Hideki Tokunaga

Sakaki H, et al. J Gynecol Oncol. 2027 ;38:e16. https://doi.org/10.3802/jgo.2027.38.e16

Aim: Despite advancements in maintenance therapies, recurrent epithelial ovarian cancer remains a clinical challenge with varying outcomes. This study aimed to evaluate the clinicopathological status and prognostic factors of patients with recurrent epithelial ovarian cancer. Methods: We conducted a retrospective survey through the Committee on Gynecologic Oncology of the Japan Society of Gynecology and Obstetrics across 16 institutions. Results: Histological subtypes included high‐grade serous (HGS; n = 304), clear‐cell (CC; n = 83), endometrioid (EM; n = 35), mucinous ( n = 12), and low‐grade serous ( n = 9) carcinomas. At recurrence, the median age was 61 years, 74.0% of patients had a platinum‐free interval (PFI) ≥ 6 months, and 78.8% maintained a performance status (PS) of 0. Genetic testing identified 42 BRCA1/2 mutations and 52 cases of homologous recombination deficiency positivity. Recurrence occurred primarily in the peritoneum, lymph nodes, and liver. For PFI ≥ 6 months, paclitaxel/carboplatin ± bevacizumab was the primary treatment; for PFI < 6 months, pegylated liposomal doxorubicin ± bevacizumab predominated. The overall response rate was 69.9% for PFI ≥ 6 months versus 17.7% for PFI < 6 months. Median overall survival was 27.9 months. Multivariate analysis confirmed histological subtype (CC/EM vs. HGS), PS, CA125 (≥ 100 U/mL), and PFI as significant independent prognostic factors, while first‐line molecularly targeted therapy use showed no significant impact. Conclusion: PFI, histological subtype, PS, and CA125 levels are important prognostic factors for the use of molecular‐targeted agents for recurrent epithelial ovarian cancer. Patients with CC and EM subtypes experience worse outcomes than those with HGS, highlighting the need for subtype‐specific management in recurrent ovarian cancer.

Background: Mucinous borderline ovarian tumors (MBOTs) are rare neoplasms with excellent prognosis, yet the optimal surgical extent remains controversial. No large-scale study in Japan has evaluated treatment trends and prognostic factors for MBOTs. This study aimed to clarify their clinicopathological features, management patterns, and survival outcomes using a nationwide registry. Methods: Data were obtained from the Japan Society of Obstetrics and Gynecology Gynecologic Tumor Registry, including 96,476 ovarian tumors treated between 2004 and 2018. Among them, 12,766 MBOT cases were identified. Surgical procedures—hysterectomy, omentectomy, lymphadenectomy, and adjuvant chemotherapy—were analyzed. Survival analyses of 8564 cases with complete prognostic data were performed using Kaplan–Meier and Cox proportional hazards models. Results: Over 90% of MBOTs were stage I, and the median age was 52 years. Hysterectomy was performed in 50.8%, omentectomy in 57.9% (2015–2018 subset), and lymphadenectomy in 7.6%. Only 2.6% received adjuvant chemotherapy. The 5-year overall survival exceeded 95%. Multivariate analysis identified age ≥ 50 years (HR 2.5, 95% CI 1.8–3.6) and stage IC (HR 2.7, 95% CI 1.9–3.6) as independent adverse factors. Omentectomy showed a marginal survival benefit (HR 0.6, p = 0.05), whereas hysterectomy, lymphadenectomy, and chemotherapy conferred no advantage. Chemotherapy correlated with poorer outcomes, likely due to confounding by indication. Conclusions: This nationwide cohort—the largest MBOT series reported to date—demonstrates conservative management with excellent prognosis in Japan. Radical surgery and chemotherapy provide no survival benefit, whereas fertility-sparing surgery appears appropriate for younger patients.

Shoji T, et al. J Gynecol Oncol. 2026 ;37:e150. https://doi.org/10.3802/jgo.2026.37.e150

Ishibashi M, et al. J Gynecol Oncol. 2026 ;37:e127. https://doi.org/10.3802/jgo.2026.37.e127

Zhang H, et al. J Gynecol Oncol. 2026 Jan;37:e63. https://doi.org/10.3802/jgo.2026.37.e63

Morisada T, et al. J Gynecol Oncol. 2025 Apr;36(3):e119. https://doi.org/10.3802/jgo.2025.36.e119

Kakuwa T, et al. J Gynecol Oncol. 2025 Mar;36:e77. https://doi.org/10.3802/jgo.2025.36.e77

Nishio S, et al. J Gynecol Oncol. 2025 Mar;36:e93. https://doi.org/10.3802/jgo.2025.36.e93

Kakuwa T, et al. J Gynecol Oncol. 2025 Mar;36:e78. https://doi.org/10.3802/jgo.2025.36.e78