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Cancers
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New Advances in the Diagnosis of Gynecological Cancer
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New Advances in the Diagnosis of Gynecological Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Causes, Screening and Diagnosis".

Deadline for manuscript submissions: closed (16 May 2025) | Viewed by 2157

Special Issue Editors

Prof. Dr. Andrea Ciavattini

E-Mail Website
Guest Editor
Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
Interests: pre-invasive and invasive cervical lesions; pre-invasive and invasive endometrial pathology; gynecologic oncology; endoscopy
Special Issues, Collections and Topics in MDPI journals
Dr. Luca Giannella

E-Mail Website
Guest Editor
Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, 60213 Ancona, Italy
Interests: pathology of the lower genital tract disease; HPV related disaese; HPV vaccination; HPV genotype distribution
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Over the past years, we have witnessed significant strides in the diagnosis of gynecological cancer. These advancements, driven by technological innovations, imaging, molecular biology, and personalized medicine, are novel and crucial. For instance, liquid biopsy, a non-invasive method that involves analyzing circulating tumor DNA and other biomarkers in blood samples, is gaining momentum in diagnosing and monitoring gynecological cancers. Similarly, molecular profiling techniques, like next-generation sequencing and gene expression profiling, are revolutionizing how we understand gynecological cancers. The development of artificial intelligence and machine learning algorithms with which to analyze medical imaging data, including MRI, CT, and ultrasound scans, for the early detection and characterization of gynecological tumors, is another significant breakthrough. These diagnostic advances promise to improve outcomes in gynecological cancer by enabling earlier detection, more accurate risk stratification, and tailored therapeutic interventions.

Prof. Dr. Andrea Ciavattini
Dr. Luca Giannella
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 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

  • endometrial cancer
  • ovarian cancer
  • cervical cancer
  • vulvar cancer
  • liquid biopsy
  • molecular profiling
  • artificial intelligence and machine learning
  • advanced imaging modalities

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Published Papers (2 papers)

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12 pages, 244 KiB  
Article
Microsatellite Instability as a Risk Factor for Occult Lymph Node Metastasis in Early-Stage Endometrial Cancer: A Retrospective Multicenter Study
by Carlo Ronsini, Stefano Restaino, Federico Paparcura, Giuseppe Vizzielli, Antonio Raffone, Mariano Catello Di Donna, Giuseppe Cucinella, Vito Chiantera and Pasquale De Franciscis
Cancers 2025, 17(7), 1162; https://doi.org/10.3390/cancers17071162 - 30 Mar 2025
Viewed by 1122
Abstract
Objectives: This study investigates the association between microsatellite instability (MSI) and the risk of occult lymph node metastases (LNMs) in patients with early-stage endometrial cancer (EC) who showed no evidence of nodal involvement on preoperative imaging. Methods: A retrospective multicenter cohort study was [...] Read more.
Objectives: This study investigates the association between microsatellite instability (MSI) and the risk of occult lymph node metastases (LNMs) in patients with early-stage endometrial cancer (EC) who showed no evidence of nodal involvement on preoperative imaging. Methods: A retrospective multicenter cohort study was conducted, including 237 patients with EC who underwent primary staging surgery between January 2022 and October 2024. The patients were stratified into two groups based on MSI status. The primary outcome was the prevalence of occult LNMs. Statistical analyses included univariate and multivariate logistic regression models, adjusting for potential confounders such as tumor grading and lymphovascular space invasion (LVSI). The significance of the models was assessed using the maximum likelihood method and Bayesian Information Criterion (BIC). Measures to reduce bias included blinding the data analyst, standardization of histopathological evaluation, and exclusion of patients with genetic conditions predisposing to MSI. Results: The MSI group had a significantly higher incidence of occult LNMs compared to the MSS group (19% vs. 6.7%, p = 0.005). The multivariate analysis confirmed MSI as an independent risk factor for LNMs (OR = 1.105, 95% CI 1.016–1.202, p = 0.020). The sub-analysis showed that loss of MLH1/PMS2 or both MLH1/PMS2 and MSH2/MSH6 heterodimers further increased LNMs risk, independently from other risk factors. Conclusions: MSI is independently associated with a higher risk of occult LNMs in early-stage EC, suggesting a potential role for MSI profiling in refining lymph node staging strategies. Future prospective studies should assess the prognostic impact of this association and its implications for surgical decision-making. Full article
(This article belongs to the Special Issue New Advances in the Diagnosis of Gynecological Cancer)

Other

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15 pages, 1491 KiB  
Systematic Review
Clinical Outcomes of Cervical Adenocarcinoma In Situ According to Conservative or Demolitive Treatment: A Systematic Review and Meta-Analysis
by Giovanni Delli Carpini, Camilla Cicoli, Marco Bernardi, Jacopo Di Giuseppe, Luca Giannella and Andrea Ciavattini
Cancers 2025, 17(11), 1839; https://doi.org/10.3390/cancers17111839 - 30 May 2025
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Abstract
Background/Objectives: The objective of this systematic review and meta-analysis was to compare the risk of recurrence and residual disease between conservative and demolitive treatment in patients diagnosed with cervical adenocarcinoma in situ (AIS). Methods: Bibliographic databases (CENTRAL, PubMed, Cochrane Database of Systematic Reviews, [...] Read more.
Background/Objectives: The objective of this systematic review and meta-analysis was to compare the risk of recurrence and residual disease between conservative and demolitive treatment in patients diagnosed with cervical adenocarcinoma in situ (AIS). Methods: Bibliographic databases (CENTRAL, PubMed, Cochrane Database of Systematic Reviews, and Google Scholar) were searched for studies published up to December 2024 reporting both conservative and demolitive treatment outcomes. Exclusion criteria were the lack of outcomes of interest, the reporting of only one treatment modality, and a lack of follow-up. The ROBINS-I tool was used to assess the risk of bias. The evaluated outcomes were AIS or invasive recurrence and AIS or invasive residual after margin positivity at the first excision. A meta-analysis with a fixed-effect model and the Mantel–Haenszel method for risk ratio (RR) with a 95% confidence interval (CI) was performed. Heterogeneity was evaluated with the chi-squared test and quantified with the I2 method. A meta-regression was performed using the year of publication, CKC use, margin positivity, and follow-up duration as predictors. Results: Nineteen studies were included, reporting data about 5934 patients with AIS diagnosis after conization. The meta-analysis showed a higher risk of recurrence as AIS in conservatively treated patients (11 studies, RR = 8.44, 95% CI 3.36–21.19, p < 0.001, I2 = 0.0%, p = 0.73), while no differences were observed in the risk of recurrence as invasive adenocarcinoma (10 studies, RR = 1.67, 95% CI 0.82–3.39, p = 0.16, I2 = 0.00%, p = 0.48). No difference between the two treatment modalities in terms of AIS residual (nine studies, RR = 0.89, 95% CI 0.62–1.26, p = 0.50, I2 = 33%, p = 0.15) or invasive residual (three studies, RR = 0.48, 95% CI 0.09–2.41, p = 0.37, I2 = 0.0%, p = 0.94) after margin positivity at the first excision emerged. The meta-regression showed no association with the predictors. Conclusions: The safety profile of a conservative treatment for AIS patients seems not to differ from that of a demolitive approach in terms of invasive recurrence or residual, while it seems to be associated with a higher risk of AIS recurrence. Future research should focus on optimizing follow-up strategies to detect AIS recurrences early. Full article
(This article belongs to the Special Issue New Advances in the Diagnosis of Gynecological Cancer)
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