{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T10:38:13Z","timestamp":1785148693118,"version":"3.55.0"},"reference-count":22,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,4,6]],"date-time":"2025-04-06T00:00:00Z","timestamp":1743897600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Intraoperative radiation therapy (IORT) is the delivery of a single large dose of radiation to a limited volume of tissue at the time of surgery. The aim of this study is to assess outcomes in patients who underwent IORT for gynecologic malignancies and to identify parameters that can predict a good outcome. Methods: This is a retrospective single-center cohort study including all women treated with surgery and IORT for a primary or recurrent gynecologic cancer between 2014 and 2022 at the Bern University Hospital, Switzerland. Results: A total of 30 patients with gynecologic malignancies were treated with surgery and IORT. Of these patients, 63.3% presented with cervical cancer, 23.3% with sarcoma, 10% with endometrial cancer, and 3.3% with carcinosarcoma of the ovary. Seventy percent (21\/30) of women had an ECOG performance status of 0 at time of IORT. There was no difference in survival among women with incomplete surgical resection (R1\/2 vs. R0) at time of IORT. Fifty percent of patients suffered postoperative complication of Clavien-Dindo grade &gt;III, but there was no significant correlation of these complications to overall survival (p = 0.58). Three-year disease-free survival was 53.3%, and five-year overall survival was 53.3%. ECOG status was a significant parameter in DSS (p = 0.002) and OS (p = 0.02). Conclusion: Surgery with IORT is potentially a good treatment option in selected patients with recurrent or locally advanced cervical or endometrial cancer. An ECOG status of 0 is a significant parameter for good outcomes and should be taken into consideration for treatment decisions.<\/jats:p>","DOI":"10.3390\/cancers17071240","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T03:23:07Z","timestamp":1743996187000},"page":"1240","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Intraoperative Radiation Therapy for Gynecologic Malignancies: When Is It Indicated?"],"prefix":"10.3390","volume":"17","author":[{"given":"Flavia","family":"Pagano","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital of Berne, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2469-9824","authenticated-orcid":false,"given":"Flurina Annacarina Maria","family":"Saner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital of Berne, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Codruta","family":"Ionescu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital of Berne, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7278-923X","authenticated-orcid":false,"given":"Elena","family":"Riggenbach","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital of Berne, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"L\u00f6ssl","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital of Berne, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3415-9162","authenticated-orcid":false,"given":"Franziska","family":"Siegenthaler","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital of Berne, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1947-1315","authenticated-orcid":false,"given":"Michael David","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital of Berne, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Imboden","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital of Berne, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.ygyno.2014.07.093","article-title":"Does intra-operative radiation at the time of pelvic exenteration improve survival for patients with recurrent, previously irradiated cervical, vaginal, or vulvar cancer?","volume":"135","author":"Backes","year":"2014","journal-title":"Gynecol. 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