Gynecologic Cancers: Integrating Established Standards and Innovative Approaches

Dear Colleagues,

The clinical management of gynecological cancers continues to evolve at the interface between well-established therapeutic standards and rapidly emerging technologies. Classical topics remain highly relevant—including radical hysterectomy and fertility-preserving surgery for early cervical cancer, cytoreductive approaches for advanced ovarian disease, and the standardized use of concomitant chemoradiation and brachytherapy in locally advanced cervical carcinoma. These conventional modalities have significantly improved survival outcomes, yet optimization of surgical extent, timing of adjuvant therapy, and management of long-term toxicities remain subjects of active clinical debate. In parallel, the field is witnessing a paradigm shift toward precision and minimally invasive strategies: robotic and laparoscopic platforms, sentinel lymph node mapping with near-infrared fluorescence, nerve-sparing pelvic surgery, and cytoreductive procedures combined with hyperthermic intraperitoneal chemotherapy (HIPEC) are redefining surgical oncology practice. 

In radiation oncology, adaptive image-guided radiotherapy (IGRT), MRI-Linac systems, and brachytherapy guided by MRI or PET are improving target definition and sparing of normal tissues. Novel biological concepts—including FLASH irradiation, proton and heavy-ion therapy, and the integration of radiomics, radiogenomics, and artificial intelligence—are expanding the potential of radiotherapy from a purely physical to a biologically driven discipline. The synergistic combination of radiotherapy with immunotherapy or targeted agents opens new translational perspectives, particularly in recurrent or radioresistant tumors.

Beyond the major cancer types, this Special Issue also invites contributions addressing rare gynecologic tumors—such as vulvar, vaginal, and uterine sarcomas, as well as germ-cell and sex-cord stromal tumors and so on—for which optimal multimodal management is still being defined. By bringing together both classical and emerging clinical topics, this Special Issue aims to foster interdisciplinary dialogue between surgeons and radiation oncologists, highlighting progress and challenges in achieving personalized, effective, and compassionate care for women with gynecologic malignancies. This Special Issue welcomes the submission of original research articles, review articles (with systematic reviews being especially encouraged when applicable), and meta-analyses addressing any aspect of the clinical, surgical, or radiation management of gynecological cancers.

Prof. Dr. Radu Vladareanu
Dr. Liviu Bilteanu
Guest Editors

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• gynecological cancers
• cervical cancer
• ovarian cancer
• endometrial cancer
• vulvar and vaginal tumors
• uterine sarcoma
• fertility preservation
• robotic surgery
• image-guided radiotherapy (IGRT)
• brachytherapy
• proton and FLASH radiotherapy
• immunotherapy
• radiomics
• artificial intelligence
• digital twin
• multimodal treatment
• survivorship and quality of life