Background: In gynecologic cancer survivors, female sexual dysfunction (FSD) remains under-investigated. We attempted to estimate the prevalence of FSD associated with distress in gynecologic cancer survivors using diagnostic and statistical manual of mental disorders fifth edition (DSM-5) diagnostic criteria and to identify women at risk for FSD. Methods: We conducted a cross-sectional analysis of premenopausal women aged 20–50 with various gynecologic cancers at least one year after treatment between January 2017 and December 2019. Data of sociodemographics and physical conditions were collected via face-to-face interview during outpatient clinic visits. The domains we used to define FSD were based on DSM-5 diagnostic criteria. Statistical analysis was carried out using Student's t test, Chi-square test and multiple logistic regression. Results: A total of 126 gynecologic cancer survivors with a mean age of 42.4 years were included for analysis and 55 of them (43.7%) were diagnosed as having FSD associated with distress based on DSM-5 criteria. More than half of women (65.1%) reported decreased sexual satisfaction after cancer treatment. According to DSM-5 definition, the most common female sexual disorders were sexual interest/arousal disorder (70.9%), followed by genitopelvic pain/penetration disorder (60.0%), and orgasmic disorder (20.0%). In multiple logistic regression model, endometrial cancer diagnosis was the only independent factor predicting less influence of cancer treatment on FSD (OR 0.370; 95% CI 0.160, 0.856). Conclusion: The first study to use DSM-5 criteria for estimation of FSD prevalence. This enables clinicians to identify which women are actually needed to seek medical help. A prevalence of 43.7% of FSD associated with distress was found in a group of gynecologic cancer survivors with the most common being sexual interest/arousal disorder. Endometrial cancer survivors were at low risk for developing FSD after treatment.

The aim of the present study was to describe various hysteroscopic findings of previous cesarean delivery scar defects (PCDS), and evaluate the relationship between these findings and abnormal uterine bleeding. This was a retrospective study including patients with abnormal uterine bleeding after a cesarean section. Transvaginal ultrasound and hysteroscopy were used to detect the origin of the symptoms, and the gynecological symptoms and hysteroscopic findings were recorded. Relationships between the hysteroscopic findings and abnormal uterine bleeding were evaluated. Ninety-six (82.8%) patients presented with intermenstrual bleeding. The most common findings of scar defects on hysteroscopy were increased local vascularization (74.1%) and oozing spots (47.4%). Increased local vascularization on the defect was significantly related to intermenstrual bleeding (p = 0.048). This study categorized different findings of PCDS under hysteroscopy. Increased local vascularization on the scar defect was significantly related to intermenstrual bleeding.

Platinum-resistant ovarian cancer (PROC) refers to disease progression within 6 months after the completion of platinum-based chemotherapy. Historically, treatment options for PROC were limited with a poor prognosis and non-platinum single agent plus bevacizumab has been the mainstay of treatment. Fortunately, there have been notable advancements in recent years, leading to an advance in treatment paradigms for this challenging disease. Various combinations of chemotherapy, targeted agents such as poly (ADP-ribose) polymerase (PARP) inhibitors, and immunotherapy are being explored for an improved treatment outcome. Antibody-drug conjugates targeting folate receptor alpha, which deliver a cytotoxic payload directly to cancer cells, have emerged as a promising therapeutic approach for PROC. WEE1 inhibitors, such as adavosertib, function by inhibiting the WEE1 kinase activity, leading to premature entry of a cell into mitosis phase and thus increased DNA damage. It has been observed that cancer cells with TP53 mutations may be more sensitive to WEE1 inhibitors. Biomarker testing such as analysis of the expression level of folate receptor alpha or mutation in TP53 may be applicable for identifying patients who are more likely to respond to the specific therapy, enabling a more personalized treatment approach. This overview summarizes key clinical findings on the efficacy and safety of theses novel biomarker-driven therapeutic approaches.

Background: Pyruvate kinase M2 (PKM2) is a regulator of the processes of glycolysis and oxidative phosphorylation, but the roles that it plays in endometrial cancer remain largely unknown. This study evaluated the PKM2 expression in normal endometrium, endometrial hyperplasia, and endometrial carcinoma, and its prognostic value was investigated in endometrial carcinoma patients. Methods: A hospital-based retrospective review was conducted to examine the immunohistochemical PKM2 distribution in 206 endometrium samples from biopsies or hysterectomies. The immunoreactivity of PKM2 was divided into groups of low and high scores according to the extent and intensity of staining. Results: Intense cytoplasmic staining was observed for the PKM2 protein in malignant endometrial lesions. A high PKM2 score was observed in many endometrial carcinoma samples (50.0%), but there was a low percentage in endometrial atypical hyperplasia (12.5%). High PKM2 expression was not found in the normal endometrium (0.0%) nor endometrial hyperplasia without atypia (0.0%). The PKM2 protein score was significantly higher in endometrial carcinoma samples than premalignant endometrial lesions (p < 0.001). Notably, higher PKM2 scores in cases of endometrial carcinoma correlated with poor overall survival (p = 0.006), and the hazard ratio for death was 3.40 (95% confidence interval, 1.35–8.56). Conclusions: Our results indicate that the prevalence of PKM2^high tumor cells in endometrial carcinoma is significantly associated with worse prognostic factors and favors a poor prognosis. The expression of PKM2 is also a potential histopathological biomarker for use in the differential diagnosis of malignant and premalignant endometrial lesions.