New Directions in the Treatment of Gynecological Cancers

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

Deadline for manuscript submissions: closed (20 October 2022) | Viewed by 11602

Special Issue Editors


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Guest Editor
Department of Oncology, Poznan University of Medical Science, Poznan, Poland
Interests: ovarian cancer; endometrial cancer; uterine cancer; cervical cancer; vulvar cancer; nutrition in cancer

E-Mail Website
Guest Editor
Department of Oncology, Poznań University of Medical Sciences, Szamarzewskiego 82/84, 60-569 Poznań, Poland
Interests: ovarian cancer; endometrial cancer; uterine cancer; cervical cancer; vulvar cancer; new therapies in cancer; cancer epidemiology; HPV vaccine

Special Issue Information

Dear Colleagues,

The effective treatment of gynecological cancers is the rising problem globally. The introduction of new drugs such as bevacizumab, PARP inhibitors, or checkpoint inhibitors that target PD-1 or PD-L1 has changed treatment strategies while posing new challenges. The management of some of the side effects of these new drugs and the introduction of subsequent lines of treatment may be a problem. Finally, there are also unresolved issues around surgical and palliative treatment that must be addressed. For instance, more research is needed to identify successful strategies to prevent and screen for cancer, as well as on additional biomarkers that can predict response to planned therapy, on the management of side effects of treatment and on the improvement of quality of life, including through nutritional therapies. The scope of this Special Issue is to provide an overview of recent advances in the field of gynecological oncology and to set new research directions. Therefore, researchers in the field of gynecological cancer treatment are encouraged to submit an original article or review to this Special Issue (case reports and short reviews will not be accepted).

Dr. Marcin Mardas
Prof. Dr. Janina Markowska
Guest Editors

Manuscript Submission Information

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Keywords

  • Screening
  • Management
  • Prognostic factors
  • Biomarkers
  • Ovarian cancer
  • Endometrial cancer
  • Cervical cancer
  • Vulvar cancer
  • Nutrition in cancer
  • Targeted therapies
  • Supportive care

Published Papers (5 papers)

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Research

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8 pages, 569 KiB  
Article
Fertility-Sparing Management May Be Considered in Young Women with Uterine Sarcoma
by Szymon Piątek, Iwona Szymusik, Anna Dańska-Bidzińska, Mariusz Ołtarzewski, Gabriela Trojan and Mariusz Bidziński
J. Clin. Med. 2022, 11(16), 4761; https://doi.org/10.3390/jcm11164761 - 15 Aug 2022
Cited by 5 | Viewed by 1396
Abstract
Uterine sarcomas occur very rarely in young women. Hysterectomy, which is a standard treatment, may not be acceptable for those patients, especially nulliparous women. Fertility-sparing management may be an alternative. The aim of the study was to assess fertility-sparing management in patients with [...] Read more.
Uterine sarcomas occur very rarely in young women. Hysterectomy, which is a standard treatment, may not be acceptable for those patients, especially nulliparous women. Fertility-sparing management may be an alternative. The aim of the study was to assess fertility-sparing management in patients with uterine sarcoma. Eleven patients were eligible for the study. Histopathologic types of the tumor included: adenosarcoma (n = 3), low-grade endometrial stromal sarcoma (n = 3), low-grade myofibroblastic sarcoma (n = 1), leiomyosarcoma (n = 1), leiomyosarcoma myxoides (n = 1), rhabdomyosarcoma (n = 1), high grade endometrial stromal sarcoma (n = 1). The mean age of the patients at the time of diagnosis was 27.4 years (range: 17–35) and the average follow-up 61 months (range: 12–158). Six patients received adjuvant treatment: megestrol (n = 5) and chemotherapy (n = 1). Recurrence was diagnosed in five cases. Median time to recurrence was 35 months (range: 8–90). Three patients conceived spontaneously following treatment and gave at least one live birth. In total, five full-term pregnancies were recorded and five healthy children were born. Fertility-sparing management may be considered in some patients with uterine sarcoma; however, it may not be appropriate in high-grade endometrial stromal sarcoma. Patients with adenosarcoma may have a low chance of childbearing. Full article
(This article belongs to the Special Issue New Directions in the Treatment of Gynecological Cancers)
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12 pages, 275 KiB  
Article
Gynecological Cancers in Lynch Syndrome: A Comparison of the Histological Features with Sporadic Cases of the General Population
by Valentina Elisabetta Bounous, Elisabetta Robba, Stefania Perotto, Barbara Pasini, Nicoletta Tomasi Cont, Maria Teresa Ricci, Antonino Ditto, Marco Vitellaro, Francesco Raspagliesi and Nicoletta Biglia
J. Clin. Med. 2022, 11(13), 3689; https://doi.org/10.3390/jcm11133689 - 27 Jun 2022
Cited by 3 | Viewed by 3168
Abstract
Introduction: About 5% of endometrial cancers (ECs) are attributed to an inherited predisposition, for which Lynch syndrome (LS) accounts for the majority of cases. Women with LS have a 40–60% predicted lifetime risk of developing EC, in addition to a 40–80% lifetime risk [...] Read more.
Introduction: About 5% of endometrial cancers (ECs) are attributed to an inherited predisposition, for which Lynch syndrome (LS) accounts for the majority of cases. Women with LS have a 40–60% predicted lifetime risk of developing EC, in addition to a 40–80% lifetime risk of developing colorectal cancer and other cancers. In this population, the lifetime risk of developing ovarian cancer (OC) is 10–12%. Object: to compare the histopathological features of LS-associated EC and OC with sporadic cancers in order to evaluate whether there are differences in terms of age at diagnosis, site of occurrence in the uterus, histological type, stage at diagnosis, and tumor grading. Materials and methods: we compared data obtained from 96 patients with LS-associated gynecological cancers (82 with EC and 14 with OC) to a control group (CG) of 209 patients who developed sporadic EC, and a CG of 187 patients with sporadic OC. Results: The mean age at diagnosis of LS-associated EC and OC was much lower than in the control groups. In both groups with EC, the endometrioid histotype was the most frequently occurring histotype. However, among LS women there was a significantly higher incidence of clear cell tumors (11% versus 2.4% in the CG, p = 0.0001). Similar to the sporadic cancer cases, most of the LS-associated ECs presented at an early stage (89% of cases at FIGO I-II stage). In the LS group, the tumor frequently involved only the inner half of the endometrium (77% of cases, p < 0.01). In the LS group, 7.3% of ECs were localized to the lower uterine segment (LUS), whereas no cancer developed in the LUS in the CG. No serous OCs were diagnosed in the LS group (versus 45.5% in the CG, p = 0.0009). Most of the LS-associated OCs presented at an early stage (85% of cases at FIGO I-II stages, p < 0.01). Conclusion: LS-associated EC and OC seem to have peculiar features, occurring at a younger age and at an earlier stage. In LS, EC less frequently involves the outer half of the endometrium, with a more frequent occurrence in the LUS. The presence of clear cell EC was more frequently observed, whereas in OC, the predominant histotype was endometrioid. Full article
(This article belongs to the Special Issue New Directions in the Treatment of Gynecological Cancers)
10 pages, 1474 KiB  
Article
Survival Impact of Residual Cancer Cells in Intraoperative Peritoneal Washes following Radical Hysterectomy for Cervical Cancer
by Jong Mi Kim, Gun Oh Chong, Nora Jee-Young Park, Yeong Eun Choi, Juhun Lee, Yoon Hee Lee, Dae Gy Hong and Ji Young Park
J. Clin. Med. 2022, 11(9), 2659; https://doi.org/10.3390/jcm11092659 - 09 May 2022
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Abstract
Objective: Residual cancer cells (RCCs) contribute to cancer recurrence either because of tumor spillage or undetectable pre-existing micrometastatic tumor clones. We hypothesized that the pathologic evaluation of intraoperative peritoneal washes may reveal RCCs. The aim of this study was to evaluate the survival [...] Read more.
Objective: Residual cancer cells (RCCs) contribute to cancer recurrence either because of tumor spillage or undetectable pre-existing micrometastatic tumor clones. We hypothesized that the pathologic evaluation of intraoperative peritoneal washes may reveal RCCs. The aim of this study was to evaluate the survival impact of RCCs identified in intraoperative peritoneal washes and their correlation with clinicopathologic parameters following radical hysterectomy for cervical cancer. Methods: A total of 229 patients with cervical cancer who underwent radical hysterectomy with pelvic and/or paraaortic lymphadenectomy were included. The intraoperative peritoneal washes after surgery were filtered through a strainer and the presence of tumor cells in the residual aspirate was determined. Univariate and multivariate analyses of clinicopathological parameters were performed to identify predictors of recurrence. Results: RCCs in intraoperative peritoneal washes were identified in 19 patients (8.3%). Multivariate analysis revealed that deep stromal invasion (hazard ratio [HR], 13.32; 95% confidence interval [CI], 1.81–98.27; p = 0.0111), lymph node metastasis (HR, 2.00; 95% CI, 1.01–3.99; p = 0.0482), and neoadjuvant chemotherapy (HR, 2.34; 95% CI, 1.89–4.61; p = 0.0139) were associated with tumor recurrence. However, the presence of RCCs was not associated with tumor recurrence (HR, 2.60; 95% CI, 0.74–9.11; p = 0.1352). Multiple logistic regression analysis revealed that RCCs were associated with neoadjuvant chemotherapy (odds ratio [OR], 0.22; 95% CI, 0.05–0.99; p = 0.0488) and large tumor size (OR, 4.16; 95% CI, 0.77–22.48; p = 0.0981). Conclusions: Although the presence of RCCs in intraoperative peritoneal washes do not significantly impact survival outcomes, there was a tendency of inferior survival outcomes in patients with RCCs. RCCs were associated with neoadjuvant chemotherapy and large tumor size. Full article
(This article belongs to the Special Issue New Directions in the Treatment of Gynecological Cancers)
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10 pages, 690 KiB  
Article
miRNAs in the Expression Regulation of Dopamine-Related Genes and Proteins in Endometrial Cancer
by Michał Czerwiński, Anna Bednarska-Czerwińska, Nikola Zmarzły, Dariusz Boroń, Marcin Oplawski and Beniamin Oskar Grabarek
J. Clin. Med. 2021, 10(21), 4939; https://doi.org/10.3390/jcm10214939 - 26 Oct 2021
Cited by 4 | Viewed by 2045
Abstract
Disruption of the dopaminergic system leads to many diseases, including cancer. Dopamine and its receptors are involved in the regulation of proliferation, cell death, invasion, and migration. Better understanding of the mechanisms involved in these processes could reveal new molecular markers and therapeutic [...] Read more.
Disruption of the dopaminergic system leads to many diseases, including cancer. Dopamine and its receptors are involved in the regulation of proliferation, cell death, invasion, and migration. Better understanding of the mechanisms involved in these processes could reveal new molecular markers and therapeutic targets. The aim of this study was to determine the expression profile of dopamine-related genes and proteins in endometrial cancer and to assess whether miRNAs are involved in its regulation. Sixty women were recruited for the study: 30 with endometrial cancer and 30 without cancer. The expression profiles of dopamine-related genes were determined in endometrial tissue samples using microarrays and qRT-PCR. Then, protein concentration was determined with the ELISA test. In the last step, miRNA detection was performed using microarrays. The matching of miRNAs to the studied genes was carried out using the TargetScan tool. The analysis showed DRD2 and DRD3 overexpression, with a reduction in DRD5 expression, which could be due to miR-15a-5p, miR-141-3p, miR-4640-5p, and miR-221-5p activity. High levels of OPRK1 and CXCL12, related to the activity of miR-124-3p.1 and miR-135b-5p, have also been reported. Low COMT expression was probably not associated with miRNA regulation in endometrial cancer. Full article
(This article belongs to the Special Issue New Directions in the Treatment of Gynecological Cancers)
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Review

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21 pages, 590 KiB  
Review
Influence of Probiotics in Prevention and Treatment of Patients Who Undergo Chemotherapy or/and Radiotherapy and Suffer from Mucositis, Diarrhoea, Constipation, Nausea and Vomiting
by Aleksandra Garczyk, Iwona Kaliciak, Konstanty Drogowski, Paulina Horwat, Stanisław Kopeć, Zuzanna Staręga, Paweł Bogdański, Marta Stelmach-Mardas and Marcin Mardas
J. Clin. Med. 2022, 11(12), 3412; https://doi.org/10.3390/jcm11123412 - 14 Jun 2022
Cited by 6 | Viewed by 2603
Abstract
The administration of probiotics to patients treated with chemo- and/or radiotherapy is assumed to be beneficial. The aim of this study was to evaluate the effects of probiotic intake on the severity of selected gastrointestinal side effects of chemotherapy and radiotherapy. The searched [...] Read more.
The administration of probiotics to patients treated with chemo- and/or radiotherapy is assumed to be beneficial. The aim of this study was to evaluate the effects of probiotic intake on the severity of selected gastrointestinal side effects of chemotherapy and radiotherapy. The searched databases included PubMed, Web of Science, and Scopus from which twenty-one studies were included. Most of them concerned diarrhoea, however, two of the studies examined constipation, another two nausea and vomiting, and eight of the included studies regarded mucositis. The total number of patients equalled 2621. The time of the conducted therapy, the administered species, neoplasm pathology, and adjuvant therapy varied. The outcome was assessed by gathering information about the statistical significance of the improvements. An enhancement was observed in thirteen studies, where probiotics had a significant impact on each of the included chemo- and/or radiotherapy side effects. However, the heterogeneity of the assessed data makes it impossible to state a firm conclusion. Full article
(This article belongs to the Special Issue New Directions in the Treatment of Gynecological Cancers)
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