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Diagnosis and Treatment of Obstetrics and Gynecology Cancers
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Diagnosis and Treatment of Obstetrics and Gynecology Cancers

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 5 October 2026 | Viewed by 8364

Special Issue Editor

Dr. Gaspare Cucinella

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital IVF UNIT, University of Palermo, 90146 Palermo, Italy
Interests: obstetrics and gynecology; endoscopy; cancer; laparoscopy; fertility preservation; medical therapies; genital prolapse; urinary incontinence; endometriosis; oncological gynecology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue explores the evolving challenges in the diagnosis and management of gynecological malignancies and pregnancy-related cancers. In the area of gynecological oncology, we highlight the latest advances in multimodal treatment strategies for a variety of gynecological tumors, including cervical cancer, ovarian cancer, and endometrial cancer, including liquid biopsies for early detection, sentinel lymph node mapping, fertility-sparing surgical techniques, and PARP inhibitor therapy for BRCA-mutated tumors. The obstetrics section explores the complexity of pregnancy-associated breast cancer, gestational trophoblastic tumors, and cervical cancer diagnosed during pregnancy, emphasizing multidisciplinary decision-making to optimize maternal and fetal outcomes.

This Special Issue also explores emerging topics such as immunotherapy for mismatch repair-deficient endometrial cancer, AI-assisted imaging interpretation, and survivorship care. This Special Issue brings together contributions from experts to provide clinicians with practical insights into gynecologic oncology in the field of women's health.

Dr. Gaspare Cucinella
Guest Editor

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Keywords

  • gynecological cancers
  • endometrial cancer
  • ovarian cancer
  • cervical cancer
  • vulvar cancer
  • vaginal cancer
  • breast cancer
  • surgery
  • radio-therapy
  • systemic treatment
  • immunotherapy
  • sentinel lymph node biopsy
  • minimally invasive surgery
  • fertility preservation
  • gestational trophoblastic disease

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Published Papers (4 papers)

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Research

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16 pages, 689 KB  
Article
Comparison of Second-Line Chemotherapies for First-Relapsed High-Grade Serous Ovarian Cancer: A Retrospective Study
by Jeongyun Kim, Se Ik Kim, Dong Hoon Suh, Kidong Kim, Jae Hong No and Yong Beom Kim
J. Clin. Med. 2025, 14(19), 6905; https://doi.org/10.3390/jcm14196905 - 29 Sep 2025
Cited by 1 | Viewed by 1631
Abstract
Background/Objectives: To compare oncologic outcomes of second-line chemotherapy regimens in relapsed high-grade serous ovarian cancer (HGSOC) by platinum sensitivity. Methods: We retrospectively reviewed HGSOC patients treated at two centers (June 2003–December 2020), classified by platinum-free interval (6- and 12-month cut-offs). Outcomes [...] Read more.
Background/Objectives: To compare oncologic outcomes of second-line chemotherapy regimens in relapsed high-grade serous ovarian cancer (HGSOC) by platinum sensitivity. Methods: We retrospectively reviewed HGSOC patients treated at two centers (June 2003–December 2020), classified by platinum-free interval (6- and 12-month cut-offs). Outcomes were progression-free survival (PFS, primary) and objective response and disease control rates (secondary). Regimens administered to ≥10% of patients or with favorable outcomes were compared using multivariable Cox analyses. Results: Among 468 patients (41.2% sensitive, 32.9% partially sensitive, 25.9% resistant), platinum-sensitive patients were younger (p = 0.024), diagnosed earlier, and more likely to undergo primary debulking surgery (both p < 0.001), achieving best outcomes after second-line chemotherapy (median PFS 14.8 vs. 10.5 and 5.2 months, p < 0.001). In both sensitive groups, the most common regimens were taxane + platinum ± bevacizumab, followed by pegylated liposomal doxorubicin + carboplatin, which was associated with shorter PFS in platinum-sensitive patients (hazard ratio (HR) 1.67, p = 0.016). Second-line maintenance with bevacizumab or poly(ADP-ribose) polymerase inhibitors was associated with improved PFS in both groups (p < 0.001). In platinum-resistant patients, the omission of bevacizumab (HR 2.01, p < 0.001) and a primary treatment history without cytoreduction (HR 4.43, p = 0.044) were associated with inferior outcomes. Conclusions: In platinum-sensitive patients with a favorable prognosis, taxane + platinum regimens were most commonly used and outperformed PLD + carboplatin. Maintenance therapy also conferred a meaningful benefit. In platinum-resistant disease, bevacizumab use and prior cytoreductive surgery may improve outcomes, underscoring the importance of treatment selection and surgical approach. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Obstetrics and Gynecology Cancers)
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14 pages, 800 KB  
Article
The Impact of Lymphovascular Space Invasion on Recurrence and Survival in FIGO Stage I Node-Negative Endometrioid Endometrial Cancer
by Yakup Yalcin, Bahadir Kosan, Serenat Yalcin, Merve Abay and Kemal Ozerkan
J. Clin. Med. 2025, 14(18), 6535; https://doi.org/10.3390/jcm14186535 - 17 Sep 2025
Cited by 4 | Viewed by 2097
Abstract
Background/Objective: To evaluate the prognostic impact of lymphovascular space invasion (LVSI) on disease-free survival (DFS) and overall survival (OS) in patients with FIGO 2009 stage I endometrioid endometrial cancer with pathologically negative lymph node involvement. Methods: This retrospective cohort study included [...] Read more.
Background/Objective: To evaluate the prognostic impact of lymphovascular space invasion (LVSI) on disease-free survival (DFS) and overall survival (OS) in patients with FIGO 2009 stage I endometrioid endometrial cancer with pathologically negative lymph node involvement. Methods: This retrospective cohort study included 469 patients with FIGO 2009 stage I node-negative endometrioid endometrial carcinoma who underwent comprehensive surgical staging at a single tertiary center between January 1993 and April 2025. Demographic, clinicopathological, treatment, and follow-up data were collected. Survival outcomes were assessed using Kaplan–Meier analysis, and prognostic factors were identified via univariate and multivariate Cox regression models. Results: LVSI was present in 17.7% of the cohort (n = 83). Patients with LVSI had significantly higher tumor grades, larger tumor size, and deeper myometrial invasion compared to LVSI-negative patients (p < 0.001). Recurrence was more frequent in the LVSI-positive group (14.5% vs. 6.5%, p = 0.026), with distant metastasis predominating (83.3%). The 5-year DFS was 86.4% in the LVSI-positive group versus 96.3% in the LVSI-negative group (p = 0.0020), while the 5-year OS was 72.1% vs. 91.2%, respectively (p = 0.0014). In multivariate analysis, LVSI was an independent prognostic factor for both recurrence (HR = 4.80, 95% CI: 1.62–14.21; p < 0.001) and overall mortality (HR = 3.33, 95% CI: 1.43–7.77; p = 0.012). Conclusions: LVSI is a strong and independent predictor of adverse oncologic outcomes in early-stage, node-negative endometrioid endometrial cancer. Its presence is associated with significantly decreased DFS and OS, particularly due to an increased risk of distant recurrence. These findings support the incorporation of LVSI into contemporary risk stratification and adjuvant treatment algorithms. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Obstetrics and Gynecology Cancers)
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Review

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9 pages, 362 KB  
Review
Radioguided Localisation Techniques for Non-Palpable Breast Lesions: An Umbrella Review
by Marco Cuzzocrea, Cesare Michele Iacovitti, Nickolas Peradze, Maria Luisa Gasparri, Simone Schiaffino, Lorenzo Rossi, Gaetano Paone and Giorgio Treglia
J. Clin. Med. 2026, 15(2), 750; https://doi.org/10.3390/jcm15020750 - 16 Jan 2026
Viewed by 497
Abstract
Background: Accurate localisation of non-palpable breast lesions is essential for the optimization of breast-conserving surgery (BCS) outcomes. While wire-guided localisation (WGL) remains widely used, radioguided techniques—including Radioguided Occult Lesion Localisation (ROLL) and Radioactive Seed Localisation (RSL)—have been proposed to improve margin clearance, reduce [...] Read more.
Background: Accurate localisation of non-palpable breast lesions is essential for the optimization of breast-conserving surgery (BCS) outcomes. While wire-guided localisation (WGL) remains widely used, radioguided techniques—including Radioguided Occult Lesion Localisation (ROLL) and Radioactive Seed Localisation (RSL)—have been proposed to improve margin clearance, reduce reoperations, and enhance patient outcomes. This umbrella review aimed to critically appraise and synthesize evidence from systematic reviews and meta-analyses on radioguided localisation techniques for non-palpable breast lesions, with a primary focus on comparison with wire-guided localisation (WGL). Methods: A comprehensive literature search was conducted using PubMed/Medline and the Cochrane Library databases for eligible systematic reviews/meta-analyses published until 2024, focusing on outcomes such as relative efficacy, safety, margin positivity, re-excision rates, operative efficiency, and patient-related outcomes. Results: In total, 35 records were retrieved, but only 10 evidence-based articles were selected. Radioguided approaches achieved high localisation success (often exceeding 95%) and fewer positive margins compared to WGL, while reoperation findings were mixed. Operative/localisation times were generally shorter for radioguided methods, with comparable specimen volume/weight and favourable safety profiles. Conclusions: Radioguided localisation methods provide superior or at least equivalent outcomes compared with WGL and can improve workflow; Sentinel Node and Occult Lesion Localisation (SNOLL) may support combined lesion localisation and sentinel node evaluation. Further high-quality, standardized comparative studies are needed to define the optimal resection ratio, protocol standardization and cost of the radioguided techniques and other newer probe-guided methods. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Obstetrics and Gynecology Cancers)
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13 pages, 522 KB  
Review
Uterine Fibroids and Their Association with Acute and Chronic Venous Thromboembolic Disease—An Expert Review of the Literature
by Munaza Afaq, Brooke Alexa Zlotshewer, Estefania Oliveros, Sarah Gabrielle Bauman, Anjali Vaidya, Vladimir Lakhter, Paul Forfia, Ahmed S. Sadek, Enrique Hernandez and Riyaz Bashir
J. Clin. Med. 2025, 14(12), 4065; https://doi.org/10.3390/jcm14124065 - 9 Jun 2025
Viewed by 3710
Abstract
Venous thromboembolism is significantly affected by hormonal and reproductive factors that pose unique challenges in women. Among various risk factors, the role of uterine fibroids, which are the most common benign tumors in women, is not well understood. The relationship between venous thromboembolism [...] Read more.
Venous thromboembolism is significantly affected by hormonal and reproductive factors that pose unique challenges in women. Among various risk factors, the role of uterine fibroids, which are the most common benign tumors in women, is not well understood. The relationship between venous thromboembolism and fibroids is mainly attributed to the physical compression caused by large fibroids on pelvic veins, particularly the iliac veins, leading to venous stasis and thrombosis. This review explores the prevalence, pathogenesis, risk factors, possible racial influences, and management strategies of venous thromboembolism associated with fibroids. It highlights the need for better awareness, considering the asymptomatic nature of many fibroids and their potential to lead to serious thromboembolic complications. There is a clear need for screening methods, detailed guidelines, and treatments to prevent such complications and improve women’s health care. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Obstetrics and Gynecology Cancers)
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