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Current Approaches and Future Directions in the Treatment of Gynecologic...
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Current Approaches and Future Directions in the Treatment of Gynecologic Tumors: Molecular Biology, Diagnostic Advancements and Targeted Therapeutic Strategies

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: 30 July 2025 | Viewed by 12918

Special Issue Editor

Dr. Valentin Nicolae Varlas

E-Mail Website
Guest Editor
Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 010221 Bucharest, Romania
Interests: gynecologic oncology; gynecologic cancer surgery; minimally invasive surgery; immunology and genetics of tumors; endometriosis; oncofertility
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Gynecologic tumors represent a serious public health problem as they are associated with high rates of morbidity and mortality. In recent years, the multidisciplinary integrative approach has enabled significant progress to be made in this field, which has led to a better understanding of molecular mechanisms and advanced diagnostic methods, facilitating the implementation of targeted therapies. Although oncologic medicine is becoming increasingly personalized, several knowledge gaps and unsolved problems remain. Thus, future scientific research should offer new perspectives regarding better deciphering the biology of tumor processes, early diagnosis criteria, and therapeutic strategies to improve prognoses.

In this Special Issue, through the lens of the latest medical research, I aim to highlight the continuously growing role of the integrative approach to the management of gynecologic tumors regarding intervention in biomolecular mechanisms, diagnostic criteria, and therapeutic strategies

Dr. Valentin Nicolae Varlas
Guest Editor

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Keywords

  • gynecologic tumors
  • cervical cancer
  • ovarian cancer
  • endometrial cancer
  • vulvar cancer, vaginal cancer
  • gestational trophoblastic disease
  • molecular mechanisms
  • diagnostic advancements
  • novel therapies

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Published Papers (5 papers)

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Research

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11 pages, 1254 KiB  
Article
The Impact of Surgery Delay on Early-Stage Ovarian Cancer
by Dimitrios Zouzoulas, Dimitrios Tsolakidis, Iliana Sofianou, Tilemachos Karalis, Michalis Aristotelidis, Panagiotis Tzitzis, Evangelia Deligeoroglou, Maria Topalidou, Eleni Timotheadou and Grigoris Grimbizis
Life 2025, 15(1), 122; https://doi.org/10.3390/life15010122 - 17 Jan 2025
Viewed by 909
Abstract
(1) Background: Suspicious adnexal masses should be referred to gynecological oncology units. However, when surgery waiting lists are prolonged, these patients usually suffer from a delay in surgery. This could have a negative impact on their prognosis when the final diagnosis is ovarian [...] Read more.
(1) Background: Suspicious adnexal masses should be referred to gynecological oncology units. However, when surgery waiting lists are prolonged, these patients usually suffer from a delay in surgery. This could have a negative impact on their prognosis when the final diagnosis is ovarian cancer (OC). The primary aim of this study was to investigate the impact of surgery delay on the oncological results of early-stage ovarian cancer patients. (2) Methods: We retrospectively reviewed the records of early-stage OC patients who underwent surgery in the 1st Department of Obstetrics and Gynecology from 2012 to 2019. Time to surgery was defined as the time interval from the day of first examination to the day of surgery. (3) Results: A total of 72 patients were categorized into two groups, with a cut-off point of 5 weeks: 32 were treated ≤ 5 weeks (group A), and 40 > 5 weeks (group B). Concerning age, BMI or comorbidities, no differences were found between the two groups. Furthermore, no differences were presented in the post-operative complications rate, hospital stay, ICU admittance, or in disease-free (p = 0.48) and overall survival rates (p = 0.703). (4) Conclusions: Suspicious adnexal masses should undergo careful differential diagnosis to avoid delays in the “wait and see” period when the final diagnosis is positive for malignancy. However, the time to surgery for early-stage OC over 5 weeks seems to be relatively safe, with no impact on the mortality, morbidity, or recurrence rate. Full article
(This article belongs to the Special Issue Current Approaches and Future Directions in the Treatment of Gynecologic Tumors: Molecular Biology, Diagnostic Advancements and Targeted Therapeutic Strategies)
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19 pages, 2477 KiB  
Article
The Five-Year Outcomes of Breast Cancer Surgical Management at the Colentina Surgical Clinic, Bucharest, Romania: A Descriptive Retrospective Analysis Between 2019 and 2023
by Cristian Botezatu, Daniel-Ovidiu Costea, Martina Nichilò, Angela Madalina Lazar, Dan Andraș, Mircea-Ion Radu and Bogdan Mastalier
Life 2025, 15(1), 92; https://doi.org/10.3390/life15010092 - 14 Jan 2025
Viewed by 926
Abstract
Background: Breast cancer still represents the most commonly diagnosed cancer among women, accounting for 12.5% of all new annual cancer cases worldwide. In Romania in 2020, breast cancer was the most common, with a share of new cases of 26.9%, far behind the [...] Read more.
Background: Breast cancer still represents the most commonly diagnosed cancer among women, accounting for 12.5% of all new annual cancer cases worldwide. In Romania in 2020, breast cancer was the most common, with a share of new cases of 26.9%, far behind the rates of colon cancer (11.8%) and cervix cancer (7.5%). The aim of this study is to reveal five years of experience in treating breast cancer at the Surgical Clinic of the Colentina Hospital in Bucharest, Romania. Methods: Retrospective analysis, including 68 patients admitted to our clinic between January 2019 and December 2023 undergoing modified radical mastectomy, sectorectomy, or subcutaneous mastectomy. Results: Madden-modified radical mastectomy with total excision of the axillary lymph nodes accounted for 77.94% of surgeries, with a complication rate of 13.2%, represented by lymphedema of the ipsilateral arm and prepectoral seroma. Conclusions: Continuous innovation regarding early diagnosis and treatment methods in our surgical clinic will, hopefully, contribute to improving the outcomes of our patients. Full article
(This article belongs to the Special Issue Current Approaches and Future Directions in the Treatment of Gynecologic Tumors: Molecular Biology, Diagnostic Advancements and Targeted Therapeutic Strategies)
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13 pages, 977 KiB  
Article
Effect of Preoperative Gum Chewing on Postoperative Nausea and Vomiting in Women Undergoing Robotic Laparoscopic Surgery for Uterine Myomas: A Randomized Controlled Trial
by Min Suk Chae and Hyun Jung Koh
Life 2024, 14(12), 1693; https://doi.org/10.3390/life14121693 - 20 Dec 2024
Viewed by 1308
Abstract
Background: Postoperative nausea and vomiting (PONV) remains a frequent and uncomfortable complication in women undergoing robotic gynecological procedures. Despite the use of various preventive strategies, PONV continues to negatively impact recovery and increase healthcare expenses. This study aimed to evaluate whether the preoperative [...] Read more.
Background: Postoperative nausea and vomiting (PONV) remains a frequent and uncomfortable complication in women undergoing robotic gynecological procedures. Despite the use of various preventive strategies, PONV continues to negatively impact recovery and increase healthcare expenses. This study aimed to evaluate whether the preoperative use of sugar-free chewing gum could effectively minimize the dependence on anti-emetic drugs in women undergoing robot-assisted laparoscopic surgery for uterine myomas. Methods: In this randomized, single-blind study, 92 adult women scheduled for robot-assisted laparoscopic surgery were enrolled. The participants were randomly assigned to one of two groups: a gum-chewing group, which was instructed to chew sugar-free gum for 15 min in the preoperative holding area, or a control group that did not chew gum. The primary outcome was the requirement for anti-emetic medication within the first hour after surgery, when the patient was in the post-anesthesia care unit (PACU). Secondary outcomes included the overall frequency of anti-emetic use. To assess the intervention’s effectiveness independent of any other factors, no prophylactic anti-emetics were administered during surgery. Results: Of the 92 participants, 89 completed the study, with 44 assigned to the gum-chewing group and 45 to the control group. The gum-chewing group showed a significantly lower rate of PONV, requiring anti-emetic treatment (79.5%), compared to the control group (95.6%). Additionally, the control group demonstrated a higher overall need for anti-emetic medications. Notably, there were no reported adverse effects, such as jaw discomfort, dental injuries, or gastric regurgitation, in either group. Conclusions: Chewing sugar-free gum for 15 min prior to surgery was found to be a safe, simple, and effective method to reduce the occurrence of PONV in women undergoing robot-assisted laparoscopic surgery for benign uterine tumors. This non-invasive intervention reduced the reliance on anti-emetic drugs and improved patient comfort, without introducing risks. These findings suggest that preoperative gum chewing could be routinely implemented in clinical settings to enhance surgical outcomes. Full article
(This article belongs to the Special Issue Current Approaches and Future Directions in the Treatment of Gynecologic Tumors: Molecular Biology, Diagnostic Advancements and Targeted Therapeutic Strategies)
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Review

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17 pages, 827 KiB  
Review
Artificial Intelligence in Breast Cancer Diagnosis and Treatment: Advances in Imaging, Pathology, and Personalized Care
by Petar Uchikov, Usman Khalid, Granit Harris Dedaj-Salad, Dibya Ghale, Harney Rajadurai, Maria Kraeva, Krasimir Kraev, Bozhidar Hristov, Mladen Doykov, Vanya Mitova, Maria Bozhkova, Stoyan Markov and Pavel Stanchev
Life 2024, 14(11), 1451; https://doi.org/10.3390/life14111451 - 8 Nov 2024
Cited by 9 | Viewed by 7227
Abstract
Breast cancer is the most prevalent cancer worldwide, affecting both low- and middle-income countries, with a growing number of cases. In 2024, about 310,720 women in the U.S. are projected to receive an invasive breast cancer diagnosis, alongside 56,500 cases of ductal carcinoma [...] Read more.
Breast cancer is the most prevalent cancer worldwide, affecting both low- and middle-income countries, with a growing number of cases. In 2024, about 310,720 women in the U.S. are projected to receive an invasive breast cancer diagnosis, alongside 56,500 cases of ductal carcinoma in situ (DCIS). Breast cancer occurs in every country of the world in women at any age after puberty but with increasing rates in later life. About 65% of women with the BRCA1 and 45% with the BRCA2 gene variants develop breast cancer by age 70. While these genes account for 5% of breast cancers, their prevalence is higher in certain populations. Advances in early detection, personalised medicine, and AI-driven diagnostics are improving outcomes by enabling a more precise analysis, reducing recurrence, and minimising treatment side effects. Our paper aims to explore the vast applications of artificial intelligence within the diagnosis and treatment of breast cancer and how these advancements can contribute to elevating patient care as well as discussing the potential drawbacks of such integrations into modern medicine. We structured our paper as a non-systematic review and utilised Google Scholar and PubMed databases to review literature regarding the incorporation of AI in the diagnosis and treatment of non-palpable breast masses. AI is revolutionising breast cancer management by enhancing imaging, pathology, and personalised treatment. In imaging, AI can improve the detection of cancer in mammography, MRIs, and ultrasounds, rivalling expert radiologists in accuracy. In pathology, AI enhances biomarker detection, improving HER2 and Ki67 assessments. Personalised medicine benefits from AI’s predictive power, aiding risk stratification and treatment response. AI also shows promise in triple-negative breast cancer management, offering better prognosis and subtype classification. However, challenges include data variability, ethical concerns, and real-world validation. Despite limitations, AI integration offers significant potential in improving breast cancer diagnosis, prognosis, and treatment outcomes. Full article
(This article belongs to the Special Issue Current Approaches and Future Directions in the Treatment of Gynecologic Tumors: Molecular Biology, Diagnostic Advancements and Targeted Therapeutic Strategies)
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12 pages, 1920 KiB  
Review
Status of and Challenges in Therapy of Mucinous Ovarian Cancer Associated with Pseudomyxoma Peritonei Syndrome: Review of Current Options and Future Treatment Trends
by George Pariza, Carmen Mavrodin, Alina Potorac, Octavian Munteanu and Monica Mihaela Cirstoiu
Life 2024, 14(11), 1390; https://doi.org/10.3390/life14111390 - 29 Oct 2024
Viewed by 1902
Abstract
Objective: Pseudomyxoma peritonei (PP) is a rare condition, and differentiating between primary and secondary ovarian causes is crucial for determining the appropriate oncological therapy. Given the resistance of ovarian mucinous carcinoma to standard platinum-based chemotherapy, the objective of this review is to present [...] Read more.
Objective: Pseudomyxoma peritonei (PP) is a rare condition, and differentiating between primary and secondary ovarian causes is crucial for determining the appropriate oncological therapy. Given the resistance of ovarian mucinous carcinoma to standard platinum-based chemotherapy, the objective of this review is to present the current therapeutic approaches and summarize the emerging trends in the treatment of this disease. Methods: The authors conducted an exhaustive evaluation of studies published over a 14-year period (June 2010–May 2024) concerning pseudomyxoma peritonei, mucinous ovarian carcinoma, ovarian causes of PP, and ovarian cancer using the following databases: PubMed, Scopus, and Science Direct. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The results were organized into seven subchapters and analyzed. Results: The analyzed studies present surgery followed by HIPEC as the current therapy with the best long-term survival results. However, the oncological treatment is unsatisfactory, and the choice of therapy depending on the primary origin of the tumor becomes particularly important. For the differential diagnosis between pseudomyxoma due to a gastrointestinal cause and that of ovarian origin, genetic analyses are recommended; these include the characteristics of the mucin present in the lesion, as the therapeutic response can have contradictory results depending on the primary origin of the tumor. Conclusions: Surgery followed by HIPEC remains the standard for resectable cases. However, oncological treatment has controversial results in the case of mucinous ovarian carcinoma compared to other types of ovarian cancer and to metastatic ovarian tumors associated with pseudomyxoma of the peritoneum. Based on the articles included in this review, it was found that the current trend is the study of mucin as a resistance factor against chemotherapy based on platinum products and the targeting of oncological therapy according to the tumor’s genetic characteristics. Full article
(This article belongs to the Special Issue Current Approaches and Future Directions in the Treatment of Gynecologic Tumors: Molecular Biology, Diagnostic Advancements and Targeted Therapeutic Strategies)
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