Pub Date : 2025-10-01DOI: 10.1016/j.gore.2025.101956
Sofia Bigardi, Giulia Spagnol, Livia Xhindoli, Matteo Marchetti, Orazio De Tommasi, Marco Noventa, Carlo Saccardi, Roberto Tozzi
Introduction
Gastropleural fistula (GPF) is an exceptionally rare complication in oncologic surgery, most often reported after thoracic or abdominal procedures and only sporadically described in ovarian cancer.
Case report
We describe a 72-year-old woman with advanced high-grade serous ovarian cancer who underwent interval cytoreductive surgery including bilateral diaphragmatic peritonectomy. Despite achieving optimal cytoreduction (RT 0), her postoperative course was complicated by the onset of dyspnea and hydropneumothorax. A contrast-enhanced CT scan demonstrated a fistulous tract between the gastric fundus and the pleural cavity. She underwent partial gastrectomy, diaphragmatic repair, and thoracic washout, with resolution of the fistula. No adjuvant chemotherapy was given, and disease recurrence occurred after five months, treated with carboplatin plus gemcitabine.
Conclusions
This case illustrates that GPF, although extremely uncommon in gynecologic oncology, can occur after extensive diaphragmatic surgery in multimorbid and heavily pre-treated patients. A narrative review of the literature highlights common mechanisms—including tissue ischemia, impaired healing, and oncologic treatments—across both gynecologic and non-gynecologic cases. Early recognition and prompt surgical management are essential for favorable outcomes.
{"title":"Gastropleural fistula following advanced stage ovarian cancer interval cytoreductive surgery: A case report and review of the literature","authors":"Sofia Bigardi, Giulia Spagnol, Livia Xhindoli, Matteo Marchetti, Orazio De Tommasi, Marco Noventa, Carlo Saccardi, Roberto Tozzi","doi":"10.1016/j.gore.2025.101956","DOIUrl":"10.1016/j.gore.2025.101956","url":null,"abstract":"<div><h3>Introduction</h3><div>Gastropleural fistula (GPF) is an exceptionally rare complication in oncologic surgery, most often reported after thoracic or abdominal procedures and only sporadically described in ovarian cancer.</div></div><div><h3>Case report</h3><div>We describe a 72-year-old woman with advanced high-grade serous ovarian cancer who underwent interval cytoreductive surgery including bilateral diaphragmatic peritonectomy. Despite achieving optimal cytoreduction (RT 0), her postoperative course was complicated by the onset of dyspnea and hydropneumothorax. A contrast-enhanced CT scan demonstrated a fistulous tract between the gastric fundus and the pleural cavity. She underwent partial gastrectomy, diaphragmatic repair, and thoracic washout, with resolution of the fistula. No adjuvant chemotherapy was given, and disease recurrence occurred after five months, treated with carboplatin plus gemcitabine.</div></div><div><h3>Conclusions</h3><div>This case illustrates that GPF, although extremely uncommon in gynecologic oncology, can occur after extensive diaphragmatic surgery in multimorbid and heavily pre-treated patients. A narrative review of the literature highlights common mechanisms—including tissue ischemia, impaired healing, and oncologic treatments—across both gynecologic and non-gynecologic cases. Early recognition and prompt surgical management are essential for favorable outcomes.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101956"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-19DOI: 10.1016/j.gore.2025.101953
Miriam Nakalembe , Collins Mpamani , Jane Namugga , Carolyn Nakisige , Grace Banturaki , Phillip Tonui , Peter Itsura , Omenge Orang’o , Kapten Muthoka , Anthony Ngeresa , Beverly Musick , Aaron Ermel , Patrick Loehrer , Darron R. Brown , Yan Tong
Objectives
Cervical cancer, caused by “high-risk” (HR) HPV, is the most common malignancy and the leading cause of cancer deaths among women living in Kenya and Uganda. Women living with HIV (WLWH) are at a high risk for HR-HPV infection. This longitudinal, observational cohort analysis was conducted to identify factors that are important among WLWH in prediction of cervical intraepithelial neoplasia grades 2 or 3 (CIN2/3).
Methods
Data of this analysis was based on a study of HPV natural history and cervical cancer among Kenyan and Ugandan WLWH. Demographic, behavioral and biological data were collected; HR-HPV DNA testing of cervical swabs was performed (Roche Cobas Assay); all WLWH underwent cervical biopsy on two occasions.
Results
Of 114 WLWH enrolled, the median age was 38.2 years. All WLWH were receiving ART during the study. CIN2/3 was found in 13 (11.4 %) WLWH; HPV 16 was detected in 10 (8.8 %); HPV 18 in 11 (9.6 %), and Non-16/18 HR-HPV in 62 (54.4 %). Aflatoxin exposure was not associated with CIN2/3 in this analysis. A multivariable logistic regression found that cervical detection of HPV 18 was significantly associated with CIN2/3 (OR = 6.36, 95 % CI = 1.36–29.75, p = 0.019), after adjusting for the effects of HIV viral load, CD4 counts, and Non-16/18 HR-HPV detection.
Conclusions
CIN2/3 was detected in 11.4% of WLWH; HPV 18 detection in cervical swabs was strongly associated with CIN2/3. Larger studies among WLWH are needed to determine optimal approaches for screening and treatment to prevent cervical cancer.
{"title":"Cervical HPV 18 detection is associated with high-grade cervical dysplasia in Kenyan and Ugandan women living with HIV","authors":"Miriam Nakalembe , Collins Mpamani , Jane Namugga , Carolyn Nakisige , Grace Banturaki , Phillip Tonui , Peter Itsura , Omenge Orang’o , Kapten Muthoka , Anthony Ngeresa , Beverly Musick , Aaron Ermel , Patrick Loehrer , Darron R. Brown , Yan Tong","doi":"10.1016/j.gore.2025.101953","DOIUrl":"10.1016/j.gore.2025.101953","url":null,"abstract":"<div><h3>Objectives</h3><div>Cervical cancer, caused by “high-risk” (HR) HPV, is the most common malignancy and the leading cause of cancer deaths among women living in Kenya and Uganda. Women living with HIV (WLWH) are at a high risk for HR-HPV infection. This longitudinal, observational cohort analysis was conducted to identify factors that are important among WLWH in prediction of cervical intraepithelial neoplasia grades 2 or 3 (CIN2/3).</div></div><div><h3>Methods</h3><div>Data of this analysis was based on a study of HPV natural history and cervical cancer among Kenyan and Ugandan WLWH. Demographic, behavioral and biological data were collected; HR-HPV DNA testing of cervical swabs was performed (Roche Cobas Assay); all WLWH underwent cervical biopsy on two occasions.</div></div><div><h3>Results</h3><div>Of 114 WLWH enrolled, the median age was 38.2 years. All WLWH were receiving ART during the study. CIN2/3 was found in 13 (11.4 %) WLWH; HPV 16 was detected in 10 (8.8 %); HPV 18 in 11 (9.6 %), and Non-16/18 HR-HPV in 62 (54.4 %). Aflatoxin exposure was not associated with CIN2/3 in this analysis. A multivariable logistic regression found that cervical detection of HPV 18 was significantly associated with CIN2/3 (OR = 6.36, 95 % CI = 1.36–29.75, p = 0.019), after adjusting for the effects of HIV viral load, CD4 counts, and Non-16/18 HR-HPV detection.</div></div><div><h3>Conclusions</h3><div>CIN2/3 was detected in 11.4% of WLWH; HPV 18 detection in cervical swabs was strongly associated with CIN2/3. Larger studies among WLWH are needed to determine optimal approaches for screening and treatment to prevent cervical cancer.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101953"},"PeriodicalIF":1.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-19DOI: 10.1016/j.gore.2025.101959
Terrence Wong , Joellen Fresia , Nicholas Adzibolosu , Logan Corey , Sharon Wu , Larissa Mattei , Joanne Xiu , Kurt Hodges , Matthew Oberley , Premal H. Thaker , Rami Musallam , Mira Kheil , Sudeshna Bandyopadhyay , Ira Winer , Robert Morris , Rouba Ali-Fehmi
Objective
Patients with a biopsy diagnosis of atypical endometrial hyperplasia (AEH) or endometrial intraepithelial neoplasia (EIN) have a significant underlying risk of concurrent endometrial cancer (EC). We sought to determine whether molecular and/or immune signatures can be utilized to differentiate between pre-operative, premalignant lesions with and without concurrent occult endometrioid adenocarcinoma.
Methods
A single-institution database was queried for patients diagnosed with AEH/EIN on pre-operative sampling who then underwent subsequent hysterectomy. Whole exome and whole transcriptome sequencing of tissue samples were performed by CARIS Life Sciences. Quantification of immune cells from RNA sequencing data was estimated using quanTIseq.
Results
We identified 34 patients with matched pre-operative and hysterectomy specimens: 19 patients (56 %) with AEH/EIN only and 15 patients (44 %) with EC. Forty-four pathologic specimens (65 %) were successfully profiled. The most frequent genomic alterations in the EC cohort were PTEN (83.3 %), MSI-H (22.2 %), PIK3R1 (22.2 %), and CTNNB1 (16.7 %). There were no MSI-H or CTNNB1 alterations in the AEH/EIN cohort. Median expression of all ten immune checkpoint genes analyzed (CD80, CD86, CD274, CTLA4, HAVCR2/TIM3, IFNG, IDO1, LAG3, PDCD1, PDCD1LG2) were numerically higher for pre-operative biopsies in the EC cohort. Infiltrates of pro-tumorigenic regulatory T cells (+2.42 %) and tumor-suppressing neutrophils (+11.75 %) and CD8 + T cells (+2.39 %) trended higher (p < 0.05) in this same cohort – absolute fractions of tumor-suppressing NK cells and M1 macrophages were also greater.
Conclusions
Pre-operative AEH/EIN biopsy specimens exhibit different molecular and immune profiles depending on the coexistence of concurrent EC. Further characterization of these signatures may lead to advances in diagnostic precision and prognostic capability.
{"title":"Impact of molecular and immune signature on endometrial biopsies with atypical hyperplasia with and without concurrent endometroid carcinoma","authors":"Terrence Wong , Joellen Fresia , Nicholas Adzibolosu , Logan Corey , Sharon Wu , Larissa Mattei , Joanne Xiu , Kurt Hodges , Matthew Oberley , Premal H. Thaker , Rami Musallam , Mira Kheil , Sudeshna Bandyopadhyay , Ira Winer , Robert Morris , Rouba Ali-Fehmi","doi":"10.1016/j.gore.2025.101959","DOIUrl":"10.1016/j.gore.2025.101959","url":null,"abstract":"<div><h3>Objective</h3><div>Patients with a biopsy diagnosis of atypical endometrial hyperplasia (AEH) or endometrial intraepithelial neoplasia (EIN) have a significant underlying risk of concurrent endometrial cancer (EC). We sought to determine whether molecular and/or immune signatures can be utilized to differentiate between pre-operative, premalignant lesions with and without concurrent occult endometrioid adenocarcinoma.</div></div><div><h3>Methods</h3><div>A single-institution database was queried for patients diagnosed with AEH/EIN on pre-operative sampling who then underwent subsequent hysterectomy. Whole exome and whole transcriptome sequencing of tissue samples were performed by CARIS Life Sciences. Quantification of immune cells from RNA sequencing data was estimated using quanTIseq.</div></div><div><h3>Results</h3><div>We identified 34 patients with matched pre-operative and hysterectomy specimens: 19 patients (56 %) with AEH/EIN only and 15 patients (44 %) with EC. Forty-four pathologic specimens (65 %) were successfully profiled. The most frequent genomic alterations in the EC cohort were PTEN (83.3 %), MSI-H (22.2 %), PIK3R1 (22.2 %), and CTNNB1 (16.7 %). There were no MSI-H or CTNNB1 alterations in the AEH/EIN cohort. Median expression of all ten immune checkpoint genes analyzed (CD80, CD86, CD274, CTLA4, HAVCR2/TIM3, IFNG, IDO1, LAG3, PDCD1, PDCD1LG2) were numerically higher for pre-operative biopsies in the EC cohort. Infiltrates of pro-tumorigenic regulatory T cells (+2.42 %) and tumor-suppressing neutrophils (+11.75 %) and CD8 + T cells (+2.39 %) trended higher (p < 0.05) in this same cohort – absolute fractions of tumor-suppressing NK cells and M1 macrophages were also greater.</div></div><div><h3>Conclusions</h3><div>Pre-operative AEH/EIN biopsy specimens exhibit different molecular and immune profiles depending on the coexistence of concurrent EC. Further characterization of these signatures may lead to advances in diagnostic precision and prognostic capability.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101959"},"PeriodicalIF":1.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-16DOI: 10.1016/j.gore.2025.101958
Glenn P. Boyles , Chelsey I. Vranes , Leslie H. Clark , Kimberly Dessources , J. Michael Straughn Jr
Objectives
To characterize the scholarly accomplishments and attitudes regarding scholarly productivity among recent gynecologic oncology (GYO) fellowship graduates and identify factors which may influence academic productivity.
Methods
A 21-item web-based survey was distributed to individuals who had graduated from GYO fellowship within the past five years (2020–2024). Data on demographics, fellowship program characteristics, and scholarly accomplishments were collected. Descriptive statistics and univariate logistic regression were performed.
Results
115 individuals participated in the survey yielding a response rate of 31.2 %. The median number (min, max) of first-author published manuscripts was 4 (0, 18), conference posters was 4 (0, 30), and oral plenaries was 1 (0, 10). Graduates from programs with larger GYO clinical divisions were more likely to publish 4 or more first-author manuscripts compared to those from smaller divisions (OR 2.50; 95 % CI 1.09–5.74). The factors most frequently cited as supporting scholarly productivity were positive mentorship (65.4 %), access to existing databases (33.7 %), and timing of research year(s) (32.7 %). Reported barriers included clinical volume (63.5 %), inadequate technical support (36.5 %), and lack of mentorship (29.8 %). Fellows who had a clinical year prior to their dedicated research time were more likely to view timing of their research year(s) as contributory to their scholarly productivity (OR 2.89; 95 % CI 1.19–7.02).
Conclusions
This study provides valuable descriptive data on the scholarly accomplishments of recent GYO fellows. Clinical division size and timing of research year(s) seem to positively impact scholarly productivity.
目的了解妇科肿瘤科应届毕业生的学术成就及对学术生产力的态度，探讨影响学术生产力的因素。方法对近5年（2020-2024年）毕业的GYO奖学金毕业生进行21项网络调查。收集了人口统计、奖学金项目特点和学术成就方面的数据。进行描述性统计和单变量逻辑回归。结果共有115人参与调查，回复率为31.2%。第一作者发表稿件的中位数（min, max）为4(0,18)，会议海报为4(0,30)，口头全体会议为1（0,10）。与来自较小科室的毕业生相比，来自较大GYO临床科室的毕业生更有可能发表4篇或更多的第一作者手稿（or 2.50; 95% CI 1.09-5.74）。最常被引用的支持学术生产力的因素是积极的指导（65.4%），对现有数据库的访问（33.7%）和研究年度的时间安排（32.7%）。报告的障碍包括临床数量（63.5%）、技术支持不足（36.5%）和缺乏指导（29.8%）。在专门研究时间之前有临床一年的研究员更有可能将其研究年的时间安排视为对其学术生产力的贡献（OR 2.89; 95% CI 1.19-7.02）。结论本研究为近年来GYO研究员的学术成就提供了有价值的描述性数据。临床部门的规模和研究年份的时间似乎对学术生产力有积极的影响。
{"title":"Scholarly productivity during gynecologic oncology fellowship: A cross-sectional survey of graduates from 2020 to 2024","authors":"Glenn P. Boyles , Chelsey I. Vranes , Leslie H. Clark , Kimberly Dessources , J. Michael Straughn Jr","doi":"10.1016/j.gore.2025.101958","DOIUrl":"10.1016/j.gore.2025.101958","url":null,"abstract":"<div><h3>Objectives</h3><div>To characterize the scholarly accomplishments and attitudes regarding scholarly productivity among recent gynecologic oncology (GYO) fellowship graduates and identify factors which may influence academic productivity.</div></div><div><h3>Methods</h3><div>A 21-item web-based survey was distributed to individuals who had graduated from GYO fellowship within the past five years (2020–2024). Data on demographics, fellowship program characteristics, and scholarly accomplishments were collected. Descriptive statistics and univariate logistic regression were performed.</div></div><div><h3>Results</h3><div>115 individuals participated in the survey yielding a response rate of 31.2 %. The median number (min, max) of first-author published manuscripts was 4 (0, 18), conference posters was 4 (0, 30), and oral plenaries was 1 (0, 10). Graduates from programs with larger GYO clinical divisions were more likely to publish 4 or more first-author manuscripts compared to those from smaller divisions (OR 2.50; 95 % CI 1.09–5.74). The factors most frequently cited as supporting scholarly productivity were positive mentorship (65.4 %), access to existing databases (33.7 %), and timing of research year(s) (32.7 %). Reported barriers included clinical volume (63.5 %), inadequate technical support (36.5 %), and lack of mentorship (29.8 %). Fellows who had a clinical year prior to their dedicated research time were more likely to view timing of their research year(s) as contributory to their scholarly productivity (OR 2.89; 95 % CI 1.19–7.02).</div></div><div><h3>Conclusions</h3><div>This study provides valuable descriptive data on the scholarly accomplishments of recent GYO fellows. Clinical division size and timing of research year(s) seem to positively impact scholarly productivity.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101958"},"PeriodicalIF":1.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-13DOI: 10.1016/j.gore.2025.101949
Die Fan , Xiaoxia Jiang , Lin Wu , Yujie Hao , Chengbin Lu , Zheng Li
Background
Ewing’s sarcoma (ES) is an aggressive malignancy affecting bone and soft tissues, predominantly occurring in the skeletal system. The occurrence of Ewing’s sarcoma (ES) or primitive neuroectodermal tumor (PNET) with in the female genital tract is rare. Even rarer is its occurrence in the vagina, with only 22 cases reported to date. Accurate diagnosis necessitates a multifaceted approach that includes morphology, immunohistochemistry, and molecular pathology; the gold standard for diagnosis is next-generation sequencing (NGS), which is characterized by chromosomal translocations resulting in FET-ETS gene fusions.
Case description.
We present an exceptionally rare case of Ewing’s sarcoma in a 35-year-old woman of childbearing age. She exhibited a painless vaginal mass measuring approximately 2.5 × 2 × 0.9 cm, and according to the existing literature, our case represents the smallest tumor documented in primary vaginal Ewing’s sarcoma. Immunohistochemistry (IHC) revealed membrane positivity for CD99, along with positive expression of NKX2.2, FLI-1, and VIM. Furthermore, next-generation sequencing (NGS) conducted at the Affiliated Cancer Hospital of Fudan University identified an EWSR1-FLI1 gene fusion, thereby confirming the diagnosis of vaginal Ewing’s sarcoma.
Conclusion
Vaginal Ewing’s sarcoma is characterized by the absence of specific clinical manifestations and signs, along with a high rate of recurrence and metastasis. The management of these tumors primarily involves optimal local surgical intervention, followed by adjuvant therapies such as radiotherapy and/or chemotherapy.
{"title":"Primary Ewing’s sarcoma of the vagina: A rare case report and literature review","authors":"Die Fan , Xiaoxia Jiang , Lin Wu , Yujie Hao , Chengbin Lu , Zheng Li","doi":"10.1016/j.gore.2025.101949","DOIUrl":"10.1016/j.gore.2025.101949","url":null,"abstract":"<div><h3>Background</h3><div>Ewing’s sarcoma (ES) is an aggressive malignancy affecting bone and soft tissues, predominantly occurring in the skeletal system. The occurrence of Ewing’s sarcoma (ES) or primitive neuroectodermal tumor (PNET) with in the female genital tract is rare. Even rarer is its occurrence in the vagina, with only 22 cases reported to date. Accurate diagnosis necessitates a multifaceted approach that includes morphology, immunohistochemistry, and molecular pathology; the gold standard for diagnosis is next-generation sequencing (NGS), which is characterized by chromosomal translocations resulting in FET-ETS gene fusions.</div><div>Case description.</div><div>We present an exceptionally rare case of Ewing’s sarcoma in a 35-year-old woman of childbearing age. She exhibited a painless vaginal mass measuring approximately 2.5 × 2 × 0.9 cm, and according to the existing literature, our case represents the smallest tumor documented in primary vaginal Ewing’s sarcoma. Immunohistochemistry (IHC) revealed membrane positivity for CD99, along with positive expression of NKX2.2, FLI-1, and VIM. Furthermore, next-generation sequencing (NGS) conducted at the Affiliated Cancer Hospital of Fudan University identified an EWSR1-FLI1 gene fusion, thereby confirming the diagnosis of vaginal Ewing’s sarcoma.</div></div><div><h3>Conclusion</h3><div>Vaginal Ewing’s sarcoma is characterized by the absence of specific clinical manifestations and signs, along with a high rate of recurrence and metastasis. The management of these tumors primarily involves optimal local surgical intervention, followed by adjuvant therapies such as radiotherapy and/or chemotherapy.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101949"},"PeriodicalIF":1.3,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-13DOI: 10.1016/j.gore.2025.101947
Premal H. Thaker , Hui Lu , Yitong J. Zhang , Myrto Trapali , Paul Swinburn , Nicolas Krucien , Doris White , Joslyn Chaiprasert-Paguio , Bhavana Pothuri , Jie Ting
Objective
This study assessed treatment preferences of patients with recurrent/metastatic cervical cancer, a disease with poor prognosis.
Methods
A survey with two discrete choice experiments was completed by 150 patients with recurrent/metastatic cervical cancer in the US. Discrete choice experiment 1 included treatment attributes, and discrete choice experiment 2 included risk mitigation plan attributes.
Results
Participants valued 12-month overall survival rate as the most important attribute, followed by disease control rate; both efficacy attributes were rated as more important than the risk of side effects such as peripheral neuropathy and corneal side effects. Participants’ willingness to accept a treatment profile requiring a risk mitigation plan was influenced by the number of clinic visits and out-of-pocket costs.
Conclusions
Patients with recurrent/metastatic cervical cancer prioritize overall survival and disease control rate as the most important attributes. These findings can be used to inform shared decision-making and treatment discussions among patients, clinicians, and the care team.
{"title":"Treatment preferences of patients with recurrent or metastatic cervical cancer: a discrete choice experiment in the US","authors":"Premal H. Thaker , Hui Lu , Yitong J. Zhang , Myrto Trapali , Paul Swinburn , Nicolas Krucien , Doris White , Joslyn Chaiprasert-Paguio , Bhavana Pothuri , Jie Ting","doi":"10.1016/j.gore.2025.101947","DOIUrl":"10.1016/j.gore.2025.101947","url":null,"abstract":"<div><h3>Objective</h3><div>This study assessed treatment preferences of patients with recurrent/metastatic cervical cancer, a disease with poor prognosis.</div></div><div><h3>Methods</h3><div>A survey with two discrete choice experiments was completed by 150 patients with recurrent/metastatic cervical cancer in the US. Discrete choice experiment 1 included treatment attributes, and discrete choice experiment 2 included risk mitigation plan attributes.</div></div><div><h3>Results</h3><div>Participants valued 12-month overall survival rate as the most important attribute, followed by disease control rate; both efficacy attributes were rated as more important than the risk of side effects such as peripheral neuropathy and corneal side effects. Participants’ willingness to accept a treatment profile requiring a risk mitigation plan was influenced by the number of clinic visits and out-of-pocket costs.</div></div><div><h3>Conclusions</h3><div>Patients with recurrent/metastatic cervical cancer prioritize overall survival and disease control rate as the most important attributes. These findings can be used to inform shared decision-making and treatment discussions among patients, clinicians, and the care team.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101947"},"PeriodicalIF":1.3,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-12DOI: 10.1016/j.gore.2025.101955
Katherine Lambert , Quinn Kistenfeger , Julia Chalif , Jason M. Prosek , Floor Backes
Background
Capillary leak syndrome is a rare immune-adverse related event. There are only 3 reported cases of capillary leak syndrome in patients receiving pembrolizumab, all of which are patients with non-gynecologic squamous cell carcinomas. Here, we present a case report of capillary leak syndrome in a patient with recurrent endometrial carcinoma receiving pembrolizumab.
Methods
This is a case report and review of relevant literature. Patient consent was obtained prior to initiation of the report and submission to the journal.
Objectives
We describe a 65-year-old female with recurrent mismatch repair deficient (dMMR) FIGO grade 2 endometrioid adenocarcinoma on pembrolizumab maintenance therapy, who presented to the hospital with fatigue, lower extremity vasculitis, anasarca, and fevers of unknown origin. She was found to have hypoalbuminemia and hyponatremia. A broad workup was performed, which was overall unrevealing. She was diagnosed with capillary leak syndrome as a diagnosis of exclusion. The patient was treated with corticosteroids and IVIG with resolution of her symptoms. The patient is not currently on any maintenance therapy and there are no plans to resume pembrolizumab.
Conclusion
Our case is the first reported case of capillary leak syndrome secondary to pembrolizumab in a patient with a gynecologic malignancy. Capillary leak syndrome is a diagnosis of exclusion and is treated via immunosuppression with agents such as corticosteroids and IVIG. Expanded awareness of this immune-related adverse event is vital to prompt recognition and treatment.
{"title":"Immunotherapy-associated capillary leak syndrome in endometrial cancer: a case report and review of the literature","authors":"Katherine Lambert , Quinn Kistenfeger , Julia Chalif , Jason M. Prosek , Floor Backes","doi":"10.1016/j.gore.2025.101955","DOIUrl":"10.1016/j.gore.2025.101955","url":null,"abstract":"<div><h3>Background</h3><div>Capillary leak syndrome is a rare immune-adverse related event. There are only 3 reported cases of capillary leak syndrome in patients receiving pembrolizumab, all of which are patients with non-gynecologic squamous cell carcinomas. Here, we present a case report of capillary leak syndrome in a patient with recurrent endometrial carcinoma receiving pembrolizumab.</div></div><div><h3>Methods</h3><div>This is a case report and review of relevant literature. Patient consent was obtained prior to initiation of the report and submission to the journal.</div></div><div><h3>Objectives</h3><div>We describe a 65-year-old female with recurrent mismatch repair deficient (dMMR) FIGO grade 2 endometrioid adenocarcinoma on pembrolizumab maintenance therapy, who presented to the hospital with fatigue, lower extremity vasculitis, anasarca, and fevers of unknown origin. She was found to have hypoalbuminemia and hyponatremia. A broad workup was performed, which was overall unrevealing. She was diagnosed with capillary leak syndrome as a diagnosis of exclusion. The patient was treated with corticosteroids and IVIG with resolution of her symptoms. The patient is not currently on any maintenance therapy and there are no plans to resume pembrolizumab.</div></div><div><h3>Conclusion</h3><div>Our case is the first reported case of capillary leak syndrome secondary to pembrolizumab in a patient with a gynecologic malignancy. Capillary leak syndrome is a diagnosis of exclusion and is treated via immunosuppression with agents such as corticosteroids and IVIG. Expanded awareness of this immune-related adverse event is vital to prompt recognition and treatment.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101955"},"PeriodicalIF":1.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Low-grade endometrial stromal sarcoma (LG-ESS) is a rare uterine malignancy prone to late recurrence and distant metastasis, most commonly to the lungs. Bilateral multiple pulmonary metastases are exceedingly uncommon, and optimal management remains unclear.
Case presentation
A 51-year-old woman underwent total abdominal hysterectomy for LG-ESS at age 43. Eight years later, routine chest radiography revealed multiple bilateral pulmonary nodules. Computed tomography showed three well-circumscribed nodules (7–9 mm) in the left S4, left S8, and right S8 segments. Positron emission tomography showed minimal fluorodeoxyglucose uptake. Bilateral video-assisted thoracoscopic wedge resections were performed, achieving complete removal of all lesions. Histopathology confirmed metastatic LG-ESS (CD10/ER/PR positive). The patient received oral medroxyprogesterone acetate for five years. The therapy was discontinued following subarachnoid hemorrhage due to a ruptured posterior-circulation intracranial aneurysm and treated by surgical clipping; she has no residual neurological deficits. She remains disease-free a total of eight years after metastasectomy.
Conclusion
Complete resection of bilateral multiple pulmonary metastases from LG-ESS, combined with hormonal therapy, can achieve durable long-term disease control in carefully selected patients.
{"title":"Long-term disease-free survival after bilateral video-assisted thoracoscopic resection of multiple pulmonary metastases from endometrial stromal sarcoma: An 8-year follow-up case report","authors":"Eitetsu Koh , Yasuo Sekine , Tadao Nakazawa , Kenzo Hiroshima","doi":"10.1016/j.gore.2025.101954","DOIUrl":"10.1016/j.gore.2025.101954","url":null,"abstract":"<div><h3>Background</h3><div>Low-grade endometrial stromal sarcoma (LG-ESS) is a rare uterine malignancy prone to late recurrence and distant metastasis, most commonly to the lungs. Bilateral multiple pulmonary metastases are exceedingly uncommon, and optimal management remains unclear.</div></div><div><h3>Case presentation</h3><div>A 51-year-old woman underwent total abdominal hysterectomy for LG-ESS at age 43. Eight years later, routine chest radiography revealed multiple bilateral pulmonary nodules. Computed tomography showed three well-circumscribed nodules (7–9 mm) in the left S4, left S8, and right S8 segments. Positron emission tomography showed minimal fluorodeoxyglucose uptake. Bilateral video-assisted thoracoscopic wedge resections were performed, achieving complete removal of all lesions. Histopathology confirmed metastatic LG-ESS (CD10/ER/PR positive). The patient received oral medroxyprogesterone acetate for five years. The therapy was discontinued following subarachnoid hemorrhage due to a ruptured posterior-circulation intracranial aneurysm and treated by surgical clipping; she has no residual neurological deficits. She remains disease-free a total of eight years after metastasectomy.</div></div><div><h3>Conclusion</h3><div>Complete resection of bilateral multiple pulmonary metastases from LG-ESS, combined with hormonal therapy, can achieve durable long-term disease control in carefully selected patients.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101954"},"PeriodicalIF":1.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-09DOI: 10.1016/j.gore.2025.101940
Laura Keenahan , Muhammad Danyal Ahsan , Alicia Mecklai , Melissa K. Frey
{"title":"Navigating dual risks: Ovarian cancer prevention and cardiovascular health in patients with hereditary cancer syndromes","authors":"Laura Keenahan , Muhammad Danyal Ahsan , Alicia Mecklai , Melissa K. Frey","doi":"10.1016/j.gore.2025.101940","DOIUrl":"10.1016/j.gore.2025.101940","url":null,"abstract":"","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101940"},"PeriodicalIF":1.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-08DOI: 10.1016/j.gore.2025.101952
Enyu Tang , Jia Zeng , Yangchun Sun
Background
While surgery and radiotherapy remain primary treatments for HPV-associated vulvar/vaginal squamous cell carcinoma (SCC), the significant complications and impaired quality of life underscore the need for alternative approaches. We report two cases achieving pathological complete response (pCR) with neoadjuvant chemoimmunotherapy.
Cases
Two biopsy-confirmed HPV-associated vulvar/vaginal SCC cases with inguinal lymph node metastases (both PD-L1 CPS < 1) received three cycles of neoadjuvant camrelizumab plus nab-paclitaxel/cisplatin. Subsequent imaging demonstrated marked tumor regression, permitting urethra-preserving resection. Histopathological analysis confirmed pCR, with no recurrence at 6-month follow-up.
Conclusion
Neoadjuvant chemoimmunotherapy may be an effective treatment for HPV-associated vulvar/vaginal SCC, potentially independent of PD-L1 CPS status, while improving post-treatment quality of life compared to conventional therapies.
{"title":"Neoadjuvant chemoimmunotherapy in HPV-associated vulvar and vaginal squamous cell carcinoma with PD-L1 CPS < 1:Dual pCR evidence","authors":"Enyu Tang , Jia Zeng , Yangchun Sun","doi":"10.1016/j.gore.2025.101952","DOIUrl":"10.1016/j.gore.2025.101952","url":null,"abstract":"<div><h3>Background</h3><div>While surgery and radiotherapy remain primary treatments for HPV-associated vulvar/vaginal squamous cell carcinoma (SCC), the significant complications and impaired quality of life underscore the need for alternative approaches. We report two cases achieving pathological complete response (pCR) with neoadjuvant chemoimmunotherapy.</div></div><div><h3>Cases</h3><div>Two biopsy-confirmed HPV-associated vulvar/vaginal SCC cases with inguinal lymph node metastases (both PD-L1 CPS < 1) received three cycles of neoadjuvant camrelizumab plus nab-paclitaxel/cisplatin. Subsequent imaging demonstrated marked tumor regression, permitting urethra-preserving resection. Histopathological analysis confirmed pCR, with no recurrence at 6-month follow-up.</div></div><div><h3>Conclusion</h3><div>Neoadjuvant chemoimmunotherapy may be an effective treatment for HPV-associated vulvar/vaginal SCC, potentially independent of PD-L1 CPS status, while improving post-treatment quality of life compared to conventional therapies.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101952"},"PeriodicalIF":1.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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