Gynecologic Cancer Research Articles

Ovarian and endometrial cancers frequently harbor a mutation in the tumor suppressor gene TP53, which occurs in over 90 % of ovarian cancers and in the most aggressive endometrial cancers. The normal tumor suppressive functions of p53 are disrupted, resulting in unregulated cell growth and therapeutic resistance to standard treatments including chemotherapy and PARP inhibitors. Hence, a novel therapeutic strategy is urgently needed for p53 mutant gynecologic cancers, and we propose that converting mutant p53 to a wild type conformation and restoring its tumor suppressive functions has the potential to greatly improve treatment. In this study, we investigated the effects of two purported p53 reactivators, HO-3867 and APR-246, on cell proliferation via half-maximal inhibitory concentration (IC50) analyses using CyQUANT DNA measurements, tumor growth in vivo and gene expression by bulk RNA sequencing in gynecologic cancer cell lines that harbor oncogenic mutations in p53. We also tested these compounds in combination with the PARP inhibitor olaparib. We found that HO-3867 was very effective in inhibiting growth, with IC50 values in the low micromolar range. Importantly, HO-3867 was synergistic with olaparib treatment in five cell lines studied in vitro as well as in vivo in a xenograft model of high grade serous ovarian cancer. RNA sequencing data suggest that HO-3867 is acting through both p53-independent and p53-dependent pathways resulting in inhibition of DNA repair pathways including homologous recombination in p53 mutant cancer cells. Significance: The development of resistance to PARP inhibitors is a major problem and a cause of treatment failures in advanced gynecologic cancers, and we show that adding a p53 reactivator such as HO-3867 enhances the efficacy of PARP inhibitors in p53-mutant cancer models.

Obesity is closely linked to an increased incidence of several gynecological conditions and poses significant challenges to their surgical management. Among these, endometrial cancer stands out due to its high prevalence in patients with elevated body mass index, with nearly 60% of those requiring primary surgical treatment classified as obese or morbidly obese. The coexistence of multiple comorbidities in this population contributes to a heightened risk of perioperative and postoperative complications. Robotic-assisted surgery has emerged as a key advancement in minimally invasive gynecologic procedures, offering meaningful clinical advantages over conventional laparoscopy. These include decreased intraoperative blood loss, reduced complication rates, and shorter recovery times. Such benefits are particularly advantageous in obese patients, where robotic techniques are associated with significantly lower rates of conversion to laparotomy. Nonetheless, the surgical care of these patients remains complex and requires the coordinated expertise of seasoned surgical and anesthetic teams. The aim of this review is to provide evidence-based tips and techniques for performing successful minimally invasive robotic-assisted procedures in obese patients. This paper will review current evidence on: (1) operating room setup and patient preparation; (2) robotic port placement strategies; (3) pneumoperitoneum establishment and physiological considerations; (4) intraoperative techniques and (5) practical solutions for addressing challenges in retroperitoneal staging.

The transversal specialized formation (TSF) in oncology has been enabling non-oncologist physicians to acquire oncology skills for five years. This study aims to assess the TSF for medical gynecology residents. A 23-item questionnaire was sent to physicians from the specialized medical degree (SMD) in medical gynecology who completed the TSF between 2020 and 2023. The data were analyzed using Student's t-tests, Fischer tests, and Chi2 tests. Of the 22 residents identified, 20 (90.9%) responded to the questionnaire. Nine residents (40.9%) were from the Paris region. The reasons for undertaking the TSF included interest in gynecological and breast cancers (81.8%), clinical richness (50.0%), and scientific dynamism (50.0%). Of the 11 respondents who had completed the SMD or had a defined post-residency project, all reported working in a hospital setting. The main activity was gyneco-oncology (n=6, 55.0%), including sexology, monitoring at-risk women, post-cancer care, and medical oncology (n=5, 45.0%). The average satisfaction with the TSF was 7.2/10, with no significant regional difference (P=0.62). Suggested areas for improvement included harmonizing theoretical courses, offering specialized internships in gynecological oncology, and providing mentorship. Five years after its implementation, medical gynecologists are satisfied with the TSF in oncology. The main requests are for strengthening national courses and expanding the range of internships, all focused on the original specialty.

Cervical cancer is the fourth most common type of cancer in women worldwide. Its incidence and mortality have been declining in Germany since 1971, when cervical cancer screening began to be offered to all women in the German statutory health care system. In this study, we examine the trends in incidence and survival since 2003. We analyzed data from the epidemiological cancer registries of 10 German federal states concerning the incidence of cervical cancer (ICD-10 C53) from 2003 to 2021. The data, obtained via the Center for Cancer Registry Data at the Robert Koch Institute, were classified according to tumor stage, histological subtype, histopathological grade, and patient age. Survival rates were calculated with Cox regression models. During the study period, the mean age at diagnosis was 53.5 years. The 5-year overall survival rate did not change (2003 and 2017: 65.4% in both years). The age-standardized incidence of squamous cell carcinoma declined from 11.5 per 100 000 women in 2003 to 7.7 per 100 000 in 2021. 25.4% of women with the disease were ≥ 65 years old; compared to younger women, they more often had stage T3 and T4 disease and grade G3 tumors, and their 5-year survival rate was lower. 10.8% of the women with cervical cancer were under 35 years old. The incidence fell most sharply in this age group, from 5.1 per 100 000 women per year in 2003 to 3.1 per 100 000 per year in 2021, and women in this age group were also the most likely to have stage T1a or T1b disease. The incidence of squamous cell carcinoma of the cervix declined most markedly in the youngest age group, and this may be attributable to vaccination against HPV. The 5-year survival rates have not changed. The impact on survival of the organized screening program and treatment in certified gynecological cancer centers remains to be seen.

Peutz-Jeghers syndrome in gynecological cancers: bibliometric trends, clinical insights, and future directions

Background Body image disturbances in breast and gynecological cancer survivors involve complex interrelationships between physical changes, sexuality, and self-esteem. Existing tools inadequately capture these multidimensional, cancer-specific concerns. This study developed and validated a Four-Dimensional Body Image Score for women with breast and gynecological Cancers (4D-BISC). Methods A cross-sectional study was conducted (March–April 2025) across six Tunisian healthcare facilities. Women presenting with gynecological or breast cancers were included. Participants completed the 16-item questionnaire (5-point Likert scale) derived from validated scales (the Female Sexual Function Index (FSFI) and the Body Esteem Scale for Adolescents and Adults (BESAA)) and cancer-specific items. Psychometric properties were assessed via exploratory/confirmatory factor analyses (EFA/CFA), Cronbach’s alpha (α), and correlations with established scales (FSFI, BESAA). Results In total, 101 participants were included. CFA confirmed a robust 4-factor structure: Appearance Concerns (α=0.704), Social Exposure (α=0.737), Sexual Desirability (α=0.918) and Self-Esteem (α=0.786). The global score demonstrated excellent reliability. Strong correlations emerged between body image factors and sexual function (e.g., Sexual Desirability and sexual desire: p=0.706 and p<0.001 respectively). Breast cancer patients reported significantly worse body image globally (p=0.003), particularly in social exposure (median=26.7) and sexual desirability (median=30). Marital status and socioeconomic status significantly influenced sexuality-related concerns and self-esteem (p<0.05). Conclusion The 4D-BISC is a psychometrically valid tool capturing cancer-specific body image dimensions. It highlights critical vulnerabilities among breast and gynecological cancers cancer patients- and provides a foundation for targeted psychosocial interventions.

The significant morbidity and mortality of gynecologic cancers places a substantial burden on global healthcare and creates an urgent need for new treatment modalities. Here, we explore the emerging role of nanoparticles in treating gynecologic cancers, specifically ovarian, cervical, and endometrial cancers. These diseases are often diagnosed after they have metastasized, developed multidrug resistance, and formed immunosuppressive tumor microenvironments, hampering the effectiveness of traditional debulking surgery and chemotherapy. We first discuss the gynecologic cancer-specific barriers to nanoparticle drug delivery, including systemic and off-target toxicity, peritoneal fluid shear and convective forces, stromal fibrosis, and immunosuppressive tumor microenvironments. We then comprehensively analyze how various nanoparticle drug delivery platforms, such as liposomes, ionizable lipid nanoparticles, and layer-by-layer nanoparticles, have been engineered preclinically to selectively target tumor cells and increase retention within tumor lesions. Additionally, we examine the application of nanoparticles in delivering nucleic acids and immunotherapies, which can heat up immunologically cold tumors and tumor microenvironments to restore antitumor immune function. Despite promising preclinical results, additional efforts are needed to optimize nanoparticle design and ensure safe and effective translation into the clinic for all gynecologic cancers, and we conclude by discussing potential solutions to these barriers. Overall, this review explores the latest preclinical studies and emerging frontiers in nanoparticle therapies for gynecologic cancers, with a focus on efforts to overcome the disease-specific delivery challenges to effectively treat these lethal diseases.

Novel anatomical concept and standardized technique for single-port Paraaortic lymphadenectomy in gynecological cancers.

Background/Objectives: Endometrioid ovarian cancer (EnOC) is a late-diagnosed gynecological cancer with limited diagnostic methods that, when detected at an early stage, has a good prognosis. This study is the first to evaluate the plasma concentrations and diagnostic utility of selected metalloproteinases as new biomarkers for EnOC. Methods: The study group consisted of 50 newly diagnosed, untreated patients with EnOC; the control group consisted of 25 patients with endometrial cysts, 25 patients with serous cysts, and 50 healthy women. Selected matrilysins and stromelysins were determined by means of immunoenzymatic assay (ELISA) and routine markers (CA125 and HE4) using the chemiluminescence (CMIA) method. Results: Higher levels of MMP-7, MMP-10, MMP-11, and MMP-26 were found in patients with EnOC when compared to healthy women. Concentrations of MMP-7, MMP-10, and MMP-11 were higher in women with EnOC when compared to benign lesions (BL). The highest SE (98.55%), NPV (95.41%), ACC (57.58%), and AUC (0.9658) values were obtained for MMP-7. High values of diagnostic parameters were also obtained for MMP-11 and MMP-26. Conclusions: These results suggest the usefulness of MMP-7, MMP-26, and MMP-11 in the diagnosis of EnOC as new biomarkers in this pilot study.

This study aimed to identify the clinical metabolic markers associated with gynecologic cancer (GC) by comparing machine learning (ML) algorithms with orthogonal partial least squares-discriminant analysis (OPLS-DA). Untargeted metabolomic analysis was performed on plasma from 42 patients with GC (24 cervical cancer [CC], 9 endometrial cancer [EC], and 9 ovarian cancer [OC]) and 57 healthy female participants. GC and healthy control groups were classified using OPLS-DA and 8 ML algorithms. The ML algorithm with the best classification performance was used to assess CC, EC, and OC with healthy subjects, and metabolite candidates involved in each GC were selected. Upon comparing the classification model performance between the GC and control groups, random forest (RF) model displayed the best performance with an area under the curve (AUC) of 0.9999. The multi-classification RF model was established to distinguish all 4 groups and was achieved an AUC of 0.8351. The AUCs of the 3 GC subgroup assessment RF models comparing patients with CC, EC, and OC with healthy subjects were 0.9838, 0.7500, and 0.7321, respectively. Plasma concentrations of 2 identified metabolites significantly increased in patients with GCs. Several ML algorithms were used to distinguish GC, showed better performance than conventional OPLS-DA. Proline betaine and lysophosphatidyl ethanolamine (18:0/0:0) selected in RF models were suggested as metabolite candidates associated with GCs.

The role of noncoding RNAs in rare gynecological cancers.

Nanocarrier drug delivery systems for gynecological cancer therapeutics.

BackgroundGynecologic cancers, including cervical, ovarian, and endometrial cancers, remain a significant global health challenge. In 2022, 9 175 141 new cancer cases were reported among females, with 1 473 427 (16.1%) attributed to gynecologic cancers, reflecting an incidence rate of 30.4 per 100 000. These cancers were responsible for 680 372 deaths, representing 15.9% of total female cancer mortality at a rate of 17.3 per 100 000. Identifying the drivers of incidence and mortality is critical for addressing disparities and advancing the United Nations Sustainable Development Goals (SDGs), particularly those targeting health equity and gender equality.ObjectiveTo identify and analyze the socioeconomic, healthcare, lifestyle, and environmental determinants driving gynecologic cancer incidence and mortality globally. The study leveraged a cluster‐based approach across 68 countries, representing 34.9% of global nations and spanning diverse geographic and economic contexts.MethodsEighty‐seven variables were analyzed using Principal Component Analysis (PCA), consolidating them into 17 key components that explained 74.4% of the total variance. These components informed a hierarchical clustering process that grouped countries into four profiles based on shared characteristics. Cluster‐specific backward regression models examined the influence of these components on standardized incidence and mortality rates (Adjusted Rate Standardized, ARS). Monte Carlo simulations validated projections, providing robust insights into disparities.ResultsThe study revealed significant cluster‐specific variability in factors influencing gynecologic cancer outcomes. Cluster 1 excelled in lifestyle‐driven cancer prevention, whereas systemic barriers in Cluster 4 necessitate urgent healthcare investment and policy reform. Intermediate clusters exhibited variability influenced by social stability, environmental health, and healthcare infrastructure. The analysis underscored disparities in key predictors such as HPV vaccination coverage, healthcare expenditure, public health policies, and access to preventive services.ConclusionsThis study highlights the importance of tailored, cluster‐specific strategies to reduce disparities in gynecologic cancer outcomes. Interventions should prioritize equitable access to preventive care, lifestyle modifications, and healthcare investments, particularly in resource‐constrained regions. The findings align with SDG targets on health and well‐being (SDG 3) and gender equality (SDG 5), offering actionable insights to accelerate progress toward WHO's 90–70–90 goals and the elimination of cervical cancer as a public health threat.

Antibody-drug conjugates in gynecologic cancer: current landscape, clinical data, and emerging targets.

Gynecologic cancers pose a substantial global health challenge, disproportionately affecting women in low‐ and middle‐income countries (LMICs). Although high‐income countries (HICs) have witnessed advancements in prevention, early detection, and treatment, LMICs continue to experience elevated incidence and mortality rates, coupled with diminished survival outcomes. In 2022, these cancers accounted for approximately 1.4 million new cases and over 600 000 deaths worldwide, concentrated primarily in LMICs. This disparity stems from a confluence of systemic factors, including limited access to health care, absent or inadequate cervical cancer screening programs, underdeveloped healthcare infrastructure, and socioeconomic barriers such as poverty and lack of health insurance. Furthermore, shortages of trained specialists, advanced diagnostic tools, and effective treatment modalities hinder care delivery in resource‐constrained settings. This paper delves into the root causes of these disparities, exploring the systemic and structural obstacles impeding equitable gynecologic oncology care in LMICs. Evidence‐based recommendations will focus on expanding access to preventative measures like HPV vaccination and cervical cancer screening, enhancing timely diagnosis and treatment, and bolstering healthcare systems to address workforce and infrastructure deficits. Achieving equitable outcomes requires concerted global efforts to bridge resource gaps, prioritize health system reforms, and cultivate partnerships between HICs and LMICs for expertise and resource sharing. Ultimately, addressing these disparities is essential to ensure that all women, irrespective of geographic location or socioeconomic status, can access quality care, thereby mitigating the global burden of gynecologic cancers and improving survival.

Cytoreductive surgery for gynecological ovarian cancer involves the removal of tumor masses and affected tissue, aiming to achieve optimal debulking. Accelerated recovery nursing, a comprehensive care model, focuses on expediting post-surgical recovery and enhancing patient satisfaction. It has emerged as a vital approach to optimize post-surgical outcomes and patient satisfaction. This study evaluates the impact of accelerated recovery care on surgical patients to enhance recovery outcomes and patient satisfaction post-surgery. The study utilized an observational and control group design and selected 72 patients undergoing ovarian tumor cytoreductive surgery at The First Affiliated Hospital of Nanjing Medical University between October 1st, 2019, and May 31st, 2020. These patients were divided into two groups: an observation group and a control group, each comprising 36 patients, with one group receiving standard care and the other accelerated recovery care. Nursing staff provided comprehensive pre-and post-operative care, monitoring patients' vital signs using Mindray iPM10 monitors. Postoperative rehabilitation training and dietary guidance were administered. Complication rates, recovery indicators, and patient satisfaction were compared between the groups. The observation group exhibited a significantly lower complication rate (2.78%) compared to the control group (11.11%) (P < .05). Patients in the observation group demonstrated faster recovery indicators, including time to first flatulence, first defecation, and first mobilization from bed (P < .05). Additionally, abdominal distension and pain scores were lower in the observation group, with 100% patient satisfaction. Implementation of accelerated recovery nursing significantly reduces surgical patient complication rates, facilitates recovery, and enhances patient satisfaction. Nursing attention and guidance throughout the surgical process are crucial for optimal patient outcomes. This study emphasizes the importance of thorough care protocols in improving surgical recovery.

2903P Physician’s knowledge, practice, and attitudes on bone health management in patients with breast and gynaecological cancer

Evaluating patients' understanding of their gynecologic cancer: A cross-sectional survey assessing an etiology for disparities in clinical trial enrollment

Streamlining acute care for patients with gynecologic cancers: A comparative study of oncology urgent care and emergency department visits

Implementation of an endometriosis-specific MRI protocol reduces diagnostic laparoscopy rates and alters treatment paradigms in suspected deep infiltrating endometriosis.