{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T11:28:04Z","timestamp":1780399684276,"version":"3.54.1"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T00:00:00Z","timestamp":1762646400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T00:00:00Z","timestamp":1762646400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP20K18952"],"award-info":[{"award-number":["JP20K18952"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP25K19187"],"award-info":[{"award-number":["JP25K19187"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Science"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Secondary sarcomas in cervical cancer survivors are understudied. We investigated the incidence and subtypes of secondary sarcomas by treatment modalities, the\u00a0prognosis of secondary sarcomas, and whether surgery plus radiotherapy increases angiosarcoma incidence. This population\u2010based retrospective cohort study analyzed Osaka Cancer Registry data on women aged 20\u201384\u2009years diagnosed with cervical cancer (1980\u20132015), treated with surgery, radiotherapy, or both. Patients with distant metastases, survival time &lt;\u20091\u2009year, or missing data were excluded. We included 7591 patients with invasive cancer treated with surgery, 3882 with radiotherapy, and 4090 with surgery plus radiotherapy and 13,205 with carcinoma in\u00a0situ treated with surgery. We assessed the first lower\u2010body sarcoma occurrence \u2265\u20091 year post\u2010diagnosis. Sarcomas developed in 6 patients treated with surgery (0 angiosarcomas), 10 with radiotherapy (1 angiosarcoma), and 19 with surgery plus radiotherapy (9 angiosarcomas). At 10\u2009years, the cumulative incidence was 0.083% (95% confidence interval [CI], 0.024%\u20130.24%) for radiotherapy and 0.21% (95% CI, 0.10%\u20130.41%) for surgery plus radiotherapy, higher than that for surgery (invasive, 0.013%; in\u00a0situ, 0.028%) (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Angiosarcoma incidence was higher with surgery plus radiotherapy (0.080%; 95% CI, 0.023%\u20130.23%) than with radiotherapy (0.028%; 95% CI, 0.003%\u20130.16%) (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.029). Among patients diagnosed with sarcoma after radiotherapy or surgery plus radiotherapy, the 1\u2010year overall survival rate was 33.3% (95% CI, 19.6%\u201356.8%). Radiotherapy, alone or combined with surgery, increased secondary lower\u2010body sarcoma incidence compared with surgery. To our knowledge, this is the first population\u2010based study to suggest that surgery plus radiotherapy is associated with angiosarcoma in cervical cancer survivors.\n                  <\/jats:p>","DOI":"10.1111\/cas.70229","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T06:58:21Z","timestamp":1762757901000},"page":"216-225","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Secondary Lower\u2010Body Sarcomas in Cervical Cancer Survivors Following Surgery, Radiotherapy, or Both: A Population\u2010Based Study"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9097-0227","authenticated-orcid":false,"given":"Toshiki","family":"Ikawa","sequence":"first","affiliation":[{"name":"Cancer Control Center Osaka International Cancer Institute  Osaka Japan"},{"name":"Department of Radiation Oncology Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9782-8637","authenticated-orcid":false,"given":"Kayo","family":"Nakata","sequence":"additional","affiliation":[{"name":"Cancer Control Center Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0747-3287","authenticated-orcid":false,"given":"Toshitaka","family":"Morishima","sequence":"additional","affiliation":[{"name":"Cancer Control Center Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken\u2010ichi","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology and Cytology Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4161-2970","authenticated-orcid":false,"given":"Yoshihiro","family":"Kuwabara","sequence":"additional","affiliation":[{"name":"Cancer Control Center Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7728-8853","authenticated-orcid":false,"given":"Mizuki Shimadzu","family":"Kato","sequence":"additional","affiliation":[{"name":"Cancer Control Center Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Iwaki","sequence":"additional","affiliation":[{"name":"Cancer Control Center Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoyuki","family":"Kanayama","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Morimoto","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Konishi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isao","family":"Miyashiro","sequence":"additional","affiliation":[{"name":"Cancer Control Center Osaka International Cancer Institute  Osaka 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