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Epithelial ovarian cancer is characterized by aggressive peritoneal dissemination. Neutrophils are mobilized to peritoneal cavity in some patients with ovarian cancer dissemination; however, its pathological significance remains unknown. This study aimed to investigate the role of neutrophil extracellular traps (NETs) in ovarian cancer dissemination. We conducted a retrospective analysis of clinical data and samples from 340 patients with ovarian cancer who underwent primary surgery between 2007 and 2016 at the Osaka University Hospital. In vitro, NETs formation was induced by stimulating human peripheral neutrophils. The human ovarian cancer cell line, OVCAR8, was cocultured with NETs. For an ovarian cancer dissemination mouse model, we performed an intraperitoneal injection of OVCAR8 cells into nude mice. The association between NETs and peritoneal dissemination was explored, and model mice were treated with the PAD4 inhibitor GSK484 to assess antitumor efficacy. Neutrophilia (neutrophil count >7000/mm3) correlated with shorter survival, advanced peritoneal dissemination, elevated granulocyte colony-stimulating factor (G-CSF) levels, increased neutrophil count in ascites, and augmented NETs foci in peritoneal dissemination sites. In vitro assays revealed that G-CSF stimulated neutrophils to form NETs, promoting cancer cell adhesion. In vivo investigations revealed that G-CSF–producing tumor-bearing mice had accelerated peritoneal dissemination and poor prognosis. NETs formation was pathologically observed at the peritoneal dissemination sites. Inhibition of NETs formation by GSK484 significantly delayed peritoneal dissemination in vivo. In conclusion, G-CSF was associated with intra-abdominal NETs formation and increased peritoneal dissemination. NETs represent potential therapeutic targets for ovarian cancer, particularly in patients with neutrophilia. [ABSTRACT FROM AUTHOR]

Seromucinous borderline tumors (SMBT) are papillary neoplasms without invasive capabilities. Originally categorized as ovarian tumors, SMBT, being an endometriosis‐related tumor, can manifest beyond the ovaries. To date, only four cases of extraovarian SMBT have been documented in literature. In this report, we present our experience with the first case of SMBT in the uterine cervix, which exhibited highly elevated CA19‐9 levels. The patient, initially clinically diagnosed with cervical cancer, underwent treatment with radical hysterectomy and was later pathologically diagnosed with SMBT of the uterine cervix. While extraovarian SMBT, especially in the uterine cervix, is extremely rare, this condition should be considered in patients with cervical masses lacking pathological evidence of malignant disease but displaying elevated CA19‐9 levels. [ABSTRACT FROM AUTHOR]

Simple Summary: This systematic review was conducted using four public electronic databases (PubMed, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials) from the date of inception to 31 May 2023, and 10 original articles with information regarding neoadjuvant chemotherapy (NACT) for malignant ovarian germ cell tumors (MOGCT) were identified. The results of the meta-analysis showed that NACT was used in approximately 40% of advanced MOGCT cases, with a response rate of 95.8%. The uterine preservation rate was approximately 70%, and the cumulative resumed menstruation rate was 100% (n = 30). Four comparator studies evaluating NACT versus primary debulking surgery between the groups showed similar overall survival, disease-free survival, recurrence rate, and adverse event rate (grade 3–4) from chemotherapy. Although available data are limited and level I evidence is lacking, we believe that NACT may be feasible for advanced MOGCT. Further studies are required to confirm this study's results. Randomized clinical trials assessing the efficacy of neoadjuvant chemotherapy (NACT) for advanced epithelial ovarian cancer have predominantly included women with high-grade serous carcinomas. The response rate and oncological outcomes of NACT for malignant ovarian germ cell tumors (MOGCT) are poorly understood. This study aimed to examine the effects of NACT on women with MOGCT by conducting a systematic review of four public search engines. Fifteen studies were identified, and a further descriptive analysis was performed for 10 original articles. In those studies, most women were treated with a bleomycin, etoposide, and cisplatin regimen, and one to three cycles were used in most studies. Four studies comparing NACT and primary debulking surgery showed similar complete response rates (n = 2; pooled odds ratio [OR] 0.90, 95% confidence interval [CI] 0.15–5.27), comparable overall survival (n = 3; 87.0–100% versus 70.0–100%), disease-free survival (n = 3; 87.0–100% versus 70.0–100%), recurrence rate (n = 1; OR 3.50, 95%CI 0.38–32.50), and adverse events rate from chemotherapy between the groups. In conclusion, NACT may be considered for the management of MOGCT; however, possible candidates for NACT use and an ideal number of NACT cycles remain unknown. Further studies are warranted to validate the efficacy of NACT in advanced MOGCT patients. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion To compare the surgical and oncologic outcomes between patients with locally recurrent cervical cancer undergoing robotic‐assisted salvage radical hysterectomy (RH) and those undergoing conventional open salvage RH, performed by a single surgeon.This retrospective comparative observational study utilized data obtained from consecutive patients with locally recurrent cervical cancer, developed after definitive radiotherapy. These patients either underwent robot‐assisted RH (robotic group) or conventional open RH (open group). Clinicopathological characteristics, surgical outcomes, and oncological outcomes were compared between the two groups.The operative time was slightly longer in the robotic group; however, this difference was not statistically significant. Estimated blood loss was significantly lower in the robotic group (median; 0 mL [robotic group] vs. 700 mL [open group]: p < 0.01). The incidence of intraoperative and early and late complications did not statistically differ between the two groups. The mean follow‐up was 29.0 and 17.1 months in the open and robotic groups, respectively. Disease recurrence rates were similar between the two groups (40% [robotic group] vs. 44.4% [open group]). Kaplan–Meier survival analysis for progression‐free survival and overall survival did not show statistically significant differences between the two groups.Robot‐assisted salvage RH in women with locally recurrent cervical cancer showed perioperative and oncological outcomes comparable to those of the open procedure. Although our results suggest that the robot‐assisted approach is as good as or better than the open approach, further investigation is required to establish a more robust conclusion. [ABSTRACT FROM AUTHOR]

Low-grade endometrial stromal sarcoma (LGESS) is a rare disease, accounting for less than 1% of all uterine malignancies. Standard treatment is total hysterectomy and bilateral tubal oophorectomy, although fertility preservation may be desirable because of the young age of onset. We document a case of fertility preservation in a 27-year-old nulligravida diagnosed with LGESS, which not only enabled the successful birth of two live infants but also underscores the efficacy of a multidisciplinary approach to patient treatment through the Hyogo Oncofertility Network (HOF-net). The patient underwent laparoscopic removal of a lesion initially suspected to be either a uterine myoma or an adnexal tumor. Through the HOF-net, a pioneering collaboration among patients, oncologists, and fertility specialists, she was connected to our department with the aim of achieving pregnancy in the future, even amidst her cancer diagnosis. Following the surgery, and during a medically advised period of contraception, assisted reproductive technology with the double stimulation (DuoStim) method was utilized to cryopreserve six embryos, followed by high-dose progestin therapy to mitigate the risk of cancer recurrence. Once the contraceptive mandate had been concluded, the implantation of the first thawed embryo during a hormone replacement cycle led to a viable pregnancy and the subsequent birth of a healthy child by cesarean section. Similarly, during the contraceptive period, after undergoing high-dose progestin therapy, a second thawed embryo transfer was performed, resulting in a successful pregnancy and the birth of a second child. Subsequently, she underwent a total hysterectomy and bilateral salpingectomy with preservation of both ovaries at another hospital 39 months after the initial surgery. No recurrence or residual disease was observed. The necessity for comprehensive informed consent was underscored by the potential for LGESS recurrence. Furthermore, the efficient coordination facilitated by the HOF-net enabled swift access to assisted reproductive services, aligning with the patient's primary healthcare plan. This case highlights the critical role of early engagement with assisted reproductive technologies and a multidisciplinary treatment strategy in facilitating successful outcomes for patients with LGESS, demonstrating the feasibility of fertility preservation in managing this condition., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Ooi et al.)

The choroid plexus (CP) is present on the ventricular walls of the brain, produces cerebrospinal fluid (CSF), contains many blood vessels, and is a major functional component of the blood-CSF barrier. The CP is an important site in the pathophysiology of various neurological diseases, including Alzheimer's disease and meningeal amyloidosis. We performed gene silencing in the CP in vivo by using an antisense oligonucleotide (ASO). A short ASO of length 12 nucleotides was intravenously injected into rats. The ASO was not delivered to neurons or glia in the central nervous system, but was successfully delivered into the CP, and resulted in a significant reduction of endogenous target gene expression in epithelial cells within the CP. Although the mechanism of uptake of the ASO by the CP was not elucidated, the ASO bound to albumin in vivo, and the distribution of ASO delivery was similar to that of albumin delivery. These findings suggest that we inhibited target gene expression in the epithelial cells of the CP via albumin-ASO conjugates. This strategy should be useful for investigations of the function of CP, and for the development of new gene-silencing therapies for diseases with pathophysiology related to the CP.