Background: The study aimed to evaluate the impact of integrating molecular classification with imaging-based preoperative staging on risk stratification prediction in endometrial cancer patients in accordance with ESGO/ESTRO/ESP (European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology) 2021 guidelines. Methods: A retrospective cohort of 143 endometrial cancer patients was analyzed to assess changes in preoperative risk stratification after incorporating molecular classification into clinical evaluation. Preoperative clinical staging was primarily based on transvaginal ultrasound imaging. The overall agreement between preoperative risk group estimates (with/without molecular classification) and final postoperative outcomes was assessed using weighted Cohen’s Kappa, with bootstrap 95% confidence intervals and quadratic weights. Results: The addition of molecular classification significantly improved preoperative risk stratification accuracy (from 59.4 to 73.4%), particularly for patients post-operatively classified as high-risk. Kappa values indicated an improvement in overall agreement between preoperative and postoperative risk stratification following the addition of molecular classification, from 0.551 (95% CI: 0.430–0.671) to 0.767 (95% CI: 0.675–0.849). The non-overlapping confidence intervals indicated statistical significance. Preoperative assessment without molecular input tended to underestimate risk stratification. However, 26.6% of patients remained misclassified due to other factors, mostly within the intermediate and high-intermediate risk groups. Conclusions: Incorporating molecular classification enhances preoperative risk stratification and has the potential to tailor surgical treatment. Further validation through prospective multicentric studies is needed to support our findings.

Objective: To evaluate the safety, adequacy, and accuracy of tru-cut biopsy of gynaecologic tumours in a population of Czech women. Methods: A four-year retrospective study of ultrasound-guided tru-cut biopsy of gynaecologic tumours was conducted in the Department of Obstetrics and Gynaecology, Charles University, Hradec Kralove, Czech Republic. Results: One hundred and four women with gynaecologic tumours underwent transvaginal tru-cut biopsy within the study period. The most common indication for tru-cut biopsy in more than one-half of the women was a suspicion of malignancy/inability to exclude malignancy (59, 56.7%). Most of the tumours were malignant on histopathological examination (71, 68.3%), with advanced ovarian cancer being the most common type of malignancy (43/71, 60.6%). The overall adequacy and accuracy rates of tru-cut biopsy were 93.3% and 93.3%, respectively. Most of the inadequate samples were obtained from overweight and obese women (5/7, 71.4%), with only one biopsy sample taken in the majority of the inadequate biopsies (5/7, 71.4%). Accuracy was higher for malignant than benign tumours (97.7% vs. 82.4%). For malignant tumours, accuracy was highest for advanced ovarian cancers (33/40, 82.5%). Only one case was complicated by bleeding, giving an overall complication rate of 1%. The complicated biopsy was taken by a gynae-oncology trainee. Conclusions: Tru-cut biopsy is a cost-effective and safe preoperative diagnostic modality for patients with gynaecologic tumours, offering high adequacy and accuracy. It is particularly useful in patients with advanced ovarian cancer, most of whom present late with inoperable tumours that contraindicate primary surgery.

Pelvic organ prolapse (POP) is increasingly relevant in aging populations. Oxidative stress (OS) may weaken pelvic support structures, but previous studies relied on invasive tissue sampling, limiting longitudinal use. This study evaluated whether OS markers can be detected non-invasively in vaginal fluid and whether they correlate with POP severity. We prospectively enrolled 160 women with POP between February 2021 and June 2023. Vaginal fluid samples were collected, and three OS markers: 8-hydroxy-2′-deoxyguanosine (8-OHdG), 4-hydroxynonenal (HNE), and advanced glycation end products (AGE) were quantified using commercial ELISA kits. POP severity was assessed by POP-Q and ultrasound parameters. 8-OHdG was consistently detectable and significantly elevated in advanced POP compared to early stages (p = 0.001), showing a modest positive correlation with prolapse severity (ρ = 0.24, p < 0.001). Regression analysis confirmed 8-OHdG as an independent predictor of prolapse severity (R² = 0.964). AGE levels did not differ significantly between groups, and HNE values were below detection thresholds in most samples. No associations were found between OS markers and age, BMI, or menopause duration. Non-invasive assessment of oxidative stress in vaginal fluid is feasible. Elevated 8-OHdG correlates with POP severity, supporting its potential as a biomarker for disease monitoring and future translational research.

Karcinom vaje?n?ku je heterogenn? onemocn?n? s celkov? ?patnou progn?zou, jeho? l??ba by m?la b?t nastavena s ohledem na kvalitu ?ivota a p?e?it? pacientky. Z?kladem spr?vn?ho nastaven? l??ebn? strategie je kvalitn? p?edopera?n? diagnostika a ... Karcinom vaje?n?ku je heterogenn? onemocn?n? s celkov? ?patnou progn?zou, jeho? l??ba by m?la b?t nastavena s ohledem na kvalitu ?ivota a p?e?it? pacientky. Z?kladem spr?vn?ho nastaven? l??ebn? strategie je kvalitn? p?edopera?n? diagnostika a ...

Skeletal muscle ageing is characterized by distinct histomorphological changes. The aim of this review is to describe these changes in the pelvic floor mus