Vulvar cancer is a relatively rare disease. The aim of this study was to investigate prognostic factors in vulvar squamous cell carcinoma patients treated with primary surgery. Forty cases of vulvar squamous cell carcinoma treated with primary surgery were retrospectively analyzed. Overall survival (OS) and disease-specific survival (DSS) were calculated using the Kaplan–Meier method and prognostic factors were analyzed by multivariate analyses. The median age was 68 years. The FIGO stage distribution was as follows: 18 cases (45.0 %) in stage I, four cases (10.0 %) in stage II, 15 cases (37.5 %) in stage III, and three cases (7.5 %) in stage IV. A radical local excision was performed in 15 patients, and radical vulvectomy in 25 patients, and seven of these patients were treated with postoperative RT. The 5-year DSS rate was 72.6 %, and the 5-year OS rate was 70.3 %. Age and surgical margin ≤5 mm were independent prognostic factors for OS, and positive inguinal LN metastasis and surgical margin ≤5 mm were identified as independent prognostic factors for DSS. Complete radical excision is important regardless of operation mode. Adjuvant treatment should be considered for inguinal LN positive patients.

Objective:To compare patients with cervical cancer who were primarily treated with concurrent chemoradiotherapy (CCRT) using 20 mg m−2 CDDP for 5 days every 3 weeks with weekly regimens of 40 mg m−2.Methods:We retrospectively analyzed 185 patients with Stage IB–IVA squamous-cell carcinoma of the cervix who were treated with CCRT between 2005 and 2013 at our hospital. The CCRT regimen consisted of cisplatin (CDDP) at 20 mg m−2 for 5 days every 3 weeks or 40 mg m−2 weekly, administered concomitantly with RT.Results:The median age was 50 years (range: 22–70 years) in the triweekly group and was 50.5 years (range: 28–70 years) in the weekly group. The 5-year overall survival rate in the triweekly and weekly groups were 82.0% and 83.3%, respectively (p = 0.851); their disease-free survival rate was 79.6% and 78.1%, respectively (p = 0.672). In the triweekly group, 56 patients (50.9%) had grade 3/4 leukopenia, which was significantly higher than that of 11 patients (15%) in the weekly group (p < 0.0001).Conclus...

Background. A rare case of low-grade endometrial stromal sarcoma (LG-ESS) extending to inferior vena cava (IVC) and cardiac chambers.Case Report. A 40-year-old woman had IVC tumor, which was incidentally detected by abdominal ultrasonography during a routine medical checkup. CT scan revealed a tumor in IVC, right iliac and ovarian veins, which was derived from the uterus and extended into the right atrium and ventricle. The operation was performed, the heart and IVC were exposed, and cardiopulmonary bypass was initiated. A right atriotomy was performed, and the intracardiac mass was removed. Then the tumor in IVC and the right internal iliac vein were removed after longitudinal venotomies in the suprarenal and infrarenal vena cava, the right common iliac vein. Next the pelvis was explored. Tumors were found originating from the posterior wall of the uterus and continuing into both the right uterine and ovarian vein. The patient underwent total hysterectomy with bilateral salpingooophorectomy. Complete tumor resection was achieved. Histopathological analysis confirmed a diagnosis of LG-ESS. She showed no evidence of disease for 2 years and 3 months.Conclusions. Our case highlights the importance of a multidisciplinary approach in treating this rare cardiovascular pathological condition through preoperative assessment to final operation.

•Secondary uterine sarcomas occur in < 1% of patients treated with CCRT.•Secondary uterine sarcomas can occur > 5 years from CCRT.•The median survival period from the secondary tumor occurrence was only 4 months.•All our patients had heterologous carcinosarcoma of the uterine corpus.

Nishio S, et al. J Gynecol Oncol. 2025 Apr;36:e118. https://doi.org/10.3802/jgo.2025.36.e118

5527 Background: Patients with persistent cervical cancer after definitive radiotherapy/concurrent chemoradiotherapy (RT/CCRT) have a poor prognosis. Salvage hysterectomy (HT) is considered curative treatment; however, very little data exists showing the survival advantage of HT over standard therapy. Methods: Patients with persistent cervical cancer treated with definitive RT/CCRT at 35 institutions from 2005–2014 were reviewed retrospectively. Those who underwent a HT for residual cervical disease after definitive RT/CCRT were matched (histology, FIGO stage at initial treatment, brachytherapy application, age and performance status at diagnosis of residual tumor, diameter and parametrial invasion by residual tumor, and the number of lymph node tumors at diagnosis, etc.) with propensity scores for patients who underwent systemic chemotherapy (CT). Oncologic outcomes between the two groups using a propensity score matched–cohort analysis were compared. Results: A total of 142 patients with residual cervical disease after definitive RT/CCRT were included after matching (HT: 71, systemic CT: 71). A difference in all background factors between HT and CT groups was not observed. At a median follow-up of 4.6 years, 33 (46.5%) and 47 deaths (66.2%) occurred in HT and CT groups, respectively. Median overall survival was 3.8 and 1.5 years in HT and CT groups, respectively (p= 0.0019, hazards ratio [HR] 2.438, 95% confidence interval [CI] 1.362–4.361), and median progression-free survival was 2.7 and 0.7 years, respectively (p= 0.0046, HR 2.235, 95% CI 1.262–3.960). Increasing tumor size was significantly associated with a high incomplete resection rate (p= 0.0385, Odds Ratio 0.941, 95% CI 0.888–0.997). The cut-off value for the residual tumor diameter regarding complete resection after receiver operating characteristic (ROC) analysis was 11 mm (sensitivity 70%, specificity 86.9%). Conclusions: Salvage HT may be considered curative treatment for patients with residual cervical disease after definitive RT/CCRT. The diameter of residual tumor is important in selecting appropriate candidates for HT.