Lipidomics provides comprehensive study of all lipid components in cells, serum, plasma or tissues of organisms, aiming to the discovery of diagnostic, prognostic and predictive biomarkers of diseases such as malignancies. This systematic review evaluates studies, where lipidomics applies to the diagnosis, prognosis, prediction of ovarian cancer (OC) and the discrimination between malignant and benign ovarian masses. Literature search was conducted in PubMed, Science Direct and SciFinder. Only publications written in English language after 2012 were included. From the reference lists of primary included studies, relevant citations were identified and were also added in our list. All studies included referred to the application of lipidomics in serum/plasma samples of human cases with OC, whereby few of them included also tumor tissue samples. In some of the included studies metabolomic analysis was also involved where other metabolites besides lipids were identified. Qualitative data were assessed and risk of bias was determined using the ROBINS-I tool. In total, 29 studies were included, 15 of which applied non-targeted, 7 targeted lipidomics and 7 were reviews relevant to our aim. Most studies concerned the possible application of lipidomics in OC diagnosis, exhibiting phospholipids and sphingolipids as the most significantly altered during development of the disease. In conclusion, this systematic review highlights the potential contribution of lipids as biomarkers in OC management.

(1) Background: BRCA mutation and homologous recombination deficiency (HRD) are used to administrate PARP inhibitors (PARPi) maintenance therapy. It is known that PARPi efficacy is related to platinum sensitivity and that the latter can be demonstrated from the CA-125 elimination rate constant (KELIM). This study aims to investigate if KELIM can be another tool in the identification of patients that could be benefit from PARPi therapy.; (2) Methods: Retrospective analysis of patients with high-grade serous advanced ovarian cancer that underwent cytoreduction and was further tested for HRD status. The HRD status was tested either by myChoice HRD CDx assay or by RediScore assay. KELIM score was measured in both neoadjuvant and adjuvant settings with the online tool biomarker-kinetics.org.; (3) Results: Thirty-nine patients had available data for estimating both HRD status and KELIM score. When assuming KELIM as a binary index test with the value 1 as the cut-off point, the sensitivity was 0.86, 95% CI (0.64-0.97), and the specificity 0.83, 95% CI (0.59-0.96). On the other hand, when assuming KELIM as a continuous index test, the AUC was 81% and the optimal threshold, using the Youden index, was identified as 1.03 with a sensitivity of 85.7% and a specificity of 83.3%; (4) Conclusions: KELIM score seems to be a new, cheaper and faster tool to identify patients that can benefit from PARPi maintenance therapy.

Several tumor types have been efficiently treated with PARPis, which are now approved for the treatment of ovarian, breast, prostate, and pancreatic cancer. The BRCA1/2 genes and mutations in many additional genes involved in the HR pathway may be responsible for the HRD phenomenon. In the present study, an NGS assay was used to analyze 513 genes associated with targeted and immuno-oncology therapies in 406 samples. In addition, the %gLOH values of 24 samples were also calculated using the Affymetrix technology to compare the results obtained by the two methodologies. HR variations occurred in 20.93% of the malignancies, while BRCA1/2 gene alterations in 5.17%. %LOH was highly correlated with alterations in the BRCA1/2 genes since 76.19% (16/21) of the BRCA1/2 positive tumors had a high %LOH value (p=0.007). Moreover, the LOH status was highly correlated with the TP53 and KRAS statuses, but there was no association with the TMB value. Lin's Concordance Correlation Coefficient for the 24 evaluable samples simultaneously examined by both assays was 0.87, indicating a nearly perfect agreement. In conclusion, the addition of gLOH analysis could assist the detection of additional patients eligible for PARPis

Background and Objectives: The new molecular classification of endometrial cancer continuously changes the management of the disease in every day clinical practice. Lately, FIGO released a new staging system for endometrial cancer, which incorporates molecular sub-stages and subdivides further early-stage disease. The aim of this study is to investigate the differences between the two FIGO staging systems and evaluate the prognostic precision of the new one. Materials and Methods: We retrospectively analyzed the records of patients with endometrial cancer that were fully treated in the 1st Department of Obstetrics-Gynecology, 2012-2023. Patient characteristics, oncological outcome and follow-up information were collected. The primary outcomes were the stage shifts and the survival data. Results: 67 (15.5%) patients had a stage shift and the majority of them concerned early-stage disease and specifically up-shift from 2009 stages IA and IB to 2023 stage IIC. Concerning, survival a better median and 5-year PFS was present in Stage II disease and when compering the prognostic precision of the two FIGO staging systems no significant difference was present. Conclusions: The new 2023 FIGO staging system better distinguishes early-stage endometrial cancer into its prognostic groups and seems to be as precise as the old 2009 FIGO staging system.

Background/Objectives: Douglasectomy is defined as the removal of the pelvic peritoneum of the entire pouch of Douglas. In presumed FIGO Stage I ovarian cancer isolated microscopic cancer cells might disseminate from the ovaries to their neighboring pelvic peritoneum. However, simple hysterectomy with bilateral salpingo-oophorectomy and a staging procedure is the standard of care. This study aims to investigate the safety and feasibility of douglasectomy, compared to random pelvic biopsies, and its on the survival of patients with early ovarian cancer; Methods: We retrospectively analyzed the records of patients with presumed FIGO Stage I ovarian cancer that underwent surgery in the 1st Department of Obstetrics – Gynecology Clinic from 2012 – 2022. Patient characteristics, oncological and follow-up information were collected.; Results: 88 patients were categorized into two groups: Group A (27 patients) with douglasectomy and Group B (61 patients) with random biopsies. There was no statistically significant difference in age, BMI, comorbidities, intraoperative blood loss and ICU admittance between the two groups. On the other hand, patients with en-block hysterectomy-douglasectomy had a statistically significant higher pre-operative CA-125 values, surgery duration, rate of postoperative complications and hospital stay. Concerning survival rates, there was a statistically significant difference in dis-ease-free survival (p=0.033), but no difference was observed in overall survival (p=0.66); Conclu-sions: En-block removal of the pelvic peritoneum of the entire pouch of Douglas with the uterus is a safe and feasible technique during surgery for early ovarian cancer, which leads to improved disease-free survival and local control.