Recurrent epithelial ovarian cancer (rOC) remains a major therapeutic challenge because of its high relapse rate and the progressive development of chemoresistance. Secondary cytoreductive surgery (S-CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been explored as locoregional strategies to overcome the limitations of systemic therapy, but their clinical value varies substantially according to platinum sensitivity, surgical completeness, and patient selection. In platinum-sensitive rOC (PS-rOC), evidence from randomized controlled trials (RCTs) demonstrates that S-CRS provides survival benefit only when completeness of CRS (C-CRS) to CCR0 is achieved in rigorously selected patients using validated selection tools. Meta-analytic data further confirmed that incomplete resection confers little clinical advantage and may fail to offset surgical morbidity. The addition of HIPEC to S-CRS in this setting is supported by a biologically plausible rationale and has been associated with an overall survival (OS) benefit, although no consistent improvement in progression-free survival (PFS) has been demonstrated and treatment-related adverse events (TRAEs), particularly hematologic and renal AEs, are increased. These findings support a selective, center-experienced, and protocol-conscious application of HIPEC rather than routine use. In contrast, high-level evidence supporting S-CRS or S-CRS plus HIPEC in platinum-resistant rOC (PR-rOC) remains lacking. Available data are derived primarily from small retrospective series and systematic reviews with substantial heterogeneity and selection bias, precluding definitive conclusions regarding survival benefit. Several ongoing phase III RCTs are expected to clarify the optimal role, timing, and patient selection for HIPEC-based strategies across different disease settings. Overall, current evidence supports an individualized, biology-driven approach to rOC, integrating surgical feasibility, anticipated systemic treatment efficacy, and careful risk–benefit assessment within a multidisciplinary framework.

Objective: Using repeated laparoscopic pectopexy with anterior colporrhaphy for treating woman with recurrent stage III pelvic organ prolapse (POP) who was complicated with a detached mesh from prior pectopexy. Case report: A 68-year-old woman presented in 2024 with recurrent stage III POP two years after laparoscopic subtotal hysterectomy and laparoscopic pectopexy (LP). She reported a vaginal mass and voiding difficulty associated with 250 mL post-void residual urine. Repeated LP and anterior colporrhaphy were conducted, due to a detached mesh from the cervical stump, with intact pectineal ligament anchors, with taking 120 min of the operation time and minimal blood loss. She was discharged on day 3. At six months, POP-Q stage 0 was achieved, voiding symptoms resolved (15 mL residual), and quality of life improved without complications. Conclusion: Repeated LP seemed to effectively correct recurrent POP, offering durable outcomes with minimal morbidity.

OBJECTIVE:This study aimed to assess prognosis related to poly (ADP-ribose) polymerase inhibitor (PARPi) maintenance therapy (MT) in newly diagnosed patients with advanced-stage epithelial ovarian cancer (adsOC, primary setting). Additionally, it evaluated the effect on recurrent patients after the front- or second-line PARPi MT (recurrence setting). METHODS:This multicenter retrospective study analyzed adsOC patients undergoing standard of care therapy (cytoreductive surgery and chemotherapy), regardless whether PARPi MT was followed or not from December 2011 to May 2023. The prognostic factors affecting survival outcomes (progression-free survival [PFS] and overall survival [OS]) in primary and recurrence settings were analyzed. RESULTS:A total of 218 patients were analyzed, including 25% with BRCAm, 13% with homologous recombination deficiency (HRD), and 62% with homologous recombination proficiency (HRP). The median follow-up was 35.5 months. In primary setting, International Federation of Gynecology and Obstetrics IIIC/IV, Eastern Cooperative Oncology Group (ECOG) >1, neoadjuvant chemotherapy, non-high-grade serous carcinoma (HGSOC) or non-endometrioid, HRP and absence of PARPi MT were associated with worse outcome. In recurrence setting, ECOG >1, platinum-resistance, non-HGSOC or non-endometrioid, non-BRCAm and previous PARPi MT were associated with poor prognosis. Rechallenge of PARPi in recurrent patients did not show statistically different outcome compared to those without PARPi. CONCLUSION:Besides, the best survival occurring in adsOC patients with BRCAm, HRD patients treated with PARPi MT also experienced significantly prolonged PFS and OS. However, prior frontline PARPi MT was associated with poorer OS if the recurrence occurred. Treatment for recurrence status with PARPi MT did not show survival benefits.

OBJECTIVE:The prognostic significance of glandular involvement in high-grade squamous intraepithelial lesions (HSIL) following cervical conization remains unclear. This research aimed to evaluate the clinical impact of glandular involvement on surgical outcomes. MATERIALS AND METHODS:Between December 2019 and December 2020, 119 patients who underwent cervical conization were retrospectively observed. Patient characteristics, such as human papillomavirus (HPV) status, cytology results, glandular involvement, conization specimen depth and volume, margin status, and recurrence were collected and analyzed. RESULTS:Glandular involvement was significantly associated with positive endocervical margins (22.0 % vs. 6.5 %, p = 0.017), higher prevalence of preceding HSIL or CIN (cervical intraepithelial neoplasm)2/CIN3 cytology (60.4 % vs. 42.0 %), and increased HPV16 infection among high-risk HPV positive patients (69.2 % vs. 34.8 %, p = 0.050). No significant differences were observed in recurrence rates among patients with HSIL with or without glandular involvement. Multivariable analysis identified that margin status is the only independent predictor of recurrence (positive margin: OR [odds ratio] 26.85, 95 % CI [confidence interval] 2.59-277.86, p = 0.006 or uncertain margins: OR 29.90, 95 % CI 1.09-818.17, p = 0.044). CONCLUSION:While glandular involvement in HSIL is associated with positive endocervical margins, abnormal preceding cytology, and higher risk of HPV16 infection, it does not independently predict recurrence following conization. Instead, positive surgical margins are the primary factor of recurrence, highlighting the value of achieving complete excision to optimize patient outcomes.