{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T14:29:39Z","timestamp":1794580179909,"version":"4.9.1"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,11,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This retrospective comparative study aimed to assess the feasibility and benefits of newly developed pneumovaginoscopy-assisted radical hysterectomy (PVRH) combined with systemic chemotherapy (neoadjuvant and adjuvant) compared to primary concurrent chemoradiotherapy in the treatment of stage IIB\u2013IIIA locally advanced cervical cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between June 2014 and December 2023, 117 patients with stage IIB\u2013IIIA cervical cancer were treated. Fifty-nine patients were treated with PVRH combined with systemic chemotherapy [45 patients with neoadjuvant chemotherapy (NAC) and adjuvant chemotherapy, 14 patients with adjuvant chemotherapy only)] or with primary concurrent chemoradiotherapy (n\u00a0=\u00a058).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The neoadjuvant chemotherapy, pneumovaginoscopy-assisted radical hysterectomy, and adjuvant chemotherapy (NPA) completion rates were all 100%. The adjuvant radiotherapy avoidance rate was 94.8%. All patients resumed self-urination within 3 months of surgery. The achievement rates of R0 resection were 100% for vagina and 97.8% (1\/45 of NAC cases) for parametrium. The adverse events associated with NPA were less severe than those associated with primary concurrent chemoradiotherapy. The patients with complete or partial response by NAC had a prognosis comparable to primary concurrent chemoradiotherapy; however, the patients with stable disease by NAC had a significantly poorer prognosis than primary concurrent chemoradiotherapy. In squamous cell carcinoma, the rate of distant metastasis was numerically lower with NPA group compared to the concurrent chemoradiotherapy group; however, this trend was not observed in the subgroup that showed a poor response to preoperative chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Endoscopy-assisted precise RH with perioperative chemotherapy is a feasible multidisciplinary strategy for stage IIB\u2013IIIA cervical cancer, demonstrating high surgical precision and functional preservation. While these results may suggest potential benefits of this treatment, their interpretation requires caution, and patient selection based on the response to preoperative therapy is considered important.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jjco\/hyag132","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:50:58Z","timestamp":1785498658000},"page":"1328-1337","source":"Crossref","is-referenced-by-count":0,"title":["Endoscopy-assisted precise radical hysterectomy and perioperative chemotherapy for locally advanced cervical cancer: feasibility and clinical outcomes compared with radiotherapy"],"prefix":"10.1093","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0986-5495","authenticated-orcid":false,"given":"Masato","family":"Kita","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kansai Medical University , Shinmachi 2-5-1, Hirakata-city, Osaka 573-1010 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Butsuhara","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kansai Medical University , Shinmachi 2-5-1, Hirakata-city, Osaka 573-1010 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomomi","family":"Mizokami","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kansai Medical University , Shinmachi 2-5-1, Hirakata-city, Osaka 573-1010 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromi","family":"Murata","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kansai Medical University , Shinmachi 2-5-1, Hirakata-city, Osaka 573-1010 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Shiraga","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kansai Medical University , Shinmachi 2-5-1, Hirakata-city, Osaka 573-1010 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetaka","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kansai Medical University , Shinmachi 2-5-1, Hirakata-city, Osaka 573-1010 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"2026111309173010000_ref1","author":"Gaillard","year":"2024"},{"key":"2026111309173010000_ref2","doi-asserted-by":"publisher","first-page":"295","DOI":"10.21147\/j.issn.1000-9604.2019.02.04","article-title":"Chinese guidelines for diagnosis and treatment of cervical cancer 2018 (English version)","volume":"31","author":"National Health Commission of the People\u2019s Republic of China","year":"2019","journal-title":"CJCR"},{"key":"2026111309173010000_ref3","doi-asserted-by":"publisher","first-page":"e22","DOI":"10.3802\/jgo.2017.28.e22","article-title":"Practice guidelines for management of cervical cancer in Korea: a Korean Society of Gynecologic Oncology Consensus Statement","volume":"28","author":"Lim","year":"2017","journal-title":"J Gynecol Oncol"},{"key":"2026111309173010000_ref4","doi-asserted-by":"publisher","first-page":"iv72","DOI":"10.1093\/annonc\/mdx220","article-title":"Cervical cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up","volume":"28","author":"Marth","year":"2017","journal-title":"Ann Oncol"},{"key":"2026111309173010000_ref5","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1007\/s11912-020-0888-x","article-title":"Management of stage IIB cervical cancer: an overview of the current evidence","volume":"22","author":"Matsuzaki","year":"2020","journal-title":"Curr Oncol Rep"},{"key":"2026111309173010000_ref6","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1016\/S0140-6736(18)32470-X","article-title":"Cervical cancer","volume":"393","author":"Cohen","year":"2019","journal-title":"Lancet"},{"key":"2026111309173010000_ref7","doi-asserted-by":"publisher","first-page":"CD005342","DOI":"10.1002\/14651858.CD005342.pub4","article-title":"Adjuvant platinum-based chemotherapy for early stage cervical cancer","volume":"11","author":"Falcetta","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"2026111309173010000_ref8","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1016\/j.ygyno.2010.07.031","article-title":"Neoadjuvant chemotherapy followed by radical hysterectomy plus postoperative chemotherapy but no radiotherapy for stage IB2-IIB cervical cancer\u2014irinotecan and platinum chemotherapy","volume":"119","author":"Matsumura","year":"2010","journal-title":"Gynecol Oncol"},{"key":"2026111309173010000_ref9","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1016\/j.ygyno.2012.07.104","article-title":"Neoadjuvant chemotherapy plus radical surgery followed by chemotherapy in locally advanced cervical cancer","volume":"127","author":"Angioli","year":"2012","journal-title":"Gynecol Oncol"},{"key":"2026111309173010000_ref10","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3389\/fonc.2020.608333","article-title":"Postoperative adjuvant chemotherapy improved the prognosis in locally advanced cervical cancer patients with optimal response to neoadjuvant chemotherapy","volume":"10","author":"Feng","year":"2020","journal-title":"Front Oncol"},{"key":"2026111309173010000_ref11","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1007\/s10147-020-01787-7","article-title":"Phase II study of a new multidisciplinary therapy using once every 3 week carboplatin plus dose-dense weekly paclitaxel before and after radical hysterectomy for locally advanced cervical cancer","volume":"26","author":"Nagao","year":"2021","journal-title":"Int J Clin Oncol"},{"key":"2026111309173010000_ref12","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1097\/IGC.0000000000000430","article-title":"Outcome of International Federation of Gynecology and Obstetrics Stage IIB cervical cancer from 2003 to 2012: an evaluation of treatments and prognosis: a retrospective study","volume":"25","author":"Guo","year":"2015","journal-title":"Int J Gynecol Cancer"},{"key":"2026111309173010000_ref13","doi-asserted-by":"publisher","first-page":"6443","DOI":"10.1038\/s41598-018-24413-z","article-title":"Adjuvant chemotherapy after surgery can improve clinical outcomes for patients with IB2-IIB cervical cancer with neoadjuvant chemotherapy followed by radical surgery","volume":"8","author":"Sun","year":"2018","journal-title":"Sci Rep"},{"key":"2026111309173010000_ref14","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.3390\/curroncol29020093","article-title":"Minimally invasive surgery for cervical cancer in light of the LACC trial: what have we learned?","volume":"29","author":"Touhami","year":"2022","journal-title":"Curr Oncol"},{"key":"2026111309173010000_ref15","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1136\/ijgc-00009577-200503000-00035","article-title":"A systematic nerve-sparing radical hysterectomy technique in invasive cervical cancer for preserving postsurgical bladder function","volume":"15","author":"Sakuragi","year":"2005","journal-title":"Int J Gynecol Cancer"},{"key":"2026111309173010000_ref16","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.ygyno.2007.08.076","article-title":"Anatomic identification and functional outcomes of the nerve sparing Okabayashi radical hysterectomy","volume":"107","author":"Fujii","year":"2007","journal-title":"Gynecol Oncol"},{"key":"2026111309173010000_ref17","first-page":"5","article-title":"Nerve sparing radical hysterectomy in early stage cervical cancer. Latest developments and review of the literature","volume":"36","author":"Kavallaris","year":"2015","journal-title":"Eur J Gynaecol Oncol"},{"key":"2026111309173010000_ref18","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2023.34.e80","article-title":"Pneumovaginoscopy-assisted radical hysterectomy for early-stage cervical cancer: a novel bidirectional approach for tumor spillage prevention and R0 resection","volume":"34","author":"Kita","year":"2023","journal-title":"J Gynecol Oncol"},{"key":"2026111309173010000_ref19","first-page":"1","article-title":"Chemotherapy with bevacizumab for uterine cervical cancer: a multicenter retrospective case-control study","volume":"75","author":"Yokoe","year":"2023","journal-title":"Adv Obstet Gynecol"},{"key":"2026111309173010000_ref20","doi-asserted-by":"publisher","first-page":"5720","DOI":"10.1200\/JCO.2008.21.1060","article-title":"Achievement of at least very good partial response is a simple and robust prognostic factor in patients with multiple myeloma treated with high-dose therapy: long-term analysis of the IFM 99-02 and 99-04 trials","volume":"27","author":"Harousseau","year":"2009","journal-title":"J Clin Oncol"},{"key":"2026111309173010000_ref21","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1097\/IGC.0b013e318213653d","article-title":"Local control after tailored surgical treatment of early cervical cancer","volume":"21","author":"Cibula","year":"2011","journal-title":"Int J Gynecol Cancer"},{"key":"2026111309173010000_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.pdpdt.2023.103655","article-title":"A pilot study of repeated 5-aminolevulinic acid photodynamic therapy for cervical intraepithelial neoplasia by a newly developed intravaginal irradiation system","volume":"43","author":"Hisamatsu","year":"2023","journal-title":"Photodiagnosis Photodyn Ther"},{"key":"2026111309173010000_ref23","doi-asserted-by":"publisher","first-page":"CD012828","DOI":"10.1002\/14651858.CD012828.pub2","article-title":"Nerve-sparing radical hysterectomy compared to standard radical hysterectomy for women with early stage cervical cancer (stage Ia2 to IIa)","volume":"2019","author":"Kietpeerakool","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"2026111309173010000_ref24","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1186\/1471-2407-14-63","article-title":"Radical hysterectomy with adjuvant radiotherapy versus radical radiotherapy for FIGO stage IIB cervical cancer","volume":"14","author":"Chai","year":"2014","journal-title":"BMC Cancer"},{"key":"2026111309173010000_ref25","doi-asserted-by":"publisher","first-page":"228","DOI":"10.21147\/j.issn.1000-9604.2016.02.12","article-title":"Adjuvant chemotherapy for early-stage cervical cancer","volume":"28","author":"Asano","year":"2016","journal-title":"Chin J Cancer Res"},{"key":"2026111309173010000_ref26","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1159\/000449023","article-title":"Neoadjuvant and adjuvant chemotherapy of cervical cancer","volume":"39","author":"Mallmann","year":"2016","journal-title":"Oncol Res Treat"},{"key":"2026111309173010000_ref27","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1159\/000447576","article-title":"Integrating chemotherapy in the management of cervical cancer: a critical appraisal","volume":"91","author":"Kumar","year":"2016","journal-title":"Oncology"},{"key":"2026111309173010000_ref28","doi-asserted-by":"publisher","first-page":"1548","DOI":"10.1200\/JCO.2017.75.9985","article-title":"Neoadjuvant chemotherapy followed by radical surgery versus concomitant chemotherapy and radiotherapy in patients with stage IB2, IIA, or IIB squamous cervical cancer: a randomized controlled trial","volume":"36","author":"Gupta","year":"2018","journal-title":"J Clin Oncol"},{"key":"2026111309173010000_ref29","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/j.ygyno.2012.01.033","article-title":"Chemoradiation and adjuvant chemotherapy in advanced cervical adenocarcinoma","volume":"125","author":"Tang","year":"2012","journal-title":"Gynecol Oncol"},{"key":"2026111309173010000_ref30","doi-asserted-by":"publisher","first-page":"1397","DOI":"10.21873\/anticanres.16288","article-title":"Recent advances in the management of small cell carcinoma of the uterine cervix","volume":"43","author":"Miyoshi","year":"2023","journal-title":"Anticancer Res"},{"key":"2026111309173010000_ref31","doi-asserted-by":"publisher","first-page":"S1276","DOI":"10.1016\/j.annonc.2023.10.028","article-title":"A randomised phase III trial of induction chemotherapy followed by chemoradiation compared with chemoradiation alone in locally advanced cervical cancer: the GCIG INTERLACE trial","volume":"34","author":"McCormack","year":"2023","journal-title":"Ann Oncol"},{"key":"2026111309173010000_ref32","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1080\/01443615.2021.2012437","article-title":"The effect of consolidation chemotherapy after concurrent chemoradiation on the prognosis of locally advanced cervical cancer: a systematic review and meta-analysis","volume":"42","author":"Zhong","year":"2022","journal-title":"J Obstet Gynaecol"},{"key":"2026111309173010000_ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.gore.2021.100743","article-title":"Resection of vaginal recurrence of granulosa cell tumor by pneumovaginal endoscopic surgery","volume":"36","author":"Kita","year":"2021","journal-title":"Gynecol Oncol Rep"},{"key":"2026111309173010000_ref34","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1111\/ases.13100","article-title":"R0 resection of vaginal stump recurrence of gynecologic malignancy by bi-directional endoscopic approach: a case series of four patients","volume":"16","author":"Yokoe","year":"2023","journal-title":"Asian J Endosc Surg"},{"key":"2026111309173010000_ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.gore.2023.101135","article-title":"Fertility-sparing radical resection of juvenile clear cell adenocarcinoma of the cervix by pneumovaginal endoscopic surgery","volume":"45","author":"Kita","year":"2023","journal-title":"Gynecol Oncol Rep"}],"container-title":["Japanese Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jjco\/article-pdf\/56\/11\/1328\/70672635\/hyag132.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jjco\/article-pdf\/56\/11\/1328\/70672635\/hyag132.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T14:17:40Z","timestamp":1794579460000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jjco\/article\/56\/11\/1328\/8762918"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,18]]},"references-count":35,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,8,18]]},"published-print":{"date-parts":[[2026,11,13]]}},"URL":"https:\/\/doi.org\/10.1093\/jjco\/hyag132","relation":{},"ISSN":["1465-3621"],"issn-type":[{"value":"1465-3621","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,11]]},"published":{"date-parts":[[2026,8,18]]}}}