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Neoadjuvant and Adjuvant Therapy for Gynecologic Malignancies

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A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 15 August 2024 | Viewed by 2974

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Special Issue Editors

Dr. Dimitrios Haidopoulos

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Guest Editor

Gynaecologic Oncology Unit, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
Interests: gynecologic oncology; endometrial cancer; cervical cancer; ovarian cancer; vulvar cancer; cytoreductive surgery

Dr. Vasilios Pergialiotis

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Guest Editor

Special Issue Information

Dear Colleagues,

Gynecological cancer accounts for approximately 1.3 million deaths a year worldwide. More than 3 million women are expected to be diagnosed with malignant lesions of the female tract annually. Chemotherapy and radiotherapy have been widely used on neo-adjuvant and adjuvant bases to help increase the survival of patients with advanced-stage disease. Although significant benefits have been observed for their use over the last decade, gynecological cancer is far from being defeated; hence, new strategies are evolving in the field.

In the present Special Issue, we would like to welcome contributions that will include original research articles (clinical and preclinical), reviews or shorter perspective articles that emphasize the benefit and pitfalls of adjuvant and neoadjuvant therapies in gynecological cancer patients. Topics such as but not limited to neo-adjuvant and adjuvant chemotherapies for ovarian, endometrial, cervical and vulvar cancers, with an emphasis on their impact on survival outcomes and patient-reported outcomes, including quality of life, are welcome in the present Special Issue.

We hope that leading experts will share their perspectives on the clinical management and outcome of patients with gynecological cancer and will contribute to current knowledge with novel evidence that will provide the groundwork for further research.

Dr. Dimitrios Haidopoulos
Dr. Vasilios Pergialiotis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

adjuvant therapy
neoadjuvant therapy
chemotherapy
radiotherapy
targeted treatment
ovarian cancer
endometrial cancer
vulvar cancer
cervical cancer

Published Papers (4 papers)

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Research

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11 pages, 523 KiB

Open AccessArticle

The Use of CA-125 KELIM to Identify Which Patients Can Achieve Complete Cytoreduction after Neoadjuvant Chemotherapy in High-Grade Serous Advanced Ovarian Cancer

by Dimitrios Zouzoulas, Dimitrios Tsolakidis, Panagiotis Tzitzis, Iliana Sofianou, Kimon Chatzistamatiou, Vasilis Theodoulidis, Maria Topalidou, Eleni Timotheadou and Grigoris Grimbizis

Cancers 2024, 16(7), 1266; https://doi.org/10.3390/cancers16071266 - 24 Mar 2024

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Abstract

(1) Background: Neoadjuvant chemotherapy followed by interval debulking surgery is used in the treatment of advanced ovarian cancer. However, no tool can safely predict if complete cytoreduction after 3–4 cycles can be achieved. This study aims to investigate if the KELIM score can be a triage tool in the identification of patients that will be ideal candidates for interval debulking surgery (IDS). (2) Methods: We retrospectively analyzed the records of patients with high-grade serous advanced ovarian cancer that were treated in the 1st Department of Obstetrics–Gynecology, 2012–2022, with neoadjuvant chemotherapy followed by IDS. Patient characteristics, oncological outcome and follow-up information were collected. The primary outcome was the association of the KELIM score with residual disease. (3) Results: 83 patients were categorized into two groups: Group A (51 patients) with favorable (≥1) and Group B (32 patients) with unfavorable (<1) KELIM scores. A statistically significant correlation between KELIM and residual disease (p < 0.05) exists, showing that patients with a favorable KELIM score can achieve a complete IDS. Furthermore, there was a statistically significant difference in overall survival (p = 0.017), but no difference was observed in progression-free survival (p = 0.13); (4) Conclusions: KELIM seems to safely triage patients after neoadjuvant chemotherapy and decide who will benefit from IDS. Full article

(This article belongs to the Special Issue Neoadjuvant and Adjuvant Therapy for Gynecologic Malignancies)

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13 pages, 2744 KiB

Open AccessArticle

Management of Patients with Hypersensitivity to Platinum Salts and Taxane in Gynecological Cancers: A Cross-Sectional Study by the European Network of Young Gynaecologic Oncologists (ENYGO)

by Tibor A. Zwimpfer, Esra Bilir, Khayal Gasimli, Andrej Cokan, Nicolò Bizzarri, Zoia Razumova, Joanna Kacperczyk-Bartnik, Tanja Nikolova, Andrei Pletnev, Ilker Kahramanoglu, Alexander Shushkevich, Aleksandra Strojna, Charalampos Theofanakis, Tereza Cicakova, Marcus Vetter, Céline Montavon, Gilberto Morgan and Viola Heinzelmann-Schwarz

Cancers 2024, 16(6), 1155; https://doi.org/10.3390/cancers16061155 - 14 Mar 2024

Viewed by 735

Abstract

Platinum and taxane chemotherapy is associated with the risk of hypersensitivity reactions (HSRs), which may require switching to less effective treatments. Desensitization to platinum and taxane HSRs can be used to complete chemotherapy according to the standard regimen. Therefore, we aimed to investigate the current management of HSRs to platinum and/or taxane chemotherapy in patients with gynecologic cancers. We conducted an online cross-sectional survey among gynecological and medical oncologists consisting of 33 questions. A total of 144 respondents completed the survey, and 133 respondents were included in the final analysis. Most participants were gynecologic oncologists (43.6%) and medical oncologists (33.8%), and 77.4% (n = 103) were involved in chemotherapy treatment. More than 73% of participants experienced >5 HSRs to platinum and taxane per year. Premedication and a new attempt with platinum or taxane chemotherapy were used in 84.8% and 92.5% of Grade 1–2 HSRs to platinum and taxane, respectively. In contrast, desensitization was used in 49.4% and 41.8% of Grade 3–4 HSRs to platinum and taxane, respectively. Most participants strongly emphasized the need to standardize the management of platinum and taxane HSRs in gynecologic cancer. Our study showed that HSRs in gynecologic cancer are common, but management is variable and the use of desensitization is low. In addition, the need for guidance on the management of platinum- and taxane-induced HSRs in gynecologic cancer was highlighted. Full article

(This article belongs to the Special Issue Neoadjuvant and Adjuvant Therapy for Gynecologic Malignancies)

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13 pages, 781 KiB

Open AccessArticle

Splenectomy as Part of Maximal-Effort Cytoreductive Surgery in Advanced Epithelial Ovarian Cancer

by Vasilios Pergialiotis, Eleftherios Zachariou, Vasilios Lygizos, Dimitrios Efthymios Vlachos, Emmanouil Stamatakis, Kyveli Angelou, Georgios Daskalakis, Nikolaos Thomakos and Dimitrios Haidopoulos

Cancers 2024, 16(4), 790; https://doi.org/10.3390/cancers16040790 - 15 Feb 2024

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Abstract

Introduction: A splenectomy is frequently performed during debulking surgery for advanced ovarian cancer. Its impact on perioperative and survival outcomes remains questionable as current evidence is conflicting. In the present study, we sought to determine the factors that affect survival rates in ovarian cancer patients that undergo a splenectomy as part of maximal-effort cytoreduction. Patients and methods: A retrospective chart review was conducted that included all epithelial ovarian cancer patients that had surgical cytoreduction for advanced epithelial ovarian cancer. Differences among splenectomized and non splenectomized patients were evaluated as well as the impact of known risk factors on survival outcomes of splenectomized patients. Results: Overall, 245 patients were identified and 223 were included in the present series, of whom 91 had a splenectomy. Recurrence rates as well as death rates were comparable among splenectomized and non-splenectomized patients; however, both the disease-free survival (log-rank = 0.001), as well as the overall survival of splenectomized patients (log-rank = 0.006), was shorter. Thrombotic events as well as rates of pulmonary embolism were comparable. Sepsis was more common among splenectomized patients. The site of splenic metastases did not influence patients’ survival. Among splenectomized patients, those offered primary debulking had longer progression-free survival (log-rank = 0.042), although their overall survival did not differ compared to patients submitted to interval debulking. Complete debulking significantly improved the overall survival compared to optimal debulking (log-rank = 0.047). Splenectomized patients that developed sepsis had worse overall survival (log-rank = 0.005). Discussion: The findings of our study support the feasibility of splenectomy in advanced epithelial ovarian cancer; however, its impact on patients’ survival is considerable. Therefore, every effort should be made to avoid splenic injury which will result in unintended splenectomy for non-oncological reasons. Full article

(This article belongs to the Special Issue Neoadjuvant and Adjuvant Therapy for Gynecologic Malignancies)

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Other

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20 pages, 2545 KiB

Open AccessSystematic Review

Accuracy of Frozen Section Biopsy in the Diagnosis of Endometrial Cancer: A Systematic Review and Meta-Analysis

by Stergios Kopatsaris, Aikaterini Apostolopoulou, Ioannis Tsakiridis, Antigoni Tranidou, Fotios Zachomitros, Evangelos Papanikolaou, Alexandros Daponte, Ioannis Kalogiannidis and Themistoklis Dagklis

Cancers 2024, 16(6), 1200; https://doi.org/10.3390/cancers16061200 - 19 Mar 2024

Viewed by 602

Abstract

The early and accurate diagnosis of endometrial cancer is of paramount importance for the survival of these patients. The aim of this study was to systematically appraise the available data regarding the accuracy of frozen section biopsy in diagnosing endometrial cancer. A thorough literature search was performed in PubMed/Medline, Scopus and the Cochrane Central Register of Controlled Trials databases from inception up to January 2023, with the use of specific, relevant key terms. A quality evaluation for each study was performed with the QUADAS-2 tool, whereas a bivariate random-effect model was performed to generate a summary receiver-operated curve. Heterogeneity was evaluated with Cochrane Q and Higgins’ I2 statistics. Subgroup analyses were performed for studies focused on atypical hyperplasia and those focused on endometrial cancer. The search yielded 47 studies, involving 7790 patients with endometrial cancer. Among them, only 11 could be included in the quantitative analysis. QUADAS-2 evaluation resulted in rather high quality among the included studies. Quantitative synthesis resulted in a pooled sensitivity of 0.863 and pooled specificity of 0.916. The AUC was 0.948, the Q statistic was 10.488 (10 df, p = 0.399) and Higgins’ I² (4.655%) reported no significant heterogeneity. Subgroup analyses based on the diagnosis revealed a pooled sensitivity 0.886, specificity 0.862 and AUC 0.934 for endometrial cancer versus a sensitivity of 0.816, specificity of 0.962 and AUC 0.939 for atypical hyperplasia. Frozen section appears as a valid and reliable diagnostic tool for endometrial cancer. Its reliability seems to be even higher for the diagnosis of atypical hyperplasia. Therefore, this method may be considered in clinical practice and in settings with appropriate resources. Full article

(This article belongs to the Special Issue Neoadjuvant and Adjuvant Therapy for Gynecologic Malignancies)

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