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Cancers
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Advancements in Surgical Approaches for Gynecological Cancers
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Advancements in Surgical Approaches for Gynecological Cancers

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

Deadline for manuscript submissions: 30 November 2025 | Viewed by 5612

Special Issue Editors

Dr. Anna Myriam Perrone

E-Mail Website
Guest Editor
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Interests: advancements in surgical techniques; surgical planning and decision-making; outcomes and challenges; patient-centered care
Special Issues, Collections and Topics in MDPI journals
Dr. Camelia Alexandra Coada

E-Mail Website
Guest Editor
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Interests: impact on long-term survival; multidisciplinary collaboration; current treatment challenges; molecular classification of tumors and their prognostic impact

Special Issue Information

Dear Colleagues,

Gynecological cancers, including ovarian, cervical, uterine, vulvar, and vaginal cancers, pose significant health challenges for women worldwide. With millions of women diagnosed each year, these cancers have a profound impact on both individual lives and public health. However, thanks to remarkable advancements in surgical approaches, there is newfound hope in the fight against gynecological cancers. Scientific breakthroughs and technological innovations have revolutionized the field of gynecologic oncology, offering safer, more precise, and minimally invasive surgical techniques. These advancements not only enhance diagnostic accuracy but also enable surgeons to tailor treatment plans and improve patient outcomes. The importance of these advancements in surgical approaches for gynecological cancers cannot be overstated, as they hold the potential to improve patient outcomes, enhance quality of life, and redefine the landscape of gynecologic oncology care.

We are pleased to invite you to contribute to this Special Issue titled “Advancements in Surgical Approaches for Gynecological Cancers” dedicated to the surgery of gynecological cancers, focusing on the advancements, challenges, and outcomes in this critical field.

It is well known that achieving complete surgical resection has paramount importance in the management of tumors, including gynecological cancers. The aim of this Special Issue is to provide a comprehensive overview of the evolving surgical techniques, novel approaches, and cutting-edge technologies that are revolutionizing the management of gynecological cancers. The articles included in this issue should emphasize the significance of thorough surgical planning, meticulous techniques, and multidisciplinary collaboration to ensure optimal cytoreduction and achieve negative surgical margins. By addressing the challenges and complexities associated with achieving complete surgery, this Special Issue aims to underscore the significance of this essential treatment modality in improving overall survival rates and disease-free intervals for patients with gynecological cancers. Through a comprehensive exploration of surgical advancements, techniques, and outcomes, this issue seeks to advance the knowledge and understanding of the integral role of complete surgery in the comprehensive management of gynecological malignancies.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following:

Impact of advancements in molecular and genetic classifications on therapeutic choices.

Evolving surgical techniques.

Role of neoadjuvant chemotherapy in surgical outcomes.

Minimally invasive surgical approaches.

Novel approaches.

Cutting-edge technologies.

Thorough surgical planning.

Meticulous techniques.

Application of current treatment guidelines.

Optimal cytoreduction and negative surgical margins.

Impact on overall survival and disease-free intervals.

We look forward to receiving your contributions.

Dr. Anna Myriam Perrone
Dr. Camelia Alexandra Coada
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

  • gynecological cancers
  • minimally invasive surgery
  • advancements in oncological treatments
  • challenges
  • survival outcomes
  • complete surgical resection
  • management
  • cytoreduction
  • negative surgical margins

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Published Papers (6 papers)

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11 pages, 599 KiB  
Article
Endometrial Intraepithelial Neoplasia, Concurrent Endometrial Cancer and Risk for Pelvic Sentinel Node Metastases
by Tabayi Hawez, Michele Bollino, Celine Lönnerfors and Jan Persson
Cancers 2024, 16(24), 4215; https://doi.org/10.3390/cancers16244215 - 18 Dec 2024
Cited by 2 | Viewed by 974
Abstract
Background/objectives: Given the risk of a progression, or an undiagnosed endometrial cancer (EC), the treatment of choice is hysterectomy in women with endometrial intraepithelial neoplasia (EIN). The risk of metastatic disease and whether sentinel node (SLN) biopsy should be performed remains unclear. The [...] Read more.
Background/objectives: Given the risk of a progression, or an undiagnosed endometrial cancer (EC), the treatment of choice is hysterectomy in women with endometrial intraepithelial neoplasia (EIN). The risk of metastatic disease and whether sentinel node (SLN) biopsy should be performed remains unclear. The primary aim of this prospective study was to determine the overall incidence of concurrent EC and the impact of the diagnostic tool used and the type of endometrial lesion. The secondary aim was to investigate the risk of metastatic SLNs. Methods: Between July 2019 and May 2024, 98 consecutive women with EIN deemed suitable for robotic surgery and SLN dissection were included in the study. Ultrastaging and immunohistochemistry were performed on all SLNs. Results: In total, 47% of women with preoperative EIN had EC on final histology; 13% of these had metastatic SLNs and the overall risk of metastases was 6.3%. Women who obtained their diagnosis by an endometrial biopsy had 65% risk of EC. All women with metastatic SLNs had non-polypoid lesions and five out of six obtained their diagnosis through endometrial biopsy. Conclusions: The overall risk of SLN metastases was 6.3%, all in women with a general endometrial thickening and/or a diagnosis of EIN by office endometrial biopsy, suggesting that SLN detection should be offered particularly to women with EIN who fulfill these preoperative criteria. Full article
(This article belongs to the Special Issue Advancements in Surgical Approaches for Gynecological Cancers)
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10 pages, 1415 KiB  
Article
Breast-Conserving Surgery Guided with Magnetic Seeds vs. Wires: A Single-Institution Experience
by Elisa Moreno-Palacios, Covadonga Martí, Laura Frías, Marcos Meléndez, Adolfo Loayza, María José Roca, Vicenta Córdoba, José María Oliver, Alicia Hernández and José Ignacio Sánchez-Méndez
Cancers 2024, 16(3), 566; https://doi.org/10.3390/cancers16030566 - 29 Jan 2024
Cited by 1 | Viewed by 1472
Abstract
Purpose: The aim of this study is to describe our initial experience using magnetic seeds (Magseed®) to guide breast-conserving surgery in non-palpable breast lesions and compare the use of magnetic seed with wires to guide breast-conserving surgery in terms of clinical [...] Read more.
Purpose: The aim of this study is to describe our initial experience using magnetic seeds (Magseed®) to guide breast-conserving surgery in non-palpable breast lesions and compare the use of magnetic seed with wires to guide breast-conserving surgery in terms of clinical and pathological characteristics. Methods: We performed a retrospective study including all breast-conserving surgeries for non-palpable breast lesions under 16 mm from June 2018 to May 2021. We compared breast-conserving surgeries guided with magnetic seeds (Magseed®) to those guided with wires, analyzing tumor and patient characteristics, surgical time, and pathological results of the surgical specimens. Results: Data from 225 cases were collected, including 149 cases guided by magnetic seeds and 76 cases guided by wires. The breast lesion was localized in every case. Both cohorts were similar regarding clinical and pathological characteristics. We found significant statistical differences (p < 0.02) in terms of the median volume (cm3) of the excised specimen, which was lower (29.3%) in the magnetic seed group compared with the wire group (32.5 [20.5–60.0]/46.0 [20.3–118.7]). We did not find significant differences regarding surgical time (min) or the affected or close margins. Conclusion: In our experience, the use of magnetic seed (Magseed®) is a feasible option to guide breast-conserving surgery of non-palpable lesions and enabled us to resect less breast tissue. Full article
(This article belongs to the Special Issue Advancements in Surgical Approaches for Gynecological Cancers)
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12 pages, 443 KiB  
Article
Urinary, Gastrointestinal, and Sexual Dysfunctions after Chemotherapy, Radiotherapy, Radical Surgery or Multimodal Treatment in Women with Locally Advanced Cervical Cancer: A Multicenter Retrospective Study
by Mariano Catello Di Donna, Giuseppe Cucinella, Vincenzo Giallombardo, Giulio Sozzi, Nicolò Bizzarri, Giovanni Scambia, Basilio Pecorino, Paolo Scollo, Roberto Berretta, Vito Andrea Capozzi, Antonio Simone Laganà and Vito Chiantera
Cancers 2023, 15(24), 5734; https://doi.org/10.3390/cancers15245734 - 7 Dec 2023
Cited by 6 | Viewed by 1761
Abstract
Background: Different strategies have been proposed for the treatment of locally advanced cervical cancer (LACC), with different impacts on patient’s quality of life (QoL). This study aimed to analyze urinary, bowel, and sexual dysfunctions in a series of LACC patients who underwent chemotherapy, [...] Read more.
Background: Different strategies have been proposed for the treatment of locally advanced cervical cancer (LACC), with different impacts on patient’s quality of life (QoL). This study aimed to analyze urinary, bowel, and sexual dysfunctions in a series of LACC patients who underwent chemotherapy, radiotherapy, radical surgery, or a combination of these treatments. Methods: Patients with LACC who underwent neoadjuvant radio–chemotherapy (NART/CT; n = 35), neoadjuvant chemotherapy (NACT; n = 17), exclusive radio–chemotherapy (ERT/CT; n = 28), or upfront surgery (UPS; n = 10) from November 2010 to September 2019 were identified from five oncological referral centers. A customized questionnaire was used for the valuation of urinary, gastrointestinal, and sexual dysfunctions. Results: A total of 90 patients were included. Increased urinary frequency (>8 times/day) was higher in ERT/CT compared with NACT/RT (57.1% vs. 28.6%; p = 0.02) and NACT (57.1% vs. 17.6%; p = 0.01). The use of sanitary pads for urinary leakage was higher in ERT/CT compared with NACT/RT (42.9% vs. 14.3%; p = 0.01) and NACT (42.9% vs. 11.8%; p = 0.03). The rate of reduced evacuations (<3 times a week) was less in UPS compared with NACT/RT (50% vs. 97.1%; p < 0.01), NACT (50% vs. 88.2, p < 0.01), and ERT/CT (50% vs. 96.4%; p < 0.01). A total of 52 women were not sexually active after therapy, and pain was the principal reason for the avoidance of sexual activity. Conclusions: The rate and severity of urinary, gastrointestinal, and sexual dysfunction were similar in the four groups of treatment. Nevertheless, ERT/CT was associated with worse sexual and urinary outcomes. Full article
(This article belongs to the Special Issue Advancements in Surgical Approaches for Gynecological Cancers)
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Other

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2 pages, 144 KiB  
Reply
Reply to Gücer, F.; Dünnebacke, J. Comment on “Hawez et al. Endometrial Intraepithelial Neoplasia, Concurrent Endometrial Cancer and Risk for Pelvic Sentinel Node Metastases. Cancers 2024, 16, 4215”
by Tabayi Hawez, Michele Bollino, Celine Lönnerfors and Jan Persson
Cancers 2025, 17(8), 1339; https://doi.org/10.3390/cancers17081339 - 16 Apr 2025
Viewed by 141
Abstract
We thank you for your interest in our paper and would like to comment on your reflections [...] Full article
(This article belongs to the Special Issue Advancements in Surgical Approaches for Gynecological Cancers)
2 pages, 141 KiB  
Comment
Comment on Hawez et al. Endometrial Intraepithelial Neoplasia, Concurrent Endometrial Cancer and Risk for Pelvic Sentinel Node Metastases. Cancers 2024, 16, 4215
by Fatih Gücer and Jan Dünnebacke
Cancers 2025, 17(8), 1315; https://doi.org/10.3390/cancers17081315 - 14 Apr 2025
Cited by 1 | Viewed by 155
Abstract
We read with interest the recent paper by Hawez et al [...] Full article
(This article belongs to the Special Issue Advancements in Surgical Approaches for Gynecological Cancers)
18 pages, 991 KiB  
Systematic Review
Primary or Interval Debulking Surgery for Advanced Endometrial Cancer with Carcinosis: A Systematic Review and Individual Patient Data Meta-Analysis of Survival Outcomes
by Giulia Mantovani, Camelia Alexandra Coada, Stella Di Costanzo, Francesco Mezzapesa, Lucia Genovesi, Giorgio Bogani, Francesco Raspagliesi, Alessio Giuseppe Morganti, Pierandrea De Iaco and Anna Myriam Perrone
Cancers 2025, 17(6), 1026; https://doi.org/10.3390/cancers17061026 - 19 Mar 2025
Viewed by 521
Abstract
Objective. To compare the survival outcomes of primary debulking surgery and platinum-based adjuvant chemotherapy versus interval debulking surgery after platinum-based neoadjuvant chemotherapy in patients with stage IVb endometrial cancer and peritoneal carcinosis. Methods. The online search included the following data sources: PubMed, Scopus, [...] Read more.
Objective. To compare the survival outcomes of primary debulking surgery and platinum-based adjuvant chemotherapy versus interval debulking surgery after platinum-based neoadjuvant chemotherapy in patients with stage IVb endometrial cancer and peritoneal carcinosis. Methods. The online search included the following data sources: PubMed, Scopus, WOS, and the Cochrane Library from 1990 to 2024 (PROSPERO registration code: CRD42023438602). A total of 3230 studies were identified, with the inclusion of 16. Individual patient data on survival outcomes, disease distribution, and residual tumors, as well as details of neoadjuvant chemotherapy and adjuvant treatment, were extracted. Results. A total of 285 patients were included: 197 (69%) underwent primary debulking surgery and 88 (31%) underwent interval debulking surgery. The pooled analysis revealed a median progression-free survival in the primary debulking surgery group of 18.0 months compared to 12.0 months in the interval debulking surgery group (p = 0.028; log-rank test), and a median overall survival of 30.92 months versus 28.73 months (p = 0.400; log-rank test). Among the 134 patients with available information on the residual tumor after primary debulking surgery or interval debulking surgery, 110 (82%) had no macroscopic residual tumor (residual tumor = 0). The median progression-free survival was 18.9 months in the residual tumor = 0 group compared to 6.19 months in the residual tumor > 0 group (p < 0.001; log-rank test); the median overall survival was 40.6 months versus 21 months (p = 0.028; log-rank test). Conclusions. These results indicate that primary debulking surgery should be considered the preferred treatment approach for advanced endometrial cancer with carcinosis, especially in carefully selected patients where complete cytoreduction is achievable. Further prospective studies are warranted to confirm these results and to establish standardized criteria for patient selection, incorporating molecular-integrated risk profiles for endometrial cancer. Full article
(This article belongs to the Special Issue Advancements in Surgical Approaches for Gynecological Cancers)
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