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Cancers
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Novel Approaches in the Management of Gynecological Cancers
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Novel Approaches in the Management of Gynecological Cancers

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

Deadline for manuscript submissions: 31 July 2026 | Viewed by 1517

Special Issue Editors

Dr. Mikel Gorostidi

E-Mail Website
Guest Editor
1. Gynecology Department, Hospital Universitario de Donostia, 20014 San Sebastian, Spain
2. Biogipuzkoa Health Research Institute, San Sebastián, Spain
Interests: surgical oncology; endometrial cancer; cervical cancer; cytoreductive surgery; ovarian cancer; sentinel node; pregnancy; robotics; surgical complications
Dr. Martina Aida Angeles

E-Mail Website
Guest Editor
Gynecologic Oncology Unit, Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
Interests: surgical oncology; cytoreductive surgery; ovarian cancer; surgical complications
Dr. Ignacio Zapardiel

E-Mail Website1 Website2
Guest Editor
Gynecologic Oncology Unit, La Paz University Hospital, 28046 Madrid, Spain
Interests: Surgical oncology; fertility preservation treatments; rare cancers; uterine sarcoma; vulvar cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The prevalence of gynecological cancers has increased in the past 10 years. Their management, both surgical and medical, has undergone various improvements and modifications which have positively influenced the oncological outcomes of patients. Novel approaches in such treatment include the implementation of less radical surgeries in cervical cancer patients, avoiding main urologic complications; the use of sentinel node biopsy in the assessment of nodal disease among gynecological cancers; the implementation of immunologic agents in the adjuvant treatment of patients; and the reclassification of tumors according to molecular profiles as a main factor in postoperative management.

The aim of this Special Issue is to disseminate the last evidence regarding the management of gynecological cancers, which will contribute to increasing the survival of the patients or, at least, to decreasing the morbidity of treatments.

Dr. Mikel Gorostidi
Dr. Martina Aida Angeles
Dr. Ignacio Zapardiel
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 250 words) can be sent to the Editorial Office for assessment.

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 cancer
  • ovarian cancer
  • endometrial cancer
  • cervical cancer
  • vulvar cancer
  • surgical management
  • clinical management

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Published Papers (3 papers)

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Research

29 pages, 2090 KB  
Article
Liquid Biopsy Analysis of the EV-Associated Micro-RNA Signature in Vulvar Carcinoma May Benefit Disease Diagnosis and Prognosis
by Friederike Borchardt, Leonie Kleinholz, Anna Jaeger, Jana Löptien, Vanessa Vohl, Jolanthe Kropidlowski, Klaus Pantel, Eik Vettorazzi, Linn Woelber, Harriet Wikman and Katharina Effenberger
Cancers 2026, 18(3), 438; https://doi.org/10.3390/cancers18030438 - 29 Jan 2026
Abstract
Background: Vulvar cancer mainly affects postmenopausal women, but its incidence is rising among younger individuals due to persistent HPV infection. Validated diagnostic biomarkers remain lacking, though circulating exosomal microRNAs (exomiRs) have recently emerged as promising liquid biopsy tools across various cancers. Objective: The [...] Read more.
Background: Vulvar cancer mainly affects postmenopausal women, but its incidence is rising among younger individuals due to persistent HPV infection. Validated diagnostic biomarkers remain lacking, though circulating exosomal microRNAs (exomiRs) have recently emerged as promising liquid biopsy tools across various cancers. Objective: The purpose of this study was to identify a panel of dysregulated plasma-derived extracellular vesicle (EV)-associated miRNAs, hereafter referred to as exosomal micro-RNAs, as liquid biopsy markers for the detection of vulvar cancer and for assessment of HPV-positivity. Methods: Five healthy donor (HD) and 10 vulvar cancer samples underwent Next-Generation Sequencing to screen for differentially expressed exomiRs. The seven most dysregulated and four stably expressed exomiRs were subsequently analyzed in 81 cancer and 60 HD samples by qRT-PCR. Differential expression was determined by the 2−ΔΔCT method. Binary regression was used to construct an exomiR panel. HPV status was assessed using mass spectrometry. Results: Five single exomiRs showed a statistically significant dysregulation in cancer patients compared to healthy controls: miR-143-3p, miR-223-3p, miR-451a, miR-4516 and miR-151a-5p. The combination of six exomiRs resulted in a panel with superior diagnostic ability (p < 0.001; ROC-AUC = 0.805; 95% CI: 0.726–0.884) in distinguishing cancer patients from HDs. A model consisting of miR-223-3p, miR-143-3p and miR-451a could discriminate HPV-positive from -negative (p = 0.003; ROC-AUC = 0.939), and a model of miR-4516, miR-143-3p, miR-16-5p and miR-451a was predictive of lymph node positivity (p < 0.001, ROC-AUC = 0.786). Multivariate Cox regression showed that a model of downregulated miR-16-5p and upregulated miR-451a was significantly associated with poorer survival (p = 0.023). Conclusions: This study indicates the future potential of exomiRs as diagnostic and prognostic liquid biopsy markers for vulvar cancer. Full article
(This article belongs to the Special Issue Novel Approaches in the Management of Gynecological Cancers)
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12 pages, 981 KB  
Article
Postvoid Residual Volume After Radical Hysterectomy for Early-Stage Cervical Cancer: Predictive Factors and a Decision-Making Algorithm
by Naia Seminario, Vicente Bebia, Ana Luzarraga Aznar, Marta San José, Elvira Vallés, Giulio Bonaldo, Antonio Gil-Moreno and Martina Aida Angeles
Cancers 2026, 18(1), 24; https://doi.org/10.3390/cancers18010024 - 21 Dec 2025
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Abstract
Objective: Our study evaluated the time to normalization of postvoid residual volume after radical hysterectomy and identified risk factors for postoperative bladder dysfunction. We also aimed to establish a predictive threshold for bladder dysfunction on the third postoperative day to develop a decision-making [...] Read more.
Objective: Our study evaluated the time to normalization of postvoid residual volume after radical hysterectomy and identified risk factors for postoperative bladder dysfunction. We also aimed to establish a predictive threshold for bladder dysfunction on the third postoperative day to develop a decision-making algorithm for postoperative voiding management. Methods: This retrospective, single-center study included early-stage cervical cancer patients undergoing type B1 or C1 radical hysterectomy. Factors associated with elevated postvoid residual volume were analyzed using logistic regression, and the threshold was determined using the Youden index. Results: 67 patients were included: 36 patients (53.7%) underwent C1 radical hysterectomy and 31 (46.3%) B1. At discharge, 13 (19.4%) patients required a catheter: 8 (61.5%) required intermittent catheterization, 5 (38.5%) had a Foley catheter. By postoperative day 3, 49 (73.1%) patients recovered their voiding function. The median time to postvoid residual volume recovery was 1 day (IQR: 1–2) for type B1 and 2.5 days (IQR: 2–5) for type C1 (p < 0.01). Compared with B1, C1 radicality was independently associated with a higher risk of postoperative voiding dysfunction (OR = 11.46; 95% CI: 1.75–75.24; p < 0.05). Based on these findings, we propose an algorithm for risk-adapted postoperative voiding management: B1 patients can safely have catheters removed on postoperative day 1 without a voiding trial, whereas C1 patients require one. C1 patients with postvoid residual volume ≥170 mL should have delayed catheter removal. Conclusions: Surgical radicality is a risk factor for postoperative bladder dysfunction. In type C1 radical hysterectomy, a postvoid residual volume ≥170 mL on the first postoperative day identifies patients at high risk of delayed recovery, supporting a tailored approach to postoperative voiding management. Full article
(This article belongs to the Special Issue Novel Approaches in the Management of Gynecological Cancers)
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13 pages, 299 KB  
Article
Ovarian Cancer in the Era of Precision Surgery and Targeted Therapies
by Yagmur Sisman, Tim Svenstrup Poulsen, Tine Henrichsen Schnack, Claus Høgdall and Estrid Høgdall
Cancers 2025, 17(20), 3371; https://doi.org/10.3390/cancers17203371 - 18 Oct 2025
Viewed by 769
Abstract
Background: High-grade serous ovarian cancer (HGSC) is the most common and aggressive subtype of ovarian cancer. Despite initial response to platinum-based chemotherapy, most patients relapse. Cytoreductive surgery at relapse has been shown to improve survival in selected patients, but the biological mechanisms underlying [...] Read more.
Background: High-grade serous ovarian cancer (HGSC) is the most common and aggressive subtype of ovarian cancer. Despite initial response to platinum-based chemotherapy, most patients relapse. Cytoreductive surgery at relapse has been shown to improve survival in selected patients, but the biological mechanisms underlying recurrence and resistance remain unclear. This study aimed to investigate whether the mutational profile of HGSC changes from diagnosis to relapse, and to evaluate treatment patterns and survival outcomes in a cohort undergoing cytoreductive surgery. Methods: Sixteen patients with HGSC who underwent cytoreductive surgery at both diagnosis and relapse were included. Matched tumor tissue samples (n = 32) were collected and sequenced using a 501-gene cancer panel. Only pathogenic or likely pathogenic variants were registered. Clinical data, treatment history, and survival outcomes were obtained from medical records, with a median follow-up of 63 months. Results: All patients harbored pathogenic or likely pathogenic mutations, most frequently in TP53 (88%) and BRCA1/2 (38%). The mutational landscape was largely stable, with 15 of 16 patients (94%) showing no mutational changes between diagnosis and relapse. One patient acquired a NOTCH2 mutation at relapse. Complete resection was achieved in 88% of relapse surgeries. Median time to first relapse was 32 months, and overall survival was prolonged, with 87.5% of patients alive at last follow-up. BRCA mutated patients showed longer time to relapse, and overall follow-up compared to BRCA wild-type cases. Conclusions: The somatic mutational profile of HGSC remains remarkably stable from diagnosis to relapse. Clinically, this stability suggests that repeat mutational sequencing at relapse is unlikely to yield new actionable findings and may have limited value in guiding treatment decisions. Instead, resistance mechanisms likely arise from epigenetic or non-genetic changes, underscoring the need for future research in these areas and the continued importance of optimal surgical management in selected patients. Full article
(This article belongs to the Special Issue Novel Approaches in the Management of Gynecological Cancers)
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