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Advances in the Surgical Management of Gynecological Malignancies
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Advances in the Surgical Management of Gynecological Malignancies

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 20 July 2025 | Viewed by 3165

Special Issue Editors

Prof. Dr. Laurentiu Pirtea

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Guest Editor
Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Victor Babeş", Timişoara, Romania
Interests: gynaecological surgery; gynecologic oncology; hysterectomy
Special Issues, Collections and Topics in MDPI journals
Dr. Răzvan Ştefan Ilina

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Guest Editor
Department of Surgery, Discipline of Surgical Semiology II, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
Interests: breast cancer; laparoscopic surgery; gynecological surgery

Special Issue Information

Dear Colleagues,

Advances in the surgical management of gynecological malignancies have revolutionized treatment approaches, enhancing both survival rates and quality of life for patients. With innovative techniques and technologies, surgeons can now offer more precise and less invasive procedures tailored to individual cases.

Minimally invasive surgery, including laparoscopy and robotic-assisted surgery, has become increasingly popular. These techniques enable surgeons to perform complex procedures with smaller incisions, reducing pain, blood loss, and recovery time. Additionally, they allow for better visualization and manipulation of tissues, leading to improved outcomes.

Furthermore, advances in imaging modalities such as MRI and PET-CT have enhanced preoperative planning and staging accuracy, enabling surgeons to better assess tumor extent and plan surgical approaches accordingly. This has led to more personalized treatment strategies and improved patient outcomes.

In addition to surgical techniques, there have been significant developments in adjuvant therapies such as targeted therapies and immunotherapy, which can be combined with surgery to achieve better results, particularly in advanced or recurrent cases.

Overall, these advances represent a paradigm shift in the management of gynecological malignancies, offering patients new hope and improved prospects for long-term survival and quality of life. As research continues and technology evolves, the future of surgical oncology holds even more promise for further enhancing patient care.

Prof. Dr. Laurentiu Pirtea
Dr. Răzvan Ştefan Ilina
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. Journal of Clinical Medicine 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 2600 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

  • minimally invasive surgery
  • laparoscopy surgery
  • robotic-assisted surgery
  • gynecological malignancies

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Published Papers (2 papers)

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Research

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11 pages, 791 KiB  
Article
Reducing Peritoneal Cell Dissemination in Laparoscopic Uterine Surgery: A Comparative Pilot Study on Morcellation Techniques and Peritoneal Irrigation
by Lorenz Kuessel, Lejla Sandrieser, Gerda Hofstetter, Florian Heinzl, Michal Mara, Adéla Richtárová, Eliana Montanari, René Wenzl, Alexandra Perricos-Hess and Heinrich Husslein
J. Clin. Med. 2025, 14(10), 3383; https://doi.org/10.3390/jcm14103383 - 13 May 2025
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Abstract
Following the U.S. Food and Drug Administration’s warning against power morcellators due to potential cell dissemination of occult malignancy, there has been a shift away from minimally invasive approaches. This concern also overshadows the well-documented advantages of minimally invasive surgery in benign gynecology. [...] Read more.
Following the U.S. Food and Drug Administration’s warning against power morcellators due to potential cell dissemination of occult malignancy, there has been a shift away from minimally invasive approaches. This concern also overshadows the well-documented advantages of minimally invasive surgery in benign gynecology. Objectives: To evaluate whether intraperitoneal cell dissemination during laparoscopic surgery for uterine fibroids can be reduced by (i) the choice of morcellation method and/or (ii) copious irrigation after the procedure. Methods: This prospective multicenter comparative pilot study included 72 women undergoing laparoscopic myomectomy (LM) or total laparoscopic hysterectomy (TLH) for benign conditions. Women were divided into four groups in order to compare different types of morcellation, including a reference group without morcellation: (i) LM with power morcellation (n = 21, Group A), (ii) TLH with en-bloc transvaginal tissue removal without morcellation (n = 17, Group B), (iii) TLH with manual vaginal morcellation (n = 19, Group C), and (iv) TLH with contained manual vaginal morcellation (n = 15, Group D). Patients receiving cold knife morcellation were randomized into Groups C or D. In order to assess cell spread before surgery, after surgery but before morcellation, after morcellation, and after abdominal irrigation with a total of 3000 mL saline solution, peritoneal washings were collected at six timepoints. Results: After specimen removal (TP3), cell spread was significantly higher in cases with power morcellation [13/19 (68%) in Group A] compared to transvaginal cold knife morcellation, both contained and uncontained [Group C 1/14 (7%) and Group D 1/19 (9%)] (p < 0.001), or to TLH with en bloc removal [Group B 1/17 (6%)]. Saline irrigation reduced the positive cytologies. After 3000 mL (TP6), the difference between Group A and the TLH groups was not significant [4/18 (22%) vs. 3/45 (7%), p = 0.079]. Conclusions: Our study shows that (i) transvaginal cold knife morcellation results in significantly less peritoneal cell dissemination than power morcellation, and (ii) peritoneal irrigation with 3000 mL of saline significantly reduces residual cell presence. These findings could support maintaining minimally invasive approaches while addressing safety concerns. Full article
(This article belongs to the Special Issue Advances in the Surgical Management of Gynecological Malignancies)
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Review

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22 pages, 1003 KiB  
Review
Comprehensive Review of Endometrial Cancer: New Molecular and FIGO Classification and Recent Treatment Changes
by Maria-Bianca Anca-Stanciu, Andrei Manu, Maria Victoria Olinca, Cătălin Coroleucă, Diana-Elena Comandașu, Ciprian Andrei Coroleuca, Calina Maier and Elvira Bratila
J. Clin. Med. 2025, 14(4), 1385; https://doi.org/10.3390/jcm14041385 - 19 Feb 2025
Cited by 1 | Viewed by 2613
Abstract
Endometrial cancer (EC) is the most common gynecologic malignancy in developed countries, with rising incidence due to aging populations and obesity-related factors. This review explores the evolving molecular and FIGO classifications of EC, highlighting their significance in diagnosis, prognosis, and personalized treatment strategies. [...] Read more.
Endometrial cancer (EC) is the most common gynecologic malignancy in developed countries, with rising incidence due to aging populations and obesity-related factors. This review explores the evolving molecular and FIGO classifications of EC, highlighting their significance in diagnosis, prognosis, and personalized treatment strategies. Molecular subtyping based on The Cancer Genome Atlas (TCGA) classification offers a more precise understanding of EC, dividing it into POLE ultramutated, microsatellite instability-high (MSI-H), copy-number low (CNL), and copy-number high (CNH) subtypes. Each subgroup has distinct genetic, histological, and prognostic characteristics. Recent updates to the FIGO staging system incorporate molecular features, allowing for more tailored treatment approaches. Advances in immunotherapy, targeted therapies, and novel therapeutic combinations have reshaped clinical management. This review emphasizes the integration of molecular diagnostics into routine practice, outlining challenges and future perspectives in managing EC for improved patient outcomes. Full article
(This article belongs to the Special Issue Advances in the Surgical Management of Gynecological Malignancies)
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