During pregnancy, decidual tissue can occur beyond the endometrium, predominantly on the surface of the uterus, fallopian tubes, and ovaries. This condition, called ectopic deciduosis, generally is not accompanied by any symptoms and complications, does not require treatment, and resolves completely soon after labor. However, rarely it can present with acute abdomen syndrome or imitate peritoneal malignancy and, thus, cause diagnostic difficulties and unnecessary interventions. Here, we report a challenging case of a pregnant woman admitted with acute peritonitis caused by ectopic deciduosis that mimicked peritoneal carcinomatosis. This uncommon manifestation of deciduosis hindered correct diagnosis and led to excessive surgery. While the management of the patient presented is regrettable, the case highlights the natural history of deciduosis, and therefore, important lessons could be learned from it.

A radical hysterectomy is the standard method of surgical treatment for patients with early-stage cancer of the uterine cervix. It was first introduced more than 100 years ago. Since then, various and many different radical procedures, which diverge in terms of radicality, have been described. Inconsistencies are clearly seen in practical anatomy, which were defined as surgically created artifacts. Moreover, the disparity of the procedure is most notable regarding the terminology of pelvic connective tissues and spaces. Despite these controversies, the procedure is widely performed and implemented in the majority of guidelines for the surgical treatment of cancer of the uterine cervix. However, a different and unique concept of surgical treatment of cervical cancer has been reported. It is based on ontogenetic anatomy and maps any tissue in the mature organism according to its embryologic development. The clinical implementation of this theory in the context of early cervical cancer is total mesometrial resection. The present article aims to describe and compare the anatomical and surgical basics of a radical hysterectomy (type C1/C2) and total mesometrial resection. Discrepancies regarding the terminology, resection lines, and surgical planes of both procedures are highlighted in detail. The surgical anatomy of the pelvic autonomic nerves and its surgical dissection is also delineated. This is the first article that compares the discrepancy of classic anatomy and ontogenic anatomy regarding surgical treatment of cancer of the uterine cervix. Clinical data, oncological outcome, and neoadjuvant and adjuvant treatment regarding both procedures are not the topic of the present article.

Introduction Given treatment advancements and the long life expectancy of mostly young patients with cervical cancer, their post-treatment quality of life (QoL) is essential to consider. This study aimed to evaluate the long-term QoL in cervical cancer survivors treated with various approaches. Methods We conducted a cross-sectional survey-based study using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Cervical Cancer Module 24 (EORTC-QLQ-CX24) questionnaires and involved members of the online cervical cancer patient support group (01/2024-02/2024). Eligible participants were ≥18 years old, diagnosed with stage IA2-IIB cervical cancer, and had completed their treatment. Respondents were stratified into four management groups: neoadjuvant chemotherapy + surgery +/- radiation therapy (RT), surgery + RT, RT alone, and surgery alone. Results Overall, 173 patients participated: 20 (11.6%) received neoadjuvant chemotherapy + surgery +/- RT, 50 (28.9%) had surgery + RT, 69 (39.9%) had RT alone, and 34 (19.7%) had surgery alone. Patients after surgery alone had significantly better global QoL (p<0.001). Their physical (p<0.001), role (p=0.037), emotional (p=0.024), and social (p=0.006) functioning were also substantially better. This group also reported the lowest severity of fatigue (p=0.001), nausea and vomiting (p<0.001), and diarrhea (p<0.001). Sexual functioning was better in the surgery-alone group in almost all aspects. There were no major differences in QoL among the groups, receiving RT alone or combined with other treatments. Conclusions Cervical cancer survivors who underwent surgery alone reported the highest QoL and lower symptom intensity compared to those treated with RT or treatment combinations. RT combined with other modalities did not appear to substantially decrease QoL compared to RT alone.

Endometrial cancer is the most common gynaecological malignancy in Russia and in the world. Pathological evaluation of lymph nodes is important for staging and adjuvant therapy management. Until recently, systematic lymphadenectomy was the gold standard for staging of endometrial cancer. However, this procedure has been associated with high morbidity and life-long consequences. Sentinel lymph node biopsy is an alternative procedure for staging. We conducted a literature review to evaluate the diagnostic precision, safety and methodology of sentinel lymph node mapping in endometrial cancer.

Background/Objective: The aim of this study was to compare two different staging systems (FIGO 2018 and ontogenetic staging) for cervical cancer in a locally advanced setting and to determine which one provides better prognostic stratification and a stronger association with oncological outcomes. Methods: A multicenter retrospective cohort study was conducted in patients with cervical cancer (FIGO 2018 stages IIB-IVA) primarily treated with chemoradiotherapy. The primary endpoint was the difference in accuracy for predicting cancer-specific survival at 3 years between the ontogenetic tumor staging system and the FIGO 2018 staging system. Secondary endpoints assessed the same difference in prognostic power with respect to recurrence-free survival and overall survival. Results: Of 341 patients with locally advanced cervical cancer, the ontogenetic tumor staging system demonstrated superior prognostic performance compared to the FIGO 2018 system. The ontogenetic system showed clear separation of Kaplan–Meier curves for recurrence-free, overall, and cancer-specific survival, unlike the overlapping FIGO 2018 survival curves. Multivariable Cox models controlling clinicopathological factors revealed a progressive, significant worsening of cancer-specific survival across ontogenetic tumor (oT) stages, which was not observed with FIGO staging. Formal comparisons using Harrell’s C-index, time-dependent areas under the curve (AUC), and Akaike’s information criterion confirmed the ontogenetic model’s significantly better discriminative ability and fit. Furthermore, ontogenetic staging provided significant risk stratification within the FIGO IIIC nodal-positive group and among patients with parametrial invasion, demonstrating its refined prognostic utility. Conclusions: Ontogenetic tumor staging can be effectively applied using imaging alone and was superior to the FIGO 2018 classification in this study.