Iason Psilopatis

The Role of Hyperthermic Intraperitoneal Chemotherapy in Uterine Cancer Therapy

Endometrial cancer and uterine sarcoma represent the two major types of uterine cancer. In advanced stages, both cancer entities are challenging to treat and correlate with a meagre survival and prognosis. Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is a form of localized chemotherapy that is heated to improve the chemotherapeutic effect on peritoneal metastases. The aim of the current review is to study the role of HIPEC in the treatment of uterine cancer. A literature review was conducted using the MEDLINE and LIVIVO databases with a view to identifying relevant studies. By employing the search terms “hyperthermic intraperitoneal chemotherapy”, “uterine cancer”, “endometrial cancer”, and/or “uterine sarcoma”, we managed to identify 26 studies published between 2004 and 2023. The present work embodies the most up-to-date, comprehensive review of the literature centering on the particular role of HIPEC as treatment modality for peritoneally metastasized uterine cancer. Patients treated with cytoreductive surgery, alongside HIPEC, seem to profit from not only higher survival but also lower recurrence rates. Factors such as the completeness of cytoreductive surgery, the peritoneal cancer index, the histologic subtype, or the applied chemotherapeutic agent, all influence HIPEC therapy effectiveness. In summary, HIPEC seems to represent a promising treatment alternative for aggressive uterine cancer.

The Role of Peroxisome Proliferator-Activated Receptors in Endometrial Cancer

Endometrial carcinoma is the most common malignant tumor of the female genital tract in the United States. Peroxisome proliferator-activated receptors (PPARs) are nuclear receptor proteins which regulate gene expression. In order to investigate the role of PPARs in endometrial cancer, we conducted a literature review using the MEDLINE and LIVIVO databases and were able to identify 27 relevant studies published between 2000 and 2023. The PPARα and PPARβ/δ isoforms seemed to be upregulated, whereas PPARγ levels were reported to be significantly lower in endometrial cancer cells. Interestingly, PPAR agonists were found to represent potent anti-cancer therapeutic alternatives. In conclusion, PPARs seem to play a significant role in endometrial cancer.

Histone Deacetylase Inhibitors: A Promising Therapeutic Alternative for Endometrial Carcinoma

Endometrial carcinoma is the most common malignant tumor of the female genital tract in the United States. Epigenetic alterations are implicated in endometrial cancer development and progression. Histone deacetylase inhibitors are a novel class of anticancer drugs that increase the level of histone acetylation in many cell types, thereby inducing cell cycle arrest, differentiation, and apoptotic cell death. This review is aimed at determining the role of histone acetylation and examining the therapeutic potential of histone deacetylase inhibitors in endometrial cancer. In order to identify relevant studies, a literature review was conducted using the MEDLINE and LIVIVO databases. The search terms histone deacetylase, histone deacetylase inhibitor, and endometrial cancer were employed, and we were able to identify fifty-two studies focused on endometrial carcinoma and published between 2001 and 2021. Deregulation of histone acetylation is involved in the tumorigenesis of both endometrial carcinoma histological types and accounts for high-grade, aggressive carcinomas with worse prognosis and decreased overall survival. Histone deacetylase inhibitors inhibit tumor growth, enhance the transcription of silenced physiologic genes, and induce cell cycle arrest and apoptosis in endometrial carcinoma cells both in vitro and in vivo. The combination of histone deacetylase inhibitors with traditional chemotherapeutic agents shows synergistic cytotoxic effects in endometrial carcinoma cells. Histone acetylation plays an important role in endometrial carcinoma development and progression. Histone deacetylase inhibitors show potent antitumor effects in various endometrial cancer cell lines as well as tumor xenograft models. Additional clinical trials are however needed to verify the clinical utility and safety of these promising therapeutic agents in the treatment of patients with endometrial cancer.

Leveraging artificial intelligence for evidence‐based recommendations in uterine fibroid therapy: Addressing the unmet need in German healthcare—A clinical trial

Abstract Objective To evaluate the potential of an artificial intelligence (AI)‐driven large language model, ChatGPT 4.0, to provide personalized, evidence‐based treatment recommendations for uterine fibroids. Methods ChatGPT 4.0 was trained using evidence‐based data from Uptodate and German medical literature. The algorithm generated individualized recommendations based on clinical characteristics and patient preferences. Usability and quality were assessed through questionnaires completed by 40 gynecologists and 45 women with fibroids. Results Most gynecologists found the algorithm user‐friendly and comprehensive, with 15 expressing a willingness to integrate it into practice and 24 acknowledging its potential to enhance healthcare efficiency. Although only half believed it would improve patient outcomes, the tool was generally well received. Patients found the algorithm easy to understand and helpful for exploring treatment options, with the majority feeling it empowered informed discussions with their healthcare providers. A minority expressed dissatisfaction with usability or helpfulness. Conclusion ChatGPT 4.0 offers a promising AI‐driven tool for personalized fibroid management in the absence of formal guidelines. Although not a substitute for official recommendations, it could support clinical decision making and enhance patient education. Further integration with standardized guidelines and prospective trials is needed to optimize its clinical utility.

The Role of Bitter Melon in Breast and Gynecological Cancer Prevention and Therapy

Phytotherapy has long represented a widely accepted treatment alternative to conventional therapy. Bitter melon is a vine with potent antitumor effects against numerous cancer entities. To date, no review article has, however, been published on the role of bitter melon in breast and gynecological cancer prevention and therapy. The current work constitutes the most comprehensive, up-to-date review of the literature, which highlights the promising anticancer effects of bitter melon on breast, ovarian, and cervical cancer cells and discusses future research recommendations.