Pub Date : 2026-02-01DOI: 10.1016/j.ygyno.2026.01.218
Daniel Moncada, Heidi David, Nikita Khan, Karen Asher, Danny Yakoub, Bunja Rungruang
{"title":"Disaggregated analysis of endometrial cancer outcomes among Hispanic subgroups in the United States","authors":"Daniel Moncada, Heidi David, Nikita Khan, Karen Asher, Danny Yakoub, Bunja Rungruang","doi":"10.1016/j.ygyno.2026.01.218","DOIUrl":"10.1016/j.ygyno.2026.01.218","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"205 ","pages":"Page S23"},"PeriodicalIF":4.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193018","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}
Pub Date : 2026-01-30DOI: 10.1016/j.ygyno.2026.01.235
Mark E. Sherman , Laura Pacheco-Spann , Susan Friedman , Diane Rose , William D. Foulkes , Christopher C. DeStephano , Kristina A. Butler , Kathryn J. Ruddy , Zhihui Fang , Lauren E. Haydu
Objective
To survey knowledge, preferred information sources, and risk tolerance for EC among BRCA1 and BRCA2 pathogenic variant (PV) carriers.
Methods
Electronic survey of 332 anonymous women. Descriptive statistics presented.
Results
Participants included non-Hispanic White (89.3%) United States residents (91.7%), with mean age of 45 years; 50.6% were BRCA 1 and 45.7% were BRCA 2 carriers; 56.7% had undergone risk-reducing surgery, including hysterectomy in 44.3%. Most cited reasons for hysterectomy were physician recommendation and EC risk. Among women with intact uteri, 42.2% or participants indicated that they would undergo hysterectomy if EC risk was ≥15%. When queried about specific EC risk factors, responses of “don't know” (if risk is increased or decreased) were given for 30.9%–75.5%, and specifically for BRCA1: 55.2% and for BRCA2: 72.6%. Participants expressed preferences for sources of information about EC risk (decreasing order) as gynecologic oncologists; medical oncologists; genetic counselors and gynecologists. Respondents indicated that providers recommended hysterectomy for 36.0%, against hysterectomy for 15.7% or gave conflicting information for 16.6%.
Conclusions
Many carriers have limited knowledge of EC risk and do not receive consistent counseling about hysterectomy.
{"title":"BRCA1 and BRCA2 carriers: Perceptions of endometrial cancer risk","authors":"Mark E. Sherman , Laura Pacheco-Spann , Susan Friedman , Diane Rose , William D. Foulkes , Christopher C. DeStephano , Kristina A. Butler , Kathryn J. Ruddy , Zhihui Fang , Lauren E. Haydu","doi":"10.1016/j.ygyno.2026.01.235","DOIUrl":"10.1016/j.ygyno.2026.01.235","url":null,"abstract":"<div><h3>Objective</h3><div>To survey knowledge, preferred information sources, and risk tolerance for EC among <em>BRCA1</em> and <em>BRCA2</em> pathogenic variant (PV) carriers.</div></div><div><h3>Methods</h3><div>Electronic survey of 332 anonymous women. Descriptive statistics presented.</div></div><div><h3>Results</h3><div>Participants included non-Hispanic White (89.3%) United States residents (91.7%), with mean age of 45 years; 50.6% were <em>BRCA 1</em> and 45.7% were <em>BRCA 2</em> carriers; 56.7% had undergone risk-reducing surgery, including hysterectomy in 44.3%. Most cited reasons for hysterectomy were physician recommendation and EC risk. Among women with intact uteri, 42.2% or participants indicated that they would undergo hysterectomy if EC risk was ≥15%. When queried about specific EC risk factors, responses of “don't know” (if risk is increased or decreased) were given for 30.9%–75.5%, and specifically for <em>BRCA1</em>: 55.2% and for <em>BRCA2</em>: 72.6%. Participants expressed preferences for sources of information about EC risk (decreasing order) as gynecologic oncologists; medical oncologists; genetic counselors and gynecologists. Respondents indicated that providers recommended hysterectomy for 36.0%, against hysterectomy for 15.7% or gave conflicting information for 16.6%.</div></div><div><h3>Conclusions</h3><div>Many carriers have limited knowledge of EC risk and do not receive consistent counseling about hysterectomy.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 23-31"},"PeriodicalIF":4.1,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076706","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}
Pub Date : 2026-01-30DOI: 10.1016/j.ygyno.2026.01.011
Simona Maria Fragomeni , Angela Collarino , Alex Federico , Giusi Pisano , Sara Ammar , Luca Zagaria , Pia Clara Pafundi , Giacomo Corrado , Stefano Gentileschi , Anna Caretto , Vittoria Rufini , Anna Fagotti , Giorgia Garganese
Introduction
Sentinel node biopsy (SNB) is the standard approach for nodal staging in clinically node-negative (cN0) patients with unifocal vulvar cancer ≤4 cm. Patients outside these criteria undergo lymphadenectomy, although many prove node-negative. The prospective GroSNaPET study evaluated SNB followed by lymphadenectomy in these patients. This report presents updated outcomes, long-term follow-up, and complication data.
Materials and methods
This single-center prospective study included cN0 patients ineligible for standard SNB due to ≥1 of the following: tumor >4 cm, multifocality, prior excision or (chemo)radiotherapy, unilateral nodal involvement, or relapse. All patients underwent SNB followed by complete lymphadenectomy. Histopathology was the reference standard. Complications were graded by Clavien–Dindo system. Diagnostic accuracy and survival outcomes were assessed with standard methods.
Results
Seventy-two patients (114 groins) were enrolled. The preoperative lymphoscintigraphic SNB identification rate was 94.7%. Among 265 sentinel nodes removed, 19 (7.2%) showed metastases, involving 16/108 groins (14.8%). Overall, 17/108 groins resulted metastatic. The proportion of false negatives over the entire study population was 0.9% (1/108), with a false negative rate of 5.9% (1/17). The negative predictive value was 98.9% and the diagnostic accuracy was 99.1%. Postoperative complications occurred in 70.8% cases, mainly lymphedema (19.7%) and lymphoceles (12%); 17% were Clavien–Dindo grade ≥ III. Median follow-up was 54.5 months; 22 recurrences (30.6%, including 3 inguinal) and 15 deaths (20.8%) were recorded. 5-year Disease Free Survival and Overall Survival were 65.6% and 82.7%.
Conclusions
SNB is accurate and safe beyond standard criteria. This study provides a robust comparison for GroSNaPET 2, which omits lymphadenectomy when SN is negative.
{"title":"Extending eligibility criteria for sentinel lymph node biopsy in vulvar cancer: An update on the GroSNaPET study","authors":"Simona Maria Fragomeni , Angela Collarino , Alex Federico , Giusi Pisano , Sara Ammar , Luca Zagaria , Pia Clara Pafundi , Giacomo Corrado , Stefano Gentileschi , Anna Caretto , Vittoria Rufini , Anna Fagotti , Giorgia Garganese","doi":"10.1016/j.ygyno.2026.01.011","DOIUrl":"10.1016/j.ygyno.2026.01.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Sentinel node biopsy (SNB) is the standard approach for nodal staging in clinically node-negative (cN0) patients with unifocal vulvar cancer ≤4 cm. Patients outside these criteria undergo lymphadenectomy, although many prove node-negative. The prospective GroSNaPET study evaluated SNB followed by lymphadenectomy in these patients. This report presents updated outcomes, long-term follow-up, and complication data.</div></div><div><h3>Materials and methods</h3><div>This single-center prospective study included cN0 patients ineligible for standard SNB due to ≥1 of the following: tumor >4 cm, multifocality, prior excision or (chemo)radiotherapy, unilateral nodal involvement, or relapse. All patients underwent SNB followed by complete lymphadenectomy. Histopathology was the reference standard. Complications were graded by Clavien–Dindo system. Diagnostic accuracy and survival outcomes were assessed with standard methods.</div></div><div><h3>Results</h3><div>Seventy-two patients (114 groins) were enrolled. The preoperative lymphoscintigraphic SNB identification rate was 94.7%. Among 265 sentinel nodes removed, 19 (7.2%) showed metastases, involving 16/108 groins (14.8%). Overall, 17/108 groins resulted metastatic. The proportion of false negatives over the entire study population was 0.9% (1/108), with a false negative rate of 5.9% (1/17). The negative predictive value was 98.9% and the diagnostic accuracy was 99.1%. Postoperative complications occurred in 70.8% cases, mainly lymphedema (19.7%) and lymphoceles (12%); 17% were Clavien–Dindo grade ≥ III. Median follow-up was 54.5 months; 22 recurrences (30.6%, including 3 inguinal) and 15 deaths (20.8%) were recorded. 5-year Disease Free Survival and Overall Survival were 65.6% and 82.7%.</div></div><div><h3>Conclusions</h3><div>SNB is accurate and safe beyond standard criteria. This study provides a robust comparison for GroSNaPET 2, which omits lymphadenectomy when SN is negative.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 15-22"},"PeriodicalIF":4.1,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076707","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}
Objective: Granulosa cell tumors account for 3–5% of ovarian cancers with a risk of recurrence of 10–25% in those with stage I disease. Our objective was to evaluate clinical factors associated with disease recurrence, with special attention to the role of initial surgical approach (minimally invasive vs. open abdominal) in recurrence risk.
Methods: All patients treated for GCT at University of Washington between 1980 and 2020 were included in the study. Retrospective review of demographic, medical/family/history, treatment and recurrence was performed. Descriptive statistical analysis of clinical and pathologic features, Kaplan-Meier curves, and Cox proportional hazards regression were performed.
Results: 174 patients were evaluated and 62 were eliminated due to incomplete data. 112 patients were included in the analysis sample with a median follow up time of 126 months (range 12–482 months) and median age of 46 years (IQR 37–55). Stage at diagnosis was primarily IA or IC. Surgical approach was open in 59% (N = 66), laparoscopic in 34% (N = 38), and robotic in 5% (N = 5) of patients. Tumor rupture was more common among the minimally invasive surgical approaches, compared to an open approach. Stage, need for adjuvant chemotherapy, and tumor rupture were associated with an increased risk of recurrence during the follow up period. Among patients with tumor rupture, 55% of patients had a recurrence event during the follow up period.
Conclusion: Tumor rupture at the time of surgery is a significant risk factor for recurrence. There is a higher risk of tumor rupture with minimally invasive surgery. Care should be taken to avoid iatrogenic tumor rupture.
{"title":"Granulosa cell tumors: Initial surgical approach and recurrence","authors":"Erin Dwyer , L’Oreal Kennedy , Danika Bethune , Ronit Katz , Barbara Goff","doi":"10.1016/j.ygyno.2025.12.012","DOIUrl":"10.1016/j.ygyno.2025.12.012","url":null,"abstract":"<div><div>Objective: Granulosa cell tumors account for 3–5% of ovarian cancers with a risk of recurrence of 10–25% in those with stage I disease. Our objective was to evaluate clinical factors associated with disease recurrence, with special attention to the role of initial surgical approach (minimally invasive vs. open abdominal) in recurrence risk.</div><div>Methods: All patients treated for GCT at University of Washington between 1980 and 2020 were included in the study. Retrospective review of demographic, medical/family/history, treatment and recurrence was performed. Descriptive statistical analysis of clinical and pathologic features, Kaplan-Meier curves, and Cox proportional hazards regression were performed.</div><div>Results: 174 patients were evaluated and 62 were eliminated due to incomplete data. 112 patients were included in the analysis sample with a median follow up time of 126 months (range 12–482 months) and median age of 46 years (IQR 37–55). Stage at diagnosis was primarily IA or IC. Surgical approach was open in 59% (<em>N</em> = 66), laparoscopic in 34% (<em>N</em> = 38), and robotic in 5% (<em>N</em> = 5) of patients. Tumor rupture was more common among the minimally invasive surgical approaches, compared to an open approach. Stage, need for adjuvant chemotherapy, and tumor rupture were associated with an increased risk of recurrence during the follow up period. Among patients with tumor rupture, 55% of patients had a recurrence event during the follow up period.</div><div>Conclusion: Tumor rupture at the time of surgery is a significant risk factor for recurrence. There is a higher risk of tumor rupture with minimally invasive surgery. Care should be taken to avoid iatrogenic tumor rupture.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 9-14"},"PeriodicalIF":4.1,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076708","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}
Pub Date : 2026-01-26DOI: 10.1016/j.ygyno.2026.01.006
Benjamin J. Matthews , Electra D. Paskett , Eric McLaughlin , Diane Von Ah , Rowan Chlebowski , Chloe M. Hery , Michael Pennell , Tracy Vannorsdall , Longjian Liu , Aladdin H. Shadyab , Kathy Pan , Stephanie L. Wethington
Objective
To assess whether gynecologic cancer history predicts worsened self-reported memory outcomes, accounting for the interaction of age and comorbidities.
Methods
Nested case-control study of cancer survivors enrolled in the ancillary Life and Longevity After Cancer (LILAC) study of the Women's Health Initiative (WHI) and matched cancer-free WHI participants, longitudinally followed after initial enrollment from 1993 to 1998. Postmenopausal women with incident endometrial or ovarian cancer during the WHI were compared to cancer-free women matched up to 5:1 to survivors. Participants with pre-existing cognitive dysfunction, neurodegenerative disease, or multiple cancers were excluded. The primary outcome was self-reported “moderate/severe memory problems” ≥12 months following cancer diagnosis of the index survivor. Associations of pre-diagnosis conditions with later memory problems were examined through cause-specific hazards models, accounting for competing mortality risk.
Results
Primary analyses included 1395 survivors and 5364 cancer-free controls. In multivariable analysis, cancer history was associated with decreased self-reported memory problems (cause-specific hazard ratio [csHR] 0.71 [0.57–0.87], p = 0.001). The only factors independently predictive of future memory concerns were increasing age (5-year increase; csHR 1.96 [1.84–2.09], p < 0.001), cardiovascular disease (hypertension csHR 1.24 [1.03–1.50]; major cardiovascular events csHR 1.85 [1.28–2.68], p = 0.002), diabetes (csHR 1.47 [1.10–1.96], p = 0.01), and depression (csHR 1.47 [1.11–1.95], p = 0.008).
Conclusions
After accounting for mortality differences, gynecologic cancer survivors experienced reduced hazard for self-reported moderate/severe memory problems. In this population, significant memory symptoms may represent aging and comorbidity effects more than cancer-related outcomes.
目的考虑年龄和合并症的相互作用，评估妇科癌症病史是否能预测自我报告记忆结果的恶化。方法对参加妇女健康倡议（WHI）的辅助癌症后生活和长寿（LILAC）研究的癌症幸存者和匹配的无癌症WHI参与者进行了回顾性病例对照研究，从1993年至1998年首次入组后进行了纵向随访。在WHI期间发生子宫内膜癌或卵巢癌的绝经后妇女与无癌症妇女的比例为5:1。排除已有认知功能障碍、神经退行性疾病或多种癌症的参与者。主要结局是在癌症诊断后≥12个月的指数幸存者自我报告的“中度/重度记忆问题”。通过病因特异性风险模型检查了诊断前条件与后来记忆问题的关联，并考虑了相互竞争的死亡风险。结果初步分析纳入1395名幸存者和5364名无癌对照。在多变量分析中，癌症病史与自我报告的记忆问题减少相关（病因特异性风险比[csHR] 0.71 [0.57-0.87], p = 0.001）。唯一独立预测未来记忆问题的因素是年龄增加（5年增加；csHR 1.96 [1.84-2.09], p < 0.001）、心血管疾病（高血压csHR 1.24[1.03-1.50]；主要心血管事件csHR 1.85 [1.28-2.68], p = 0.002）、糖尿病（csHR 1.47 [1.10-1.96], p = 0.01）和抑郁症（csHR 1.47 [1.11-1.95], p = 0.008）。在考虑死亡率差异后，妇科癌症幸存者自我报告的中度/重度记忆问题的风险降低。在这一人群中，显著的记忆症状可能代表着衰老和共病的影响，而不是癌症相关的结果。
{"title":"Risk of memory impairment in gynecologic cancer survivors in the Women's Health Initiative: Untangling effects of age, comorbidities, and cancer","authors":"Benjamin J. Matthews , Electra D. Paskett , Eric McLaughlin , Diane Von Ah , Rowan Chlebowski , Chloe M. Hery , Michael Pennell , Tracy Vannorsdall , Longjian Liu , Aladdin H. Shadyab , Kathy Pan , Stephanie L. Wethington","doi":"10.1016/j.ygyno.2026.01.006","DOIUrl":"10.1016/j.ygyno.2026.01.006","url":null,"abstract":"<div><h3>Objective</h3><div>To assess whether gynecologic cancer history predicts worsened self-reported memory outcomes, accounting for the interaction of age and comorbidities.</div></div><div><h3>Methods</h3><div>Nested case-control study of cancer survivors enrolled in the ancillary Life and Longevity After Cancer (LILAC) study of the Women's Health Initiative (WHI) and matched cancer-free WHI participants, longitudinally followed after initial enrollment from 1993 to 1998. Postmenopausal women with incident endometrial or ovarian cancer during the WHI were compared to cancer-free women matched up to 5:1 to survivors. Participants with pre-existing cognitive dysfunction, neurodegenerative disease, or multiple cancers were excluded. The primary outcome was self-reported “moderate/severe memory problems” ≥12 months following cancer diagnosis of the index survivor. Associations of pre-diagnosis conditions with later memory problems were examined through cause-specific hazards models, accounting for competing mortality risk.</div></div><div><h3>Results</h3><div>Primary analyses included 1395 survivors and 5364 cancer-free controls. In multivariable analysis, cancer history was associated with decreased self-reported memory problems (cause-specific hazard ratio [csHR] 0.71 [0.57–0.87], <em>p</em> = 0.001). The only factors independently predictive of future memory concerns were increasing age (5-year increase; csHR 1.96 [1.84–2.09], <em>p</em> < 0.001), cardiovascular disease (hypertension csHR 1.24 [1.03–1.50]; major cardiovascular events csHR 1.85 [1.28–2.68], <em>p</em> = 0.002), diabetes (csHR 1.47 [1.10–1.96], <em>p</em> = 0.01), and depression (csHR 1.47 [1.11–1.95], <em>p</em> = 0.008).</div></div><div><h3>Conclusions</h3><div>After accounting for mortality differences, gynecologic cancer survivors experienced reduced hazard for self-reported moderate/severe memory problems. In this population, significant memory symptoms may represent aging and comorbidity effects more than cancer-related outcomes.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"206 ","pages":"Pages 1-8"},"PeriodicalIF":4.1,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146045261","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}
Pub Date : 2026-01-22DOI: 10.1016/j.ygyno.2026.01.234
Allison L. Brodsky , Elio Tahan , Joseph Celestino , Ximing Tang , Maria G. Raso , Sherita Meyer-Gauen , Alexandra Bercow , Barrett Lawson , R. Tyler Hillman
Objective
The purpose of this study is to determine antibody-drug conjugate (ADC) target antigen expression in ovarian sex cord stromal tumors (SCSTs).
Methods
This was a retrospective, single-institution study examining SCSTs for immunohistochemical (IHC) expression of antigens targeted by five FDA-approved ADCs (TROP-2, HER2, folate receptor alpha, nectin-4, and tissue factor) plus expression of delta-like ligand 3 (DLL3), the target of tarlatamab-dlle, a bispecific T-cell engager. Demographic and clinical information were abstracted from medical records. Differences in H-scores were evaluated using the Wilcoxon rank-sum tests and correlation between variables was assessed using Spearman's rank correlation coefficient.
Results
Thirty-two SCST samples from thirty individual patients were included. The most common diagnosis was adult type granulosa cell tumor. Minimal to no staining was observed for the antigens TROP-2, HER2, folate receptor alpha, nectin-4, and DLL3. Frequent staining for tissue factor was observed in adult GCTs with a median H-score of 49.6 (interquartile range: 1.3–122.8) and 72% had ≥1% expression of tissue factor. A modest positive correlation between H-score and estrogen receptor positivity was noted (Spearman's rho = 0.49, p = 0.06). The tissue factor H-score for the single juvenile GCT was 43.2 and for the two Sertoli Leydig tumors, H-scores were 1 and 10.2.
Conclusion
The pervasive absence of HER2, folate receptor alpha, DLL3, TROP-2, and nectin-4 expression in SCSTs suggests ADCs targeting these antigens may be of limited clinical benefit. The design of clinical trials investigating the use of tissue factor-targeting ADCs for the treatment of adult GCTs warrants future consideration.
{"title":"Expression of antibody drug conjugate target antigens in ovarian sex cord stromal Tumors","authors":"Allison L. Brodsky , Elio Tahan , Joseph Celestino , Ximing Tang , Maria G. Raso , Sherita Meyer-Gauen , Alexandra Bercow , Barrett Lawson , R. Tyler Hillman","doi":"10.1016/j.ygyno.2026.01.234","DOIUrl":"10.1016/j.ygyno.2026.01.234","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study is to determine antibody-drug conjugate (ADC) target antigen expression in ovarian sex cord stromal tumors (SCSTs).</div></div><div><h3>Methods</h3><div>This was a retrospective, single-institution study examining SCSTs for immunohistochemical (IHC) expression of antigens targeted by five FDA-approved ADCs (TROP-2, HER2, folate receptor alpha, nectin-4, and tissue factor) plus expression of delta-like ligand 3 (DLL3), the target of tarlatamab-dlle, a bispecific T-cell engager. Demographic and clinical information were abstracted from medical records. Differences in H-scores were evaluated using the Wilcoxon rank-sum tests and correlation between variables was assessed using Spearman's rank correlation coefficient.</div></div><div><h3>Results</h3><div>Thirty-two SCST samples from thirty individual patients were included. The most common diagnosis was adult type granulosa cell tumor. Minimal to no staining was observed for the antigens TROP-2, HER2, folate receptor alpha, nectin-4, and DLL3. Frequent staining for tissue factor was observed in adult GCTs with a median H-score of 49.6 (interquartile range: 1.3–122.8) and 72% had ≥1% expression of tissue factor. A modest positive correlation between H-score and estrogen receptor positivity was noted (Spearman's rho = 0.49, <em>p</em> = 0.06). The tissue factor H-score for the single juvenile GCT was 43.2 and for the two Sertoli Leydig tumors, H-scores were 1 and 10.2.</div></div><div><h3>Conclusion</h3><div>The pervasive absence of HER2, folate receptor alpha, DLL3, TROP-2, and nectin-4 expression in SCSTs suggests ADCs targeting these antigens may be of limited clinical benefit. The design of clinical trials investigating the use of tissue factor-targeting ADCs for the treatment of adult GCTs warrants future consideration.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"205 ","pages":"Pages 99-104"},"PeriodicalIF":4.1,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034379","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}
Pub Date : 2026-01-22DOI: 10.1016/j.ygyno.2026.01.012
Deepti Jain , Marya Wahidi , Judy Effendi , Lien Hoang , Cristina Terinte , Anna Pesci , Takako Kiyokawa , Isabel Alvarado-Cabrero , Esther Oliva , Natalia Rakislova , Ana Felix , Douglas Allison , Esther Guerra , Andres Roma , Oluwole Fadare , Gulisa Turashvili , Carlos Parra-Herran , Gozde Kir , Ahmet Erbagci , Anne Mills , Rouba Ali-Fehmi
Background
Our study examines impact of HPV status and patient-specific characteristics on recurrence-free survival (RFS) and overall survival (OS) for SCC and ECA.
Methods
This multi-continental retrospective study analyzed clinicopathologic data of 634 patients with microscopically confirmed cervical cancer (CC; only SCC and ECA) across Asia, Europe, and North America. HPV status was determined using PCR or HPV in situ hybridization (ISH) for both HR-HPV (SCC and ECA) and LR-HPV (SCC), using same platform. Descriptive analysis and Cox regression models were produced.
Results
Out of total 634 patients, 533 (84.1%) were HPVA and 101 (15.9%) were HPVI. 65% had SCC morphology (88.1%: HPVA; 11.9%: HPVI) and 35% had ECA differentiation (76.6%: HPVA; 23.4%: HPVI). Compared to ECA, patients with SCC were older (median age: 51 vs. 45 years old; p < 0.001), had higher HPVA status (88.1% vs. 76.6%; p < 0.001), and a higher rate of lymph-vascular invasion (LVI; 64.8% vs. 56.8%; p = 0.004). However, patients with ECA had a higher rate of metastases to pelvic organs (13.5% vs. 2.4%; p < 0.001). In univariable analysis, HPV status, tumor type, higher FIGO stage, older age, LVI positive, lymph node metastasis (LNM), and adjuvant treatment were all associated with impaired RFS and OS (all p ≤ 0.007). In multivariable analysis, LVI, HPV status, institution, and tumor type remained significant for RFS, while age at diagnosis, FIGO stage, LVI, and tumor type remained significant for OS.
Conclusion
Tumor type and HPV status play significant role in determining survival outcomes in CC.
{"title":"Survival comparison analysis between cervical squamous cell carcinoma and adenocarcinoma with a special focus on the HPV status","authors":"Deepti Jain , Marya Wahidi , Judy Effendi , Lien Hoang , Cristina Terinte , Anna Pesci , Takako Kiyokawa , Isabel Alvarado-Cabrero , Esther Oliva , Natalia Rakislova , Ana Felix , Douglas Allison , Esther Guerra , Andres Roma , Oluwole Fadare , Gulisa Turashvili , Carlos Parra-Herran , Gozde Kir , Ahmet Erbagci , Anne Mills , Rouba Ali-Fehmi","doi":"10.1016/j.ygyno.2026.01.012","DOIUrl":"10.1016/j.ygyno.2026.01.012","url":null,"abstract":"<div><h3>Background</h3><div>Our study examines impact of HPV status and patient-specific characteristics on recurrence-free survival (RFS) and overall survival (OS) for SCC and ECA.</div></div><div><h3>Methods</h3><div>This multi-continental retrospective study analyzed clinicopathologic data of 634 patients with microscopically confirmed cervical cancer (CC; only SCC and ECA) across Asia, Europe, and North America. HPV status was determined using PCR or HPV in situ hybridization (ISH) for both HR-HPV (SCC and ECA) and LR-HPV (SCC), using same platform. Descriptive analysis and Cox regression models were produced.</div></div><div><h3>Results</h3><div>Out of total 634 patients, 533 (84.1%) were HPVA and 101 (15.9%) were HPVI. 65% had SCC morphology (88.1%: HPVA; 11.9%: HPVI) and 35% had ECA differentiation (76.6%: HPVA; 23.4%: HPVI). Compared to ECA, patients with SCC were older (median age: 51 vs. 45 years old; <em>p</em> < 0.001), had higher HPVA status (88.1% vs. 76.6%; p < 0.001), and a higher rate of lymph-vascular invasion (LVI; 64.8% vs. 56.8%; <em>p</em> = 0.004). However, patients with ECA had a higher rate of metastases to pelvic organs (13.5% vs. 2.4%; p < 0.001). In univariable analysis, HPV status, tumor type, higher FIGO stage, older age, LVI positive, lymph node metastasis (LNM), and adjuvant treatment were all associated with impaired RFS and OS (all <em>p</em> ≤ 0.007). In multivariable analysis, LVI, HPV status, institution, and tumor type remained significant for RFS, while age at diagnosis, FIGO stage, LVI, and tumor type remained significant for OS.</div></div><div><h3>Conclusion</h3><div>Tumor type and HPV status play significant role in determining survival outcomes in CC.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"205 ","pages":"Pages 89-98"},"PeriodicalIF":4.1,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034378","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}
Pub Date : 2026-01-20DOI: 10.1016/j.ygyno.2026.01.002
E.M. Vermaas , H.H.B. Wenzel , M.A. van der Aa , M. Snijders , B.F.M. Slangen , L.R.C.W. van Lonkhuijzen , J.W.M. Aarts
Introduction
During the coronavirus disease 2019 (COVID-19) pandemic, hospital-based follow-up care after gynaecological cancer was suddenly upended in order to reduce virus transmission, impacting the frequency and delivery of outpatient follow-up consultations in gynaecologic follow-up care. The objective of this study is to investigate the impact of the changes in follow-up care delivery on oncological outcomes in gynaecologic cancer survivors.
Methods
This nationwide population-based retrospective cohort study used data from the Netherlands Cancer Registry (NCR) and the Nationwide Network of Histopathology and Cytopathology (PALGA). Patients treated for epithelial ovarian, cervical, high stage endometrial or vulvar cancer, who either received the first two years of follow-up care pre-pandemic (2017–2019) or during the COVID-19 pandemic (2020−2021), were included. Two-year recurrence-free survival (RFS) and two-year overall survival (OS) were calculated, and analyses were adjusted for confounding.
Results
A total of 9062 patients were included, of whom 48.6 % (n = 4408) received follow-up pre-pandemic and 51.4 % (n = 4654) during COVID-19. RFS was comparable between pre-pandemic and COVID-19 cohorts in ovarian (hazard ratio [HR] 1.10, 95 % confidence interval [CI] 0.94–1.28), cervical (HR 1.07, 95 % CI 0.81–1.40), endometrial (HR 1.19, 95 % CI 0.93–1.53) and vulvar cancer (HR 1.01, 95 % CI 0.77–1.31). Moreover, there were no significant differences in OS, also after multivariable adjustments.
Conclusion
This study demonstrates that two-year RFS and two-year OS during follow-up after treatment for a gynaecologic malignancy were not impacted by the follow-up care, as provided during the COVID-19 pandemic. These findings indicate that adaptations in follow-up care during the COVID-19 pandemic were not associated with worse oncological outcomes, warranting further investigation into more flexible follow-up strategies.
导语：在2019冠状病毒病（COVID-19）大流行期间，为减少病毒传播，妇科癌症后的医院随访服务突然被颠覆，影响了妇科随访护理中门诊随访会诊的频率和提供。本研究的目的是调查妇科癌症幸存者随访护理的变化对肿瘤预后的影响。方法：这项基于全国人群的回顾性队列研究使用了来自荷兰癌症登记处（NCR）和全国组织病理学和细胞病理学网络（PALGA）的数据。研究纳入了在大流行前（2017-2019年）或COVID-19大流行期间（2020-2021年）接受过上皮性卵巢癌、宫颈癌、高分期子宫内膜癌或外阴癌治疗的前两年随访护理的患者。计算2年无复发生存期（RFS）和2年总生存期（OS），并对分析进行混杂校正。结果：共纳入9062例患者，其中48.6% （n = 4408）在流行前接受随访，51.4% （n = 4654）在COVID-19期间接受随访。大流行前和COVID-19队列的RFS在卵巢（风险比[HR] 1.10, 95%可信区间[CI] 0.94-1.28）、宫颈（风险比[HR] 1.07, 95% CI 0.81-1.40）、子宫内膜（风险比[HR] 1.19, 95% CI 0.93-1.53）和外阴癌（风险比[HR] 1.01, 95% CI 0.77-1.31）中具有可比性。此外，在多变量调整后，OS也没有显著差异。结论：本研究表明，在COVID-19大流行期间提供的随访护理不影响妇科恶性肿瘤治疗后随访的2年RFS和2年OS。这些发现表明，2019冠状病毒病大流行期间随访护理的适应与肿瘤预后恶化无关，因此有必要进一步研究更灵活的随访策略。
{"title":"Impact of COVID-19 on oncological outcomes during follow-up in gynaecological cancer: A nationwide retrospective cohort study","authors":"E.M. Vermaas , H.H.B. Wenzel , M.A. van der Aa , M. Snijders , B.F.M. Slangen , L.R.C.W. van Lonkhuijzen , J.W.M. Aarts","doi":"10.1016/j.ygyno.2026.01.002","DOIUrl":"10.1016/j.ygyno.2026.01.002","url":null,"abstract":"<div><h3>Introduction</h3><div>During the coronavirus disease 2019 (COVID-19) pandemic, hospital-based follow-up care after gynaecological cancer was suddenly upended in order to reduce virus transmission, impacting the frequency and delivery of outpatient follow-up consultations in gynaecologic follow-up care. The objective of this study is to investigate the impact of the changes in follow-up care delivery on oncological outcomes in gynaecologic cancer survivors.</div></div><div><h3>Methods</h3><div>This nationwide population-based retrospective cohort study used data from the Netherlands Cancer Registry (NCR) and the Nationwide Network of Histopathology and Cytopathology (PALGA). Patients treated for epithelial ovarian, cervical, high stage endometrial or vulvar cancer, who either received the first two years of follow-up care pre-pandemic (2017–2019) or during the COVID-19 pandemic (2020−2021), were included. Two-year recurrence-free survival (RFS) and two-year overall survival (OS) were calculated, and analyses were adjusted for confounding.</div></div><div><h3>Results</h3><div>A total of 9062 patients were included, of whom 48.6 % (<em>n</em> = 4408) received follow-up pre-pandemic and 51.4 % (<em>n</em> = 4654) during COVID-19. RFS was comparable between pre-pandemic and COVID-19 cohorts in ovarian (hazard ratio [HR] 1.10, 95 % confidence interval [CI] 0.94–1.28), cervical (HR 1.07, 95 % CI 0.81–1.40), endometrial (HR 1.19, 95 % CI 0.93–1.53) and vulvar cancer (HR 1.01, 95 % CI 0.77–1.31). Moreover, there were no significant differences in OS, also after multivariable adjustments.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that two-year RFS and two-year OS during follow-up after treatment for a gynaecologic malignancy were not impacted by the follow-up care, as provided during the COVID-19 pandemic. These findings indicate that adaptations in follow-up care during the COVID-19 pandemic were not associated with worse oncological outcomes, warranting further investigation into more flexible follow-up strategies.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"205 ","pages":"Pages 79-88"},"PeriodicalIF":4.1,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018257","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}
Pub Date : 2026-01-19DOI: 10.1016/j.ygyno.2026.01.008
Harriet Rothschild, R Tyler Hillman
{"title":"New therapeutic strategies for relapsed adult type ovarian granulosa cell Tumors: From discovery to clinical progress.","authors":"Harriet Rothschild, R Tyler Hillman","doi":"10.1016/j.ygyno.2026.01.008","DOIUrl":"https://doi.org/10.1016/j.ygyno.2026.01.008","url":null,"abstract":"","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009911","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}
Pub Date : 2026-01-19DOI: 10.1016/j.ygyno.2026.01.005
Valerie Catherine Linz , Emma Liebau , Laura Herrmann , Markus Schepers , Katharina Gillen , Michael Mohr , Mona Wanda Schmidt , Marcus Schmidt , Annette Hasenburg
Objective
Frailty, nutritional deficiencies, and anemia frequently coexist in gynecologic cancer and may adversely influence clinical outcomes. This study aimed to evaluate the prognostic value of the G8 geriatric screening tool (G8) for survival outcomes in patients undergoing gynecologic oncology surgery, with postoperative complications and selected modifiable preoperative conditions assessed as secondary outcomes.
Methods
Patients ≥60 years undergoing gynecologic oncology surgery were prospectively screened for frailty between May 2020 – June 2025. Survival was evaluated with Kaplan-Meier curves and Cox regression. Propensity score matching included demographics, comorbidities, and tumor characteristics; matched samples were analyzed using weighted Cox models.
Results
Of 257 screened patients, 180 were included (endometrial n = 72, ovarian n = 71, vulvar n = 26, cervical n = 6, vaginal cancer n = 5; mean age 69.6 ± 7.9 years; follow-up 25.1 ± 16.3 months). G8 positive patients (≤14 points) had more comorbidities and were more likely to present with preoperative anemia, hypoalbuminemia, and vitamin D or B12 deficiency. FIGO stages, surgical approach and postoperative complications were comparable. G8 positive patients were less likely to receive standard adjuvant therapy (p = 0.003). In matched analyses, G8 positivity remained significantly associated with reduced progression-free survival (HR: 1.87, 95% CI: 1.01–3.49, p = 0.047) and showed a trend toward worse overall survival (HR: 2.25, 95% CI: 0.98–5.16, p = 0.055). Surgical resection status was the strongest predictor of oncological outcome.
Conclusions
A low preoperative G8 score was associated with reduced progression-free and potentially worse overall survival in older women with gynecologic tumors. The G8 may help identify modifiable factors such as anemia or vitamin D deficiency, while complete tumor resection remained the strongest prognostic factor.
目的：虚弱、营养缺乏和贫血在妇科癌症中经常共存，并可能对临床结果产生不利影响。本研究旨在评估G8老年筛查工具（G8）对妇科肿瘤手术患者生存结局的预后价值，将术后并发症和选定的可修改术前状况评估为次要结局。方法：在2020年5月至2025年6月期间，对≥60岁接受妇科肿瘤手术的患者进行前瞻性筛查。采用Kaplan-Meier曲线和Cox回归评估生存率。倾向评分匹配包括人口统计学、合并症和肿瘤特征；匹配样本采用加权Cox模型进行分析。结果：257例患者中，纳入180例（子宫内膜72例，卵巢71例，外阴26例，宫颈6例，阴道癌5例），平均年龄69.6±7.9岁，随访25.1±16.3个月。G8阳性患者（≤14分）合并症较多，术前更易出现贫血、低白蛋白血症、维生素D或B12缺乏。FIGO分期、手术入路和术后并发症具有可比性。G8阳性患者接受标准辅助治疗的可能性较小（p = 0.003）。在匹配分析中，G8阳性仍然与无进展生存期降低显著相关（HR: 1.87, 95% CI: 1.01-3.49, p = 0.047），并显示出总生存期降低的趋势（HR: 2.25, 95% CI: 0.98-5.16, p = 0.055）。手术切除状态是肿瘤预后的最强预测因子。结论：术前G8评分较低与老年妇科肿瘤患者的无进展减少和潜在的更差的总生存率相关。G8可能有助于确定可改变的因素，如贫血或维生素D缺乏症，而完全切除肿瘤仍然是最强的预后因素。
{"title":"Association of preoperative G8 score with survival, preoperative anemia and vitamin D status in gynecologic cancer patients: 5-year analysis of the Frail-B study","authors":"Valerie Catherine Linz , Emma Liebau , Laura Herrmann , Markus Schepers , Katharina Gillen , Michael Mohr , Mona Wanda Schmidt , Marcus Schmidt , Annette Hasenburg","doi":"10.1016/j.ygyno.2026.01.005","DOIUrl":"10.1016/j.ygyno.2026.01.005","url":null,"abstract":"<div><h3>Objective</h3><div>Frailty, nutritional deficiencies, and anemia frequently coexist in gynecologic cancer and may adversely influence clinical outcomes. This study aimed to evaluate the prognostic value of the G8 geriatric screening tool (G8) for survival outcomes in patients undergoing gynecologic oncology surgery, with postoperative complications and selected modifiable preoperative conditions assessed as secondary outcomes.</div></div><div><h3>Methods</h3><div>Patients ≥60 years undergoing gynecologic oncology surgery were prospectively screened for frailty between May 2020 – June 2025. Survival was evaluated with Kaplan-Meier curves and Cox regression. Propensity score matching included demographics, comorbidities, and tumor characteristics; matched samples were analyzed using weighted Cox models.</div></div><div><h3>Results</h3><div>Of 257 screened patients, 180 were included (endometrial <em>n</em> = 72, ovarian <em>n</em> = 71, vulvar <em>n</em> = 26, cervical <em>n</em> = 6, vaginal cancer <em>n</em> = 5; mean age 69.6 ± 7.9 years; follow-up 25.1 ± 16.3 months). G8 positive patients (≤14 points) had more comorbidities and were more likely to present with preoperative anemia, hypoalbuminemia, and vitamin D or B12 deficiency. FIGO stages, surgical approach and postoperative complications were comparable. G8 positive patients were less likely to receive standard adjuvant therapy (<em>p</em> = 0.003). In matched analyses, G8 positivity remained significantly associated with reduced progression-free survival (HR: 1.87, 95% CI: 1.01–3.49, <em>p</em> = 0.047) and showed a trend toward worse overall survival (HR: 2.25, 95% CI: 0.98–5.16, <em>p</em> = 0.055). Surgical resection status was the strongest predictor of oncological outcome.</div></div><div><h3>Conclusions</h3><div>A low preoperative G8 score was associated with reduced progression-free and potentially worse overall survival in older women with gynecologic tumors. The G8 may help identify modifiable factors such as anemia or vitamin D deficiency, while complete tumor resection remained the strongest prognostic factor.</div></div>","PeriodicalId":12853,"journal":{"name":"Gynecologic oncology","volume":"205 ","pages":"Pages 70-78"},"PeriodicalIF":4.1,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009618","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}
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