{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T23:41:47Z","timestamp":1783726907232,"version":"3.55.0"},"reference-count":16,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T00:00:00Z","timestamp":1766275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T00:00:00Z","timestamp":1766275200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Persistent tumor after combined chemoradiation for locally advanced cervical cancer is an established prognostic factor. Detection may include magnetic resonance imaging, positron emission tomography (PET) combined with CT scan, ultrasound, or biopsies; however, no agreement about the best method and time point has been reached. In our institution, a standardized biopsy protocol of at least four punch biopsies is routinely performed at the last brachytherapy with re\u2010biopsies 6\u2009weeks later in cases not showing histologic complete response (hCR). This study aims to assess the prognostic relevance of these biopsies, especially with respect to the time point of hCR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>This investigation was a retrospective single\u2010center observational cohort study that included all patients treated for locally advanced or node\u2010positive cervical cancer with combined chemoradiation at the University Hospital Innsbruck between 2008 and 2023. Patients with a hCR at the end of radiotherapy were classified as primary negative and otherwise as primary positive. Primary positive patients that achieved complete response at a control biopsy 6\u2009weeks later were classified as secondary negative, and the remaining patients with residual tumor as secondary positive. Progression\u2010free survival (PFS) and overall survival (OS) were compared between all these groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 184 patients in this study, from which 46 (25%) were classified as primary positive. These patients experienced a significantly worse PFS compared to primary negative patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008, HR\u2009=\u20092.03, 95% CI [1.20, 3.45]). The difference in PFS was also evidenced when comparing primary negative patients to those who had a hCR 6\u2009weeks after radiotherapy (secondary negative) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018, HR\u2009=\u20092.00, 95% CI [1.13, 3.56]). However, in primary positive patients, OS was not significantly reduced (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.29, HR\u2009=\u20091.45, 95% CI [0.73, 2.86]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early response evaluation using punch biopsies at the time of the last brachytherapy can identify patients with residual tumor, which exhibit a statistically significant and clinically meaningful risk of disease progression. This risk was not reversed even in the case of a delayed hCR 6\u2009weeks after completion of chemoradiation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70106","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T05:54:50Z","timestamp":1766382890000},"page":"368-376","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Biopsy\u2010proven residual cervical cancer at the end of combined chemoradiation predicts poor outcome\u2014Retrospective single\u2010center cohort study"],"prefix":"10.1111","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2033-6228","authenticated-orcid":false,"given":"Christoph","family":"Ebner","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical University Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricarda","family":"Purtscheller","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical University Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5064-1397","authenticated-orcid":false,"given":"Barin","family":"Feroz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical University Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4405-5799","authenticated-orcid":false,"given":"Jana","family":"Rieker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical University Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2561-760X","authenticated-orcid":false,"given":"Linda","family":"Ebner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical University Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5902-4556","authenticated-orcid":false,"given":"Mara","family":"Mantovan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical University Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5989-573X","authenticated-orcid":false,"given":"Sergej","family":"Skvortsov","sequence":"additional","affiliation":[{"name":"Department of Therapeutic Radiology and Oncology Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Br\u00fcggl","sequence":"additional","affiliation":[{"name":"Department of Therapeutic Radiology and Oncology Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9572-9114","authenticated-orcid":false,"given":"Katharina","family":"Leitner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical University Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1053-6625","authenticated-orcid":false,"given":"Verena","family":"Wieser","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical University Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6795-3015","authenticated-orcid":false,"given":"Irina","family":"Tsibulak","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical University Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8965-9981","authenticated-orcid":false,"given":"Christian","family":"Marth","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical University Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5306-2334","authenticated-orcid":false,"given":"Alain Gustave","family":"Zeimet","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical University Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,21]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-2023-004429"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30753-1"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2016.03.011"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.22.01096"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2025.04.037"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16010198"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.31487\/j.JSO.2019.01.001"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2022.1440"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina59020192"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2112435"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30071-2"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2024.35.e113"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14093"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01808-7"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semnuclmed.2022.06.001"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-481X.2007.00351.x"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.70106","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.70106","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.70106","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T10:15:02Z","timestamp":1771064102000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.70106"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,21]]},"references-count":16,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1111\/aogs.70106"],"URL":"https:\/\/doi.org\/10.1111\/aogs.70106","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,21]]},"assertion":[{"value":"2025-04-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}