Journal of Obstetrics and Gynaecology Research最新文献_第7页

Fertility Preservation in Extramedullary Plasmacytoma of the Uterine Cervix: Global Literature Synthesis and First Case From Iran 宫颈髓外浆细胞瘤的生育能力保存：全球文献综合和伊朗首例病例。

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-11-06 DOI: 10.1111/jog.70130

Farideh Akbari, Raziyeh Vejdani, Shabnam Yaghoubi-Kondelaji, Fatemeh Zarghami, Sevil Ghaffarzadeh-Rad, Amir Vahedi, Leila Namvar

Aim

Extramedullary plasmacytoma (EMP) most commonly arises in the head and neck, with exceedingly rare involvement of the uterine cervix. Only 16 published cases of cervical EMP have been reported since 1949. This study presents the first documented case from Iran and synthesizes all reported cases to analyze clinical patterns, diagnostic pitfalls, and management strategies.

Methods

A 32-year-old Iranian woman presented with postcoital bleeding after years of intermittent spotting. Comprehensive workup in March 2024, excluded multiple myeloma. Due to her desire for pregnancy, she declined hysterectomy and radiotherapy and underwent cervical conization in June 2024, with concurrent endocervical and endometrial sampling. We also conducted a systematic review of all published cervical EMP cases.

Results

Our analysis of 16 published cervical EMP cases (including present case) demonstrates that clinical presentations are nonspecific, commonly postcoital bleeding or abnormal Pap smears, often leading to initial misdiagnosis. Treatment was highly individualized: 9 patients underwent surgery, 6 received radiotherapy (± surgery), and outcomes were generally favorable. Notably, fertility-sparing conization alone was associated with disease-free survival in three young patients, including ours, supporting the feasibility of fertility-sparing strategies under strict surveillance.

Conclusions

This case contributes critical evidence that organ-sparing management can be oncologically appropriate. Cervical EMP should be considered in differential diagnosis of atypical cervical lesions. In the absence of standardized guidelines, management must be tailored to patient values and anatomical context, not based on general EMP guidelines. Continued reporting of well-documented cases is critical to refine prognostic and therapeutic insights for this ultra-rare entity.

目的：髓外浆细胞瘤（EMP）最常见于头颈部，极少累及子宫颈。自1949年以来，仅报道了16例宫颈电磁脉冲。本研究提出了伊朗的第一个记录病例，并综合了所有报告的病例来分析临床模式、诊断缺陷和管理策略。方法：一名32岁的伊朗妇女在多年间歇性点滴出血后出现性交后出血。2024年3月全面检查，排除多发性骨髓瘤。由于怀孕的愿望，她谢绝了子宫切除术和放疗，并于2024年6月行宫颈锥切术，同时行宫颈腔和子宫内膜取样。我们还对所有已发表的宫颈EMP病例进行了系统回顾。结果：我们对16例已发表的宫颈EMP病例（包括本病例）的分析表明，临床表现是非特异性的，通常是性交后出血或子宫颈抹片检查异常，经常导致最初的误诊。治疗高度个体化：9例患者接受手术，6例接受放疗（±手术），结果普遍良好。值得注意的是，在包括我们在内的3名年轻患者中，仅保留生育能力的锥化术与无病生存率相关，这支持了在严格监测下保留生育能力策略的可行性。结论：本病例为器官保留治疗在肿瘤学上是合适的提供了重要证据。宫颈EMP在非典型宫颈病变的鉴别诊断中应予以考虑。在缺乏标准化指南的情况下，管理必须根据患者的价值和解剖情况量身定制，而不是基于一般的EMP指南。持续报道充分记录的病例对于改善这种超罕见实体的预后和治疗见解至关重要。

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引用次数: 0

Women's Health Care Committee, Japan Society of Obstetrics and Gynecology: Annual Report 2025 日本妇产科学会妇女保健委员会：《2025年年度报告》。

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-11-06 DOI: 10.1111/jog.70110

Tsuyoshi Higuchi, Takeshi Iwasa

The Women's Health Care Committee was established in 2010 to improve women's health. In the current academic year, this committee has established seven subcommittees aimed at understanding diseases related to various age groups of women, including adolescence, sexual maturity, and menopause, and at promoting research to improve quality of life. Socially significant research has focused on infections, particularly those caused by resistant bacteria. The activities of each subcommittee are described below. This report is based on the Japanese version of the annual report (Acta Obstetrica et Gynaecologica Japonica 2024; 76 (6): 682–687).

妇女保健委员会于2010年成立，旨在改善妇女的健康状况。在本学年，该委员会设立了七个小组委员会，旨在了解与不同年龄组妇女有关的疾病，包括青春期、性成熟期和更年期，并促进提高生活质量的研究。具有社会意义的研究集中在感染上，特别是由耐药细菌引起的感染。各小组委员会的活动说明如下。本报告基于年度报告的日文版本（Acta Obstetrica et gynajaponica 2024; 76(6): 682-687）。

引用次数: 0

Disseminated Herpes Simplex Virus in Pregnancy: A Systematic Review of Cases 妊娠期播散性单纯疱疹病毒：病例的系统回顾

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-11-05 DOI: 10.1111/jog.70115

Bethany Harrison, Emily Clarke

Background

Disseminated herpes simplex virus (HSV) is more common in pregnancy and has a high mortality and morbidity. It is a rare disease, inconsistently addressed by national guidelines and lacking high-quality data to guide decision making.

Objectives

This systematic review of cases of disseminated HSV in pregnant and postpartum adults aims to determine the clinical features, diagnostic methods, and maternal survival rate with and without aciclovir.

Search Strategy

A search of MEDLINE, EMBASE and Google was undertaken.

Selection Criteria

Studies were included if they were published in English, were case reports, case series, trials or literature reviews, reported data from people assigned female at birth, and were pregnant or postpartum with a laboratory-confirmed diagnosis of disseminated HSV.

Data Collection and Analysis

Two reviewers independently screened studies, extracted data on participant and intervention characteristics using a standardized Excel template, and assessed risk of bias.

Main Results

A total of 114 cases were analyzed from 109 papers (1966–2024). 104 cases (91.2%) reported from high-income countries. Most patients were in the third trimester (n = 62, 54.4%) and had HSV-2 (n = 58, 66.7%). Clinical features were non-specific: fever (n = 99, 86.8.0%), deranged liver function tests (n = 81, 71.1%), neuropsychiatric symptoms (n = 72, 63.2%), gastrointestinal symptoms (n = 72, 63.2%). Antemortem diagnosis occurred in 89.5% (n = 102). Maternal survival rate with aciclovir was 0.88 (95% CI: 0.80–0.94) and without was 0.42 (95% CI: 0.25–0.59).

Conclusions

A high index of suspicion is required for diagnosis due to non-specific clinical features. Mandatory reporting and inclusion of disseminated HSV in sepsis guidelines are recommended.

背景：播散性单纯疱疹病毒（HSV）在妊娠期更为常见，死亡率和发病率都很高。这是一种罕见疾病，国家指南不一致，缺乏指导决策的高质量数据。目的：对孕妇和产后成人播散性HSV病例进行系统回顾，旨在确定使用和不使用阿昔洛韦的临床特征、诊断方法和孕产妇生存率。检索策略：检索MEDLINE、EMBASE和谷歌。选择标准：纳入以英文发表的研究，包括病例报告、病例系列、试验或文献综述，报告的数据来自出生时被指定为女性的人，以及经实验室确诊为播散性单纯疱疹病毒的孕妇或产后。数据收集和分析：两位审稿人独立筛选研究，使用标准化Excel模板提取参与者和干预特征数据，并评估偏倚风险。主要结果：共分析109篇文献（1966 ~ 2024年）114例。高收入国家报告104例（91.2%）。大多数患者在妊娠晚期（n = 62, 54.4%），感染HSV-2 （n = 58, 66.7%）。临床特征无特异性：发热（n = 99, 86.8.0%），肝功能检查紊乱（n = 81, 71.1%），神经精神症状（n = 72, 63.2%），胃肠道症状（n = 72, 63.2%）。死前诊断率为89.5% （n = 102）。服用阿昔洛韦的母亲存活率为0.88 (95% CI: 0.80-0.94)，未服用阿昔洛韦的母亲存活率为0.42 （95% CI: 0.25-0.59）。结论：临床特征不明确，诊断时需高度怀疑。建议在败血症指南中强制报告和纳入传播性单纯疱疹病毒。

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引用次数: 0

Vesicouterine Fistula During Pregnancy: Case Report and Systematic Literature Review on Clinical Characteristics, Management, and Outcomes 妊娠期膀胱外瘘：病例报告及临床特征、处理和结局的系统文献综述。

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-11-03 DOI: 10.1111/jog.70127

Erica Trimarchi, Martina Stringari, Filippo Migliorini, Anna Festi, Pier Carlo Zorzato, Mariachiara Bosco, Simone Garzon, Alessandro Antonelli, Stefano Uccella

Background

This study presents a case of vesicouterine fistula (VUF) diagnosed during pregnancy and offers a systematic review to identify clinical guidance for managing this rare but serious obstetric complication.

Methods

We performed a systematic review of international databases from inception to May 2025, including studies on VUF diagnosed during pregnancy regardless of obstetric outcome. Studies on other genitourinary fistulas, non-pregnant women, or extrauterine pregnancies were excluded. No study design restrictions were applied.

Results

Twenty-two VUF cases with primary intrauterine implantation during pregnancy were identified, including one from our center. All had prior cesarean delivery (100%). Fourteen fetuses (63.6%) died, one pregnancy (4.5%) was terminated surgically, and seven (31.8%) resulted in live births. Conservative treatment included antibiotics and bladder catheterization. Among viable cases: two full-term (9.1%), one preterm (32–34 weeks, 4.5%), and four preterm (< 32 weeks, 18.2%).

Conclusion

Available evidence on VUF during pregnancy consists solely of case reports. Gestational age and fetal viability are key factors in guiding treatment (expectant management versus intervention). This review underscores the risk of complications and highlights the need for careful evaluation in women with risk factors, especially those with urinary or menstrual symptoms following cesarean delivery.

背景：本研究报告了一例妊娠期间诊断的膀胱外瘘（VUF），并提供了一个系统的回顾，以确定治疗这种罕见但严重的产科并发症的临床指导。方法：我们对国际数据库进行了系统回顾，从建立到2025年5月，包括怀孕期间诊断的VUF研究，无论产科结局如何。排除了其他泌尿生殖系统瘘、非孕妇或宫外妊娠的研究。没有应用研究设计限制。结果：共发现22例伴有妊娠期原发性宫内着床的VUF病例，其中1例来自本中心。所有患者均有剖宫产史（100%）。14例（63.6%）胎儿死亡，1例（4.5%）终止妊娠，7例（31.8%）活产。保守治疗包括抗生素和膀胱导尿。在可存活的病例中：2例足月（9.1%），1例早产（32-34周，4.5%），4例早产(结论：妊娠期间VUF的现有证据仅包括病例报告。胎龄和胎儿生存能力是指导治疗的关键因素（期望管理与干预）。本综述强调了并发症的风险，并强调了对有危险因素的妇女进行仔细评估的必要性，特别是那些在剖宫产后出现尿路或月经症状的妇女。

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引用次数: 0

Hysteroscopic Removal of IUD During First Trimester Pregnancy: A Minimally Invasive Option 在妊娠早期宫腔镜下取出宫内节育器：一种微创选择。

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-11-02 DOI: 10.1111/jog.70129

Erdal Seker, Hatun Çolak

İntrauterine device (IUD) failure leading to conception is a rare occurrence. When pregnancy is desired to continue in such cases, and the IUD strings are not visible, the risks to the gestation significantly increase. We report a case involving a patient who conceived with an IUD in situ and elected to continue the pregnancy. In this instance, a hysteroscopic IUD removal was performed. This case highlights that for pregnancies resulting from IUD failure, timely hysteroscopic removal of the device can be a critical intervention that may positively impact the pregnancy prognosis and outcomes.

İntrauterine节育器（IUD）失败导致受孕是罕见的。在这种情况下，如果希望继续妊娠，并且看不到宫内节育器串，则妊娠风险显着增加。我们报告一个病例，涉及一个病人怀孕与宫内节育器在原位和选择继续妊娠。本例采用宫腔镜取出宫内节育器。本病例强调，对于宫内节育器失败导致的妊娠，及时宫腔镜取出节育器可能是一项重要的干预措施，可能对妊娠预后和结局产生积极影响。

引用次数: 0

Prenatal Diagnosis of a Rare Congenital Right Subclavian Artery–Superior Vena Cava Fistula 罕见先天性右锁骨下动脉-上腔静脉瘘的产前诊断

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-10-29 DOI: 10.1111/jog.70125

Linhua Yang, Li Hou, Hui He, Liuying Zhou

The right subclavian artery (RSA)–superior vena cava (SVC) fistula represents a rare arteriovenous fistula characterized by abnormal vascular channels connecting the arterial and venous systems. This report describes the first prenatal diagnosis of an RSA–SVC fistula. Differentiation from supracardiac total anomalous pulmonary venous connection (TAPVC) is challenging; however, three indirect indicators may aid differentiation: simultaneous dilation of the innominate artery and SVC, bi-directional flow within the aortic arch, and a bi-phasic, unidirectional, spiculated flow pattern at the confluence. Timely prenatal diagnosis serves as a vital tool for clinicians and families, paving the way for timely postpartum interventions while significantly enhancing postnatal prognoses.

右锁骨下动脉(RSA) -上腔静脉（SVC）瘘是一种罕见的动静脉瘘，其特征是连接动脉和静脉系统的异常血管通道。本报告描述了第一次产前诊断的RSA-SVC瘘。与心上全异常肺静脉连接（TAPVC）的鉴别是具有挑战性的；然而，三个间接指标可能有助于鉴别：无名动脉和SVC的同时扩张，主动脉弓内的双向血流，以及汇合处的双相、单向、针状血流模式。及时的产前诊断是临床医生和家庭的重要工具，为及时的产后干预铺平了道路，同时显著提高了产后预后。

引用次数: 0

Correction to “Pregnancy-Specific Reference Intervals for Complete Blood Count Parameters in a Japanese Cohort” 更正“日本队列全血细胞计数参数的妊娠特异性参考区间”

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-10-29 DOI: 10.1111/jog.70113

K. Kawakami, R. Shimokawa, F. Saito, A. Sagara, S. Yoshimura, Y. Iwagoi, et al., “Pregnancy-Specific Reference Intervals for Complete Blood Count Parameters in a Japanese Cohort,” Journal of Obstetrics and Gynaecology Research 51, no. 7 (2025): e70011, https://doi.org/10.1111/jog.70011.

We apologize for this error.

FIGURE 3    |    Hematological changes across body mass index. Statistical significance is indicated as follows: ns, not significant; *p < 0.05; **p < 0.01; ***p < 0.001. If no other significance level is indicated, ****p < 0.0001.

FIGURE 3    |    (continued).

FIGURE 4    |    Age-related changes in complete blood count parameters during pregnancy. Statistical significance is indicated as follows: *p < 0.05, **p < 0.01, ***p < 0.001, ****p < 0.0001.

FIGURE 4    |    (continued).

K. Kawakami， R. Shimokawa， F. Saito, a . Sagara， S. Yoshimura， Y. Iwagoi等，“日本队列全血细胞计数参数的妊娠特异性参考区间”，《妇产科研究杂志》第51期。7 (2025): e70011, https://doi.org/10.1111/jog.70011.We对此错误道歉。图3    |    身体质量指数的血液学变化。统计显著性表示如下：ns，不显著；*p < 0.05；**p < 0.01；***p < 0.001。如果没有其他显著性水平，****p < 0.0001。图3     |    ( 继续)。图4    |    妊娠期间全血细胞计数参数与年龄相关的变化。统计学意义为：*p <； 0.05, **p < 0.01, **p < 0.001, ****p < 0.0001。图4     |    ( 继续)。

引用次数: 0

Annual Report of the Committee on Gynecologic Oncology, the Japan Society of Obstetrics and Gynecology: Annual Patient Report for 2022 and Annual Treatment Report for 2017 日本妇产科学会妇科肿瘤委员会年度报告：2022年年度患者报告和2017年年度治疗报告

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-10-29 DOI: 10.1111/jog.70124

Hiroaki Kajiyama, Satoshi Tamauchi, Fumiaki Takahashi, Toyomi Satoh, Board Members of the 2025 Committee on Gynecologic Oncology of the Japan Society of Obstetrics and Gynecology

Aim

To provide information including the trend of gynecological malignancies in Japan, we hereby present the Annual Patient Report for 2022 and the Annual Treatment Report for 2017, on the outcomes of patients who started treatment in 2017.

Methods

The Japan Society of Obstetrics and Gynecology maintains an annual tumor registry, where information on gynecological malignancies from various participating institutions is gathered. The data of patients whose treatment with gynecologic malignancies was initiated in 2022 were analyzed retrospectively. Survival of the patients who started treatment with cervical, endometrial, and ovarian cancer in 2017 was analyzed by using the Kaplan–Meier, log–rank, and Wilcoxson tests.

Results

Treatment was initiated in 2022 for 8039 patients with cervical cancer, 14 518 with endometrial cancer, 8524 with ovarian, tubal, and peritoneal cancer, 2360 with ovarian borderline tumors, and with the others (270 vulvar cancer, 179 vaginal cancer, 539 uterine sarcoma, 48 uterine adenosarcoma, 158 trophoblastic diseases). This clinicopathological information was summarized as the Patient Annual Report. The 5-year survival rates of the patients who initiated treatment in 2017 were as follows. For cervical cancer, the rates were 93.0%, 76.1%, 59.5%, and 28.3% for Stages I, II, III, and IV, respectively. For endometrial cancer, the rates were 94.9%, 88.8%, 72.7%, and 28.9% for Stages I, II, III, and IV, respectively. For ovarian cancer, the rates were 91.7%, 76.6%, 54.4%, and 45.2% for Stages I, II, III, and IV, respectively.

Conclusion

The annual tumor report is an important survey that provides knowledge on gynecological malignancy trends in Japan.

为了提供包括日本妇科恶性肿瘤趋势在内的信息，我们特此发布《2022年年度患者报告》和《2017年年度治疗报告》，介绍2017年开始治疗的患者的结果。方法日本妇产科学会每年进行肿瘤登记，收集来自各参与机构的妇科恶性肿瘤信息。回顾性分析我院2022年开始妇科恶性肿瘤治疗的患者资料。2017年开始接受宫颈癌、子宫内膜癌和卵巢癌治疗的患者的生存期通过Kaplan-Meier、log-rank和Wilcoxson检验进行分析。结果2022年开始治疗宫颈癌8039例，子宫内膜癌14518例，卵巢癌、输卵管癌和腹膜癌8524例，卵巢交界性肿瘤2360例，其他（外阴癌270例，阴道癌179例，子宫肉瘤539例，子宫腺肉瘤48例，滋养细胞疾病158例）。这些临床病理信息被总结为患者年度报告。2017年开始治疗的患者5年生存率如下：至于子宫颈癌，第一、二、三、四期的发病率分别为93.0%、76.1%、59.5%和28.3%。对于子宫内膜癌，I期、II期、III期和IV期的发生率分别为94.9%、88.8%、72.7%和28.9%。对于卵巢癌，I期、II期、III期和IV期的发病率分别为91.7%、76.6%、54.4%和45.2%。结论年度肿瘤报告是了解日本妇科恶性肿瘤发展趋势的重要调查资料。

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引用次数: 0

Incidence, Risk Factors, and Outcomes of Complete Uterine Rupture: A 10-Year Single-Center Retrospective Study 完全性子宫破裂的发生率、危险因素和结局：一项10年单中心回顾性研究

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-10-29 DOI: 10.1111/jog.70122

Zhexia Hu, Hong Zhang, Yun Rong, Biyun Luo, Mengjia Wang, Xueling Zhang, Tianhong Gao

Objective

This study aims to analyze the incidence, risk factors, clinical presentations, and maternal-perinatal outcomes of complete uterine rupture at a major tertiary hospital in China over a decade.

Methods

We conducted a single-center retrospective cohort study of all women who delivered at our hospital, from March 2012 to February 2022. Cases of complete uterine rupture, defined as a full-thickness tear of the uterine wall confirmed intraoperatively, were identified. Data on demographics, obstetric history, clinical manifestations, management, and outcomes were extracted and analyzed using descriptive statistics.

Results

Out of 232,563 total deliveries, 38 cases of complete uterine rupture were confirmed, yielding an incidence of 0.016% (1.6 per 10,000 deliveries). The median maternal age was 31 years (range, 23–38), and the median gestational age at rupture was 36⁺⁴ weeks (range, 13⁺⁶–40⁺⁶). A prior uterine scar was the predominant risk factor, present in 32 cases (84.2%), primarily from previous cesarean sections. Rupture occurred in unscarred uteri in 6 cases (15.8%). Clinical presentation was highly variable: acute abdominal pain was the most common symptom (n = 20, 52.6%), followed by vaginal bleeding (n = 8, 21.1%) and fetal heart rate abnormalities (n = 10, 26.3%). Notably, 8 patients (21.1%) were asymptomatic, with the rupture discovered incidentally during elective cesarean section. Maternal morbidity was significant, although all mothers survived; however, the perinatal mortality rate was high at 27.5% (11 of 40 fetuses/newborns). Thirty-seven (97.4%) patients underwent uterine repair, and one (2.6%) required a hysterectomy.

Conclusion

A prior uterine scar is the leading risk factor for complete uterine rupture. However, the heterogeneous clinical presentation, including a significant proportion of asymptomatic cases, poses a major diagnostic challenge. A high index of suspicion is crucial for timely intervention to mitigate adverse maternal and perinatal outcomes.

目的分析国内某大型三级医院近十年来完全性子宫破裂的发生率、危险因素、临床表现及母婴结局。方法对2012年3月至2022年2月在我院分娩的所有妇女进行单中心回顾性队列研究。病例完全子宫破裂，定义为全层撕裂子宫壁确认术中，被确定。提取人口统计学、产科史、临床表现、管理和结局的数据，并使用描述性统计进行分析。结果232,563例分娩中，子宫完全破裂38例，发生率为0.016%（1.6 / 10000例）。产妇的中位年龄为31岁（范围23-38），破裂时的中位胎龄为36+4周（范围13+6 - 40+6）。既往子宫瘢痕是主要危险因素，32例（84.2%），主要来自既往剖宫产手术。无瘢痕子宫破裂6例（15.8%）。临床表现差异很大：急性腹痛是最常见的症状（n = 20, 52.6%），其次是阴道出血（n = 8, 21.1%）和胎儿心率异常（n = 10, 26.3%）。值得注意的是，8例（21.1%）患者无症状，破裂是在择期剖宫产术中偶然发现的。尽管所有母亲都存活了下来，但产妇发病率很高；然而，围产期死亡率高达27.5%（40个胎儿/新生儿中有11个）。37例（97.4%）患者行子宫修复术，1例（2.6%）患者行子宫切除术。结论子宫瘢痕是导致子宫完全破裂的主要危险因素。然而，异质性的临床表现，包括相当大比例的无症状病例，构成了一个主要的诊断挑战。高怀疑指数对于及时干预以减轻不利的孕产妇和围产期结局至关重要。

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引用次数: 0

Efficacy and Safety of Concurrent Chemoradiotherapy as First-Line Treatment for Stage IVB Cervical Cancer: A Single-Center Retrospective Observational Study 同步放化疗作为IVB期宫颈癌一线治疗的疗效和安全性：一项单中心回顾性观察研究

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-10-29 DOI: 10.1111/jog.70119

Yumi Ishidera, Takayoshi Iijima, Masahiro Aichi, Yuki Ogawara, Yuichi Imai, Madoka Sugiura, Masaharu Hata, Etsuko Miyagi, Taichi Mizushima

Aim

To evaluate the efficacy and safety of concurrent chemoradiotherapy prior to systemic chemotherapy in patients with stage IVB cervical cancer.

Methods

This retrospective observational study included 40 patients diagnosed with stage IVB cervical cancer who received concurrent chemoradiotherapy as first-line therapy at the Yokohama City University Hospital between 2007 and 2021. The evaluated outcomes included concurrent chemoradiotherapy response rate, chemotherapy initiation rate, adverse events, and overall survival.

Results

The disease control rate of concurrent chemoradiotherapy was 72.5%, with no significant differences across the subgroups defined by the number of metastatic sites, presence of out-of-field lesions, parenchymal involvement, or histological subtype. Systemic chemotherapy was initiated in 89% of the patients, with a median interval of 39 days after concurrent chemoradiotherapy completion, except in one patient (3.6%) due to disease progression. Including recurrent cases, 91% of patients ultimately received systemic chemotherapy. Grade 3 or higher toxicity that significantly delayed chemotherapy initiation occurred in only one patient (3.6%). The median overall survival was 23 months, with no significant differences based on lesion distribution, parenchymal involvement, histological subtype, or metastatic burden.

Conclusions

Concurrent chemoradiotherapy may be a feasible first-line treatment option for stage IVB cervical cancer with manageable toxicity, acceptable disease control, and the potential to allow a timely transition to systemic chemotherapy.

目的评价IVB期宫颈癌患者全身化疗前同步放化疗的疗效和安全性。方法本回顾性观察研究纳入了40例诊断为IVB期宫颈癌的患者，这些患者于2007年至2021年间在横滨市立大学医院接受同步放化疗作为一线治疗。评估的结果包括同步放化疗反应率、化疗起始率、不良事件和总生存率。结果同步放化疗的疾病控制率为72.5%，在转移部位数量、有无场外病变、实质受损伤或组织学亚型的亚组之间无显著差异。89%的患者开始了全身化疗，在同步放化疗完成后的中位间隔为39天，除了一名患者（3.6%）由于疾病进展。包括复发病例在内，91%的患者最终接受了全身化疗。3级或更高毒性显著延迟化疗起始仅发生在1例患者中（3.6%）。中位总生存期为23个月，基于病变分布、实质受累、组织学亚型或转移负担无显著差异。结论同步放化疗可能是IVB期宫颈癌的一种可行的一线治疗选择，其毒性可控，疾病控制可接受，并有可能及时过渡到全身化疗。

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引用次数: 0