivariate analysis revealed that treatment of the primary malignancy after infarction was a key determinant of improved prognosis.</p><p><strong>Conclusion: </strong>This study underscores the heterogeneity in diagnostic criteria for Trousseau's syndrome and suggests that hypercoagulability serves not only as a diagnostic adjunct but also as a prognostic indicator. Moreover, intervention targeting the primary malignancy after infarction significantly enhances survival outcomes, emphasizing the necessity of an integrated therapeutic strategy.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e63"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146180576","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":"External validation of the SUCCOR Risk score for predicting recurrence in early-stage cervical cancer patients treated with radical hysterectomy.","authors":"Chayanid Detwongya, Charuwan Tantipalakorn, Kittipat Charoenkwan","doi":"10.3802/jgo.2026.37.e66","DOIUrl":"10.3802/jgo.2026.37.e66","url":null,"abstract":"<p><strong>Objective: </strong>To externally validate the Surgery in Cervical Cancer, Observational, Retrospective (SUCCOR) Risk score for predicting recurrence in early-stage cervical cancer treated with radical hysterectomy in a Thai population.</p><p><strong>Methods: </strong>A retrospective cohort of patients with the International Federation of Gynaecology and Obstetrics (FIGO) 2009 stage IB1 cervical cancer who underwent radical hysterectomy at our institution between 2003 and 2019 was analyzed. The SUCCOR Risk score was calculated using original model specifications. Progression-free survival (PFS) and overall survival were estimated by Kaplan-Meier analysis and compared across risk groups. Model performance was evaluated in terms of discrimination, calibration, and overall accuracy.</p><p><strong>Results: </strong>Of 1,309 eligible cases, 954 met the inclusion criteria. After a median follow-up of 79 months, 83 relapses (8.7%) and 66 deaths (6.9%) were observed. Five-year PFS was 95.3% in the low-risk, 88.0% in the medium-risk, and 88.0% in the high-risk groups (log-rank p=0.002). Medium-risk patients had a significantly higher relapse risk than low-risk patients (HR=2.62; 95% CI=1.51-4.53). The SUCCOR Risk score demonstrated moderate discrimination for 5-year relapse (area under the receiver operating characteristic curve=0.65; Harrell's c-statistic=0.68). Calibration analyses showed good average agreement but an attenuated calibration slope of 0.72, reflecting overdispersion of risk predictions. Overall model performance was useful, with a 5-year Brier score of 0.068 and an integrated Brier score (IBS) of 0.080, outperforming the null model (IBS=0.084).</p><p><strong>Conclusion: </strong>The SUCCOR Risk score maintained moderate discriminative ability and acceptable calibration in this Thai cohort, with modest improvement over baseline prediction. These findings support its generalizability across diverse clinical settings, though recalibration may enhance accuracy for local application.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e66"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146180565","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":"Enhanced ovarian cancer diagnosis using deep learning on pelvic ultrasound with integrated clinical data: retrospective multicenter study.","authors":"Sohyeon Jeong, Hyewon Cho, Jooyeon Kim, Sanghoon Lee, Jae Yun Song, Jin Hwa Hong, Jae Kwan Lee, Seon Kyung Kim, Hyun-Woong Cho","doi":"10.3802/jgo.2026.37.e84","DOIUrl":"10.3802/jgo.2026.37.e84","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop a deep learning (DL) model to enhance the differential diagnosis of benign and malignant ovarian tumors by integrating pelvic ultrasound images with clinical data, such as age and cancer antigen (CA)-125 levels.</p><p><strong>Methods: </strong>We analyzed pelvic ultrasound images, age, and CA-125 levels from 804 patients diagnosed with ovarian tumors (446 benign, 358 malignant) from 2015 to 2022. Images were segmented into cystic and solid components for feature extraction. Patients were divided into training (n=565), validation (n=76), and test datasets (n=163). ResNet50 and DenseNet121 models were trained on these data, with clinical information added to classifier architecture for improved prediction accuracy.</p><p><strong>Results: </strong>Using ultrasound images alone, ResNet50 and DenseNet121 achieved areas under the receiver operating characteristic curve (AUCs) of 0.84 and 0.82, respectively. When clinical data and segmented solid images were included, AUCs improved to 0.95 for ResNet50 and 0.96 for DenseNet121. For the test set, ResNet50 and DenseNet121 achieved sensitivities of 90% and 81%, specificities of 93% and 97%, positive predictive values of 92% and 95%, and negative predictive values of 92% and 86%.</p><p><strong>Conclusion: </strong>Binary classification model based on DL algorithms using ultrasound images can distinguish between benign and malignant ovarian tumors accurately. Segmentation of solid portion and clinical information of age and CA-125 at diagnosis combined with the pelvic ultrasound images increased the accuracy of the classification model.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e84"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574210","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":"Trends and future projections of endometrial cancer burden attributable to high BMI in China: an age-period-cohort analysis based on 1990-2021 data.","authors":"Bilan Xu, Jing Jiang, Ping Gu","doi":"10.3802/jgo.2026.37.e64","DOIUrl":"10.3802/jgo.2026.37.e64","url":null,"abstract":"<p><strong>Objective: </strong>Research on endometrial cancer burden associated with high body mass index (BMI) in China remains limited. This study analyzes the characteristics of high BMI-related endometrial cancer burden in China from 1990 to 2035.</p><p><strong>Methods: </strong>Joinpoint regression was used to analyze trends in age-standardized mortality rates and disability-adjusted life years (DALYs). An annual percentage change (APC) model was utilized to analyze the effects of these 3 factors on disease burden. The disease burden trends from 2022 to 2035 were predicted using the Bayesian APC model and the Nordpred model.</p><p><strong>Results: </strong>From 1990 to 2021, the number of endometrial cancer deaths attributable to high BMI in China increased by 196.78%, while DALYs rose by 179.31%. Age-standardized mortality and DALY rates increased by 19.46% and 20.86%, respectively, with average APCs of 0.56 (95% confidence interval [CI]=0.42 to 0.70) and 0.64 (95% CI=0.45 to 0.83). APC analysis revealed an initial increase followed by a decrease in mortality risk and DALYs with advancing age, an N-shaped temporal trend, and reduced burden among later birth cohorts. The Bayesian APC model projected that by 2035, the number of deaths and DALYs would increase by 158.10% and 126.89%, respectively, compared to 2021. A sensitivity analysis using the Nordpred model confirmed this upward trend.</p><p><strong>Conclusion: </strong>China faces a growing disease burden from endometrial cancer attributable to high BMI, with projections indicating a continued increase. These findings underscore the critical need for public health interventions focused on BMI management to prevent endometrial cancer, particularly among high-risk populations.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e64"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348387","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":"Comparing paclitaxel and platinum-based concurrent chemoradiotherapy with short-term adjuvant chemotherapy versus platinum-based monotherapy concurrent chemoradiotherapy in patients with postoperative gastric-type endocervical adenocarcinoma with high-risk factors for recurrence: a multicenter randomized phase III trial.","authors":"Weiling Qu, He Wang, Neng Jin, Qiu Tang","doi":"10.3802/jgo.2026.37.e79","DOIUrl":"10.3802/jgo.2026.37.e79","url":null,"abstract":"<p><strong>Background: </strong>Gastric-type endocervical adenocarcinoma (G-EAC) is a distinctive form of adenocarcinoma that is not associated with human papillomavirus. This neoplasm exhibits a low incidence, low screening and biopsy positivity, low preoperative diagnosis, and a high susceptibility to underdiagnosis and misdiagnosis. It is associated with a poor prognosis for patients. Currently, there is an absence of a standardized postoperative adjuvant treatment plan for G-EAC, which constitutes an urgent clinical problem that demands resolution. However, there is still no prospective analysis on the adjuvant treatment of cervicogastric adenocarcinoma. This study is the first randomized phase III trial, which aims to recommend better adjuvant treatment options for G-EAC patients at high risk of recurrence in China, in order to better optimize and personalize patient care and improve progression-free survival (PFS) and overall survival (OS).</p><p><strong>Methods: </strong>This trial is a prospective, multicenter study led by the Department of Radiotherapy, Women's Hospital of Zhejiang University. Recruitment will begin in March 2025, and it is expected that 238 patients with postoperative G-EAC with high risk of recurrence will be recruited from 16 clinical centers in China. Patients will be randomly assigned to the experimental group or the control group in a 1:1 ratio. The experimental group will receive paclitaxel combined with platinum-based concurrent chemoradiotherapy (CCRT) and short-term adjuvant chemotherapy, and the control group will receive the current standard treatment regimen, i.e., platinum-based CCRT, without adjuvant chemotherapy. The primary endpoint of the study is the 2-year PFS rate, and the secondary endpoints are disease treatment failure pattern, OS rate, acute/chronic toxicity incidence, and quality of life assessment.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT06870565.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e79"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463505","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":"Combined ER/PR co-positivity enhances prognostic stratification within molecular subtypes of endometrial cancer.","authors":"Ruxue Han, Yang Chen, Shuiqing Xu, Tingting Zhang, Xingran Jiang, Hua Li","doi":"10.3802/jgo.2026.37.e61","DOIUrl":"10.3802/jgo.2026.37.e61","url":null,"abstract":"<p><strong>Objective: </strong>To explore the prognostic value of combined estrogen receptor (ER)/progesterone receptor (PR) expression patterns within molecular subtypes of endometrial cancer (EC), particularly in the prognostically heterogeneous no specific molecular profile (NSMP) subtype.</p><p><strong>Methods: </strong>A retrospective cohort study of 388 EC patients underwent next-generation sequencing-based molecular classification and ER/PR immunohistochemistry. ER/PR status was categorized as co-positive (coP), co-negative, or discordant. Multivariable Cox models and concordance index (C-index) analyses assessed disease-specific survival (DSS) and progression-free survival (PFS).</p><p><strong>Results: </strong>ER/PR co-positivity independently predicted improved DSS overall (hazard ratio [HR]=0.143; 95% confidence interval [CI]=0.065, 0.314; p<0.001) after adjusting for stage and molecular subtype. In NSMP (n=254), coP predicted superior DSS (HR=0.21; 95% CI=0.06, 0.87; p=0.034), while ER positivity predicted better PFS (HR=0.13; 95% CI=0.02, 0.88; p=0.037). Adding coP to staging improved NSMP-DSS prediction (ΔC-index=+0.082; p<0.05). No significant associations were found in non-NSMP subgroups.</p><p><strong>Conclusion: </strong>ER/PR co-positivity is a powerful independent predictor of favorable DSS in EC, particularly refining risk stratification for the NSMP subtype when integrated with molecular classification.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e61"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146180562","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}