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Uterine Artery Embolization for Pure Adenomyosis: Predictive Factors Affecting Outcomes

2026-06-01T00:00:00Z

Title: Uterine Artery Embolization for Pure Adenomyosis: Predictive Factors Affecting Outcomes Authors: Han, Kichang; Kim, Man-Deuk; Kwon, Joon Ho; Seo, Seok Kyo; Alqarni, Abdullah Ali; Park, Juil; Kim, Gyoung Min; Won, Jong Yun; Cho, Jaesung; Jeong, Seok Min Abstract: Purpose: To identify factors associated with postprocedural necrosis after uterine artery embolization (UAE) for pure adenomyosis. Materials and Methods: This study included patients who underwent UAE for pure symptomatic adenomyosis between January 2011 and May 2025. Adenomyosis characteristics, including T2-weighted signal intensity, adenomyosis morphology (Types I and II), and focal versus diffuse location, were evaluated using preprocedural magnetic resonance (MR) imaging. Contrast-enhanced MR imaging was used to assess adenomyosis necrosis 3 months after UAE. Symptom severity scores (SSSs) and health-related quality of life (HRQOL) were evaluated before and 3 months after the procedure. Univariate and multivariate analyses were performed to identify factors associated with incomplete necrosis of the adenomyotic tissue. Results: Of the 147 patients (mean age, 42.7 years [SD +/- 4.2]) who underwent UAE for adenomyosis, 116 (78.9%) exhibited complete necrosis. In multivariate analysis, Type II adenomyosis (odds ratio [OR], 10.492; 95% CI, 3.492-31.523; P < .001) and heterogeneous T2 signal intensity (OR, 4.003; 95% CI, 1.565-10.242; P = .003) were significant predictive factors for incomplete necrosis. The rates of incomplete necrosis were 13.6% (17/125) for Type I adenomyosis and 63.6% (14/22) for Type II adenomyosis. The postprocedural SSS and HRQOL scores were significantly improved in patients with complete necrosis compared with those with incomplete necrosis. Conclusions: Type II morphology arising from the subserosa and a heterogeneous T2 signal are associated with an increased risk of incomplete necrosis after UAE. Incorporating these features into preprocedural counseling may help improve clinical outcomes.

A randomized phase III clinical trial of weekly versus tri-weekly cisplatin-based chemoradiotherapy for locally advanced cervical cancer: results of the TACO (GCIG/KGOG 1027/THAI 2012) study

2026-04-01T00:00:00Z

Title: A randomized phase III clinical trial of weekly versus tri-weekly cisplatin-based chemoradiotherapy for locally advanced cervical cancer: results of the TACO (GCIG/KGOG 1027/THAI 2012) study Authors: Y. Ryu, S.; Nam, B. H.; Kim, M. H.; Jang, W. I.; Sitathanee, C.; Linh, T. D.; Lee, K. H.; Lee, W. M.; Kim, E. T.; Kang, S. B.; Kim, J. H.; V. Park, J.; Lee, K. B.; Cho, C. H.; Lou, H.; Kim, Y. H.; Kim, Y. T.; Lee, Y. H.; Wu, X.; Kim, J. W.; Park, S. I.; Jeon, S.; Thinh, D. H.; Kry, S. F.; Gaffney, D.; Small, W.; Wilailak, S. Abstract: Background The standard treatment for locally advanced cervical cancer is cisplatin-based chemoradiotherapy; however, the optimal dose and dosing schedule of cisplatin remain debated. The aim of this study was to compare the clinical outcomes of weekly cisplatin at 40 mg/m(2) versus those of tri-weekly cisplatin at 75 mg/m(2) during radiation in patients with locally advanced cervical cancer. Patients and methods In this prospective, randomized clinical trial, we enrolled 314 patients with stage IIB-IVA cervical cancer, randomly assigning them in a 1 : 1 ratio into two arms. The weekly arm received a weekly dose of 40 mg/m(2) cisplatin for six cycles, whereas the tri-weekly arm received a tri-weekly dose of 75 mg/m(2) cisplatin for three cycles, both concurrently with radiotherapy. The primary endpoints included 3-year recurrence-free survival according to a superiority design, with P < 0.05 indicative of statistical significance. Overall survival, toxicity profiles, and quality of life (QOL) were also analyzed. Results Chemotherapy delay was more frequent in the weekly arm than in the tri-weekly arm (P = 0.008). However, the 3-year recurrence-free survival rate between the two arms did not significantly differ (78.7% in the weekly arm, 84.1% in the tri-weekly arm; hazard ratio 0.71, 95% confidence interval 0.39-1.32, P = 0.28). The pattern of recurrence did not differ significantly between the two arms. Grade 3 and 4 hematological toxicities occurred less frequently in the tri-weekly arm (P < 0.001). Furthermore, the tri-weekly arm had better QOL scores across several domains compared with the weekly arm. Conclusion In this study, tri-weekly cisplatin-based chemoradiotherapy was not statistically superior to a weekly schedule in terms of survival outcomes for patients with locally advanced cervical cancer. However, the tri-weekly regimen exhibited a more favorable toxicity profile and improved QOL compared with the weekly regimen. These results suggest tri-weekly cisplatin administration as a feasible alternative for chemoradiotherapy in cervical cancer.

Plain language summary of results from the DUO-E study: durvalumab given with or without olaparib in patients with advanced endometrial cancer

2026-04-01T00:00:00Z

Title: Plain language summary of results from the DUO-E study: durvalumab given with or without olaparib in patients with advanced endometrial cancer Authors: Westin, Shannon N.; Moore, Kathleen; Chon, Hye Sook; Lee, Jung-Yun; Thomes Pepin, Jessica; Sundborg, Michael; Shai, Ayelet; de la Garza, Joseph; Nishio, Shin; Gold, Michael A.; Wang, Ke; McIntyre, Kristi; Tillmanns, Todd D.; Blank, Stephanie V.; Liu, Ji-Hong; McCollum, Michael; Contreras Mejia, Fernando; Nishikawa, Tadaaki; Pennington, Kathryn; Novak, Zoltan; De Melou, Andreia Cristina; Sehouli, Jalid; Klasa-Mazurkiewicz, Dagmara; Papadimitriou, Christos; Gil-Martin, Marta; Brasiuniene, Birute; Donnelly, Conor; Liu, Xiaochun; Nieuwenhuysen, Els Van

Perioperative Outcomes of Robotic Versus Conventional Total Laparoscopic Hysterectomy in Surgically Complex Cases: A Propensity Score-Matched Study

2026-04-01T00:00:00Z

Title: Perioperative Outcomes of Robotic Versus Conventional Total Laparoscopic Hysterectomy in Surgically Complex Cases: A Propensity Score-Matched Study Authors: Eoh, Kyung Jin; Hur, Hyewon; Park, Joo Hyun Abstract: Objective: To compare perioperative outcomes between robotic and conventional total laparoscopic hysterectomy in terms of operative time, intraoperative blood loss, and postoperative recovery in surgically complex cases. Methods: This retrospective cohort study included patients that underwent total laparoscopic hysterectomy between 2020 and 2022. As robotic surgery was preferentially applied to more complex cases in an effort to minimize the risk of open conversion, propensity score matching based on uterine weight and history of abdominal surgery was performed. The normality of continuous variables was assessed using the Shapiro-Wilk test; non-normally distributed variables are reported as median [interquartile range] and compared using the Mann-Whitney U test. Multivariate linear regression with log-transformed estimated blood loss was conducted to evaluate the independent association of surgical approach with hemostatic outcomes. Results: After 1:1 matching, 93 patients were analyzed per group. Robotic surgery was associated with longer operative time but lower estimated blood loss when compared with conventional laparoscopy. Postoperative hemoglobin decline, length of hospital stay, and complication rates were comparable between groups. In multivariate analysis, uterine weight and operative time were the primary determinants of estimated blood loss; surgical approach showed a modest, independent association with lower log-transformed estimated blood loss after adjustment for these factors. Conclusions: Robotic and conventional total laparoscopic hysterectomy demonstrated comparable perioperative safety profiles with different operative trade-offs. Observed differences in estimated blood loss reflect complex interactions between surgical difficulty, operative time, and instrumentation rather than inherent platform superiority. These findings support an individualized approach to surgical modality selection based on case complexity, to minimize risk of intraoperative complication leading to open conversion.