Journal of Gynecologic Oncology最新文献

Objective: Chemotherapy-induced peripheral neuropathy (CIPN) poses a significant challenge for gynecological cancer survivors. However, information on its long-term outcomes remains limited. Recently, patient-reported outcomes (PROs), by which patients assess cancer treatment-related side effects, have been developed. This study aimed to evaluate the long-term outcomes of CIPN associated with paclitaxel and carboplatin (TC) therapy using PRO.

Methods: Patients with ovarian, corpus uteri, cervical, and other gynecological cancers who underwent surgery were included in the study, regardless of receiving postoperative chemotherapy. Patients with recurrent cancer were excluded. CIPN was assessed via PROs using the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG Ntx) subscale. The physicians assessed CIPN using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE).

Results: Of the 616 patients, 304 who received TC therapy (TC group) and 312 who were followed up without chemotherapy (NC group) were evaluated. Using the FACT/GOG Ntx subscale, the weighted mean of total score in the TC group was 8.2 in the first year, which significantly decreased over time (p<0.001). However, 5 years after initiating treatment, the scores in the TC group remained significantly higher than did those in the NC group (p=0.040). Similar trends were found using the NCI-CTCAE evaluations.

Conclusion: Following TC therapy, CIPN might improve over time. However, it might not resolve completely.

Objective: This study analyzed postoperative radiation therapy outcomes in women with International Federation of Gynecology and Obstetrics stage I clear cell and papillary serous endometrial carcinomas to inform treatment decisions.

Methods: Surveillance, Epidemiology, and End Results data (2000-2016) was analyzed for females with localized endometrial clear cell or papillary serous carcinoma. The Fine-Gray subdistribution hazard model with competing risks analysis evaluated the effect of age, histology, and radiation modality on the cumulative incidence of death from endometrial cancer. Gray's test compared survival outcomes between external beam radiation therapy (EBRT), combination of EBRT with brachytherapy, and brachytherapy.

Results: Four hundred forty-six patients were included. Mean diagnosis age was 67.92 years. Age was a significant covariate, with a 2% increased risk of death per additional year. Overall survival at 5 and 10 years was 80.87% and 77.94%, respectively. EBRT and brachytherapy were almost equally utilized; combination therapy was less common. At least 60.26% of patients treated with brachytherapy received systemic therapy, compared to 26.92% with EBRT and 12.82% with combination therapy. Brachytherapy showed superior survival outcomes compared to EBRT, with hazard ratios of 0.44 (95% confidence interval [CI]=0.26-0.74; p=0.002) for 5-year and 0.40 (95% CI=0.21-0.77; p=0.006) for 10-year outcomes. Cumulative incidence of death from cancer differed significantly between radiation modalities.

Conclusion: Patients predominantly received a single radiation modality. Brachytherapy was associated with superior survival outcomes and systemic therapy use, though patient selection factors may contribute to this finding. Increasing age was associated with a higher risk of death.

Objective: The revised 2023 International Federation of Gynecology and Obstetrics (FIGO) staging scheme for endometrial cancers (ECs) classifies tumors without myometrial invasion and with a non-aggressive histology as stage IA1, while those with aggressive histology are upgraded to stage IC. However, clinical guidelines lack evidence regarding prognostic and treatment strategies. This study evaluated survival outcomes of stage IC ECs and the impact of adjuvant therapy.

Methods: Data from the Chinese cohort and the Surveillance, Epidemiology, and End Results (SEER) database were retrospectively analyzed. Overall survival (OS) and recurrence-free survival (RFS) were assessed using Kaplan-Meier curves and Cox-regression methods to assess treatment outcomes and identify risk factors.

Results: Patients with stage IC had poorer 5-year-RFS (China: IA1 vs. IC, 97.5% vs 92.84%) and OS (SEER: IA1 vs. IC, 95.95% vs. 86.25%) than stage IA1. Despite 34/44 (77.3%) patients from China and 483/886 (54.5%) patients from SEER cohort received adjuvant therapy, no RFS (Chinese cohort, p=0.489) or OS (SEER cohort, p=0.560) improvement was observed, and neither chemotherapy, radiotherapy, nor their combination improved prognosis than no adjuvant therapy for ECs in stage IC ECs. Non-endometrioid histology was the only independent risk factor for worse OS (hazard ratio=1.672, 95% confidence interval=1.009-2.77). Subgroup analyses revealed no survival benefit from adjuvant treatment in endometrioid (p=0.943) or non-endometrioid (p=0.884) tumors.

Conclusion: In ECs without myometrial invasion, stage IC has poorer prognosis than IA1. However, adjuvant therapy did not improve survival, regardless of histologic subtype.

Objective: The aim of this study was to validate a new Japanese risk grouping in the Korean population and to identify the group benefit from adjuvant treatment.

Methods: A total of 561 patients with stage IB cervical cancer who underwent radical hysterectomy with lymphadenectomy from 2000 to 2008 across 9 Korean Gynecologic Oncology Group-affiliated institutions were included in this study. Patients had at least one intermediate-risk factor: lymphovascular space invasion, outer one-third of the deep cervical stromal invasion, or a tumor 4 cm or larger. Disease-free survival (DFS) was analyzed based on adjuvant therapies: no treatment, radiation therapy, concurrent chemoradiation therapy or systemic chemotherapy.

Results: Patients were classified into 3 groups based on their histologically-incorporated intermediate risk factors. Group 1 included patients with limited risk factors (n=385, 68.6%), group 2 (n=106, 18.9%), and group 3 (n=70, 12.5%) had increasing risk. DFS differed across groups (group 1 vs. group 2, p=0.048; group 2 vs. group 3, p=0.030). Group 1 showed no DFS benefit from adjuvant treatment, while in groups 2 and 3, receiving radiation therapy improved DFS (group 2: adjusted hazard ratio [aHR]=0.09; 95% confidence interval [CI]=0.01-0.80; p=0.031 and group 3: aHR=0.21; 95% CI=0.04-1.08; p=0.047). In group 3, receiving concurrent chemotherapy treatment did not significantly affect DFS compared to radiation alone (aHR=0.84; 95% CI=0.11-6.30; p=0.861).

Conclusion: This study revealed the prognostic value of histology-incorporated intermediate-risk stratification for early-stage cervical cancer in the Korean population. Unlike the results seen in Japanese populations, adjuvant treatment benefited higher-risk patients in terms of DFS.

Objective: To investigate the appropriate timing of radiotherapy (RT) after hysterectomy in women with early-stage endometrial cancer (EC).

Methods: We analyzed the data of 1,062 patients with early-stage EC who underwent postoperative RT at our hospital between April 1999 and November 2020. Restricted cubic spline were used to explore the relationship between the surgery-radiotherapy interval (SRI) and local recurrence-free survival (LRFS). The maximally selected rank statistics method was used to identify the optimal threshold for SRI. The overall survival (OS), disease-free survival (DFS), LRFS, and distant metastasis-free survival (DMFS) rates were estimated using the Kaplan-Meier method. Multivariate analysis was performed using the Cox proportional hazards regression.

Results: In entire cohort, patients with SRI ≥42 days had worse survival. In multivariate analysis, SRI was an independent prognostic factor for OS (p=0.011), DFS (p=0.019), LRFS (p=0.013) and DMFS (p=0.050). However, in piecewise Cox regression, the significance of SRI for DMFS disappeared. In the subgroup analysis, the optimal cut-off value for SRI in the high-intermediate risk (HIR) and high-risk (HR) groups was 33 days. Multivariate analysis showed that SRI was an independent prognostic factor only for LRFS (p=0.033) and marginally associated with OS (p=0.055).

Conclusion: The timing of postoperative RT is crucial in patients with early-stage EC. Adjuvant RT should be initiated as soon as the vaginal cuff is healed, while for HIR and HR patients, it should be initiated within 33 days.

The landscape of gynecologic cancer management has continued to evolve substantially in 2025, driven by major clinical advances spanning surgical, radiation, and systemic therapies. Recent progress in precision oncology has expanded therapeutic options beyond the BRCA era. Immune checkpoint inhibitors have become integral components of treatment for selected gynecologic malignancies characterized by distinct molecular and histopathologic features, while novel biomarker-driven approaches continue to refine patient selection. In addition, antibody-drug conjugates, which combine tumor-targeted antibodies with cytotoxic payloads, have emerged as a promising therapeutic class, demonstrating encouraging antitumor activity across multiple disease settings. In an effort to overcome the limitations of novel single-agent therapies, clinical research has increasingly focused on combination strategies based on mechanistic rationale. In parallel, advances in surgical and radiation techniques have emphasized functional preservation and improvements in quality of life while maintaining oncologic outcomes. In this review, we summarize the most noteworthy research advances reported in 2025 and discuss their potential implications for future directions in the treatment of gynecologic cancers.

Objective: To investigate the patterns of human papillomavirus (HPV) genotype distribution and identify high-risk factors for HPV infection, focusing on their etiological significance and potential public health implications.

Methods: This study enrolled 496 women from the Gynecology Outpatient Department of Wuhan Central Hospital between September 2021 and September 2024. Data were collected through medical records and questionnaire surveys to analyze the distribution characteristics of HPV infection. High-risk factors were evaluated using multivariate binary logistic regression analysis.

Results: HPV infection exhibited the highest infection rate among women ≤25 years (63.5%) and ≥49 years (55.0%), with the most common types of high-risk HPV being HPV52, 16, and 58. Protective factors included frequent condom use (odds ratio [OR]=0.580) and HPV vaccination (OR=0.564). High-risk factors included diabetes (OR=6.620), anxiety (OR=2.126), and low work intensity (OR=1.670).

Conclusion: This study demonstrated diabetes, anxiety, and low work intensity as significant risk factors for HPV infection, providing valuable etiological insights. Psychological assessments and diabetes management should be integrated into public health strategies for HPV prevention. Furthermore, multidisciplinary collaboration among gynecologists, psychologists, and endocrinologists, is also recommended to prevention and care efforts.

Objective: Cervical, uterine, and ovarian cancers are the 3 main cancers of the female reproductive system. Analyzing data from the cancer registry database will help understand the situation and trends of these diseases.

Methods: This study utilized data from Thailand's population-based cancer registries covering 16 provinces across 5 geographic regions between 2019 and 2021. Data collection included demographic characteristics, cancer incidence, histopathology, disease stage, and survival outcomes. Incidence rates were calculated using age-standardized rates (ASRs) per 100,000 population, and 5-year survival outcomes were compared across 2 time periods (2013-2017 vs. 2018-2022).

Results: During 2019-2021, Thailand recorded a mean annual ASR of 132.9 for females, with cervical cancer remaining the most common gynecologic cancer. The incidence of cervical cancer decreased from 19.5 per 100,000 in 1995-2000 to 10.3 per 100,000 in 2019-2021. Uterine cancer demonstrated a rising trend, from 3.6 per 100,000 in 2004-2006 to 6.1 per 100,000 in 2019-2021, while ovarian cancer incidence remained relatively stable at 5.9 per 100,000. Five-year survival rates improved significantly across all gynecologic cancers in 2018-2022 compared with 2013-2017. The hazard ratios for overall survival by stage ranged from 0.57 to 0.81 for cervical, 0.53 to 0.82 for uterine, and 0.57 to 0.81 for ovarian cancers (all p<0.05).

Conclusion: The incidence of cervical cancer in Thailand has declined over the past 2 decades, while the burdens of uterine and ovarian cancers are increasing. Five-year survival rates have significantly improved across all gynecologic cancer types.

Background: For patients with high-risk factors such as pelvic lymph node metastasis, positive surgical margins, or parametrial involvement, concurrent chemoradiotherapy (CCRT) with whole-pelvic radiotherapy significantly improves survival outcomes. Hypofractionated radiation therapy, which delivers higher radiation doses over fewer sessions, enhances tumor control but raises concerns about increased normal tissue toxicity. A recent Korean phase II study (POHIM-CCRT) evaluated the safety of hypofractionated intensity-modulated radiation therapy (IMRT), delivering 40 Gy in 16 fractions with weekly cisplatin following radical surgery. The results showed minimal acute toxicity. Based on these findings, the present study was designed to assess the oncologic efficacy of hypofractionated CCRT compared to conventional treatment strategies in high-risk cervical cancer patients after radical surgery.

Methods: The POHIM-P3 trial is a phase 3, randomized, multicenter study designed for women with cervical cancer requiring adjuvant CCRT after radical hysterectomy. Participants in the experimental arm receive hypofractionated IMRT to whole pelvis, delivering a total dose of 40 Gy in 16 fractions, and the control arm receive conventional radiotherapy with a total dose of 45-50.4 Gy in 25-28 fractions in combination with weekly cisplatin. The primary endpoint of the study is the 3-year disease-free survival and the secondary endpoints included acute and late side-effects, local control rates, and overall survival rates.

Trial registration: ClinicalTrials.gov Identifier: NCT06509724.