Innovations and challenges in Surgical Management of Gynecological Cancers

Innovations in the surgical management of gynecological cancers, including minimally invasive techniques and robotic-assisted surgery, have improved perioperative outcomes by reducing pain, shortening hospital stays, and accelerating recovery. Nonetheless, major challenges remain, such as tumor biological heterogeneity, treatment resistance, perioperative and long‑term complications, and unequal access to advanced surgical care, particularly in low-resource and rural settings. Fertility-preserving strategies and personalized surgical approaches are increasingly important to align treatment with patients’ reproductive goals and quality-of-life priorities. Looking ahead, the integration of precision oncology, immunotherapy, intraoperative imaging, and artificial intelligence into surgical decision-making and planning is expected to refine patient selection, optimize oncologic and functional outcomes, and reduce the risk of recurrence across the spectrum of gynecological malignancies.This Research Topic aims to address the persistent challenges and emerging opportunities in the surgical management of gynecological cancers. Despite major progress, variability in outcomes persists due to tumor heterogeneity, comorbidities, disparities in access to advanced technologies, and the burden of perioperative and late complications. To mitigate these issues, efforts must focus on expanding safe implementation of minimally invasive and robotic surgeries, enhancing surgical precision through improved intraoperative imaging and navigation, and integrating individualized treatment strategies informed by molecular and genomic profiling.Recent advances—including sentinel lymph node mapping, fertility-sparing procedures, image-guided and ultraradical surgery, enhanced recovery after surgery (ERAS) protocols, and the emerging role of artificial intelligence and machine learning in preoperative planning and intraoperative support—offer promising avenues to improve oncologic outcomes while minimizing morbidity. By bringing together multidisciplinary clinical and translational research, this Topic seeks to promote best practices, foster innovation, and support more equitable access to state-of-the-art gynecologic cancer surgery worldwide.We welcome Original Research, Review, Mini Review, and Perspective articles addressing surgical innovation, implementation, and outcomes in gynecological oncology. Contributions may include, but are not limited to, the following themes:- Surgical management of gynecological cancers (ovarian, endometrial, cervical, vulvar, vaginal, and rare tumors)- Cancer prevention and early diagnosis with surgical implications (e.g., risk‑reducing surgery, management of precursor lesions)- Technologies applied to gynecologic cancer treatment (laparoscopy, robotics, image-guided and navigation-assisted surgery)- Sentinel lymph node mapping, lymphadenectomy strategies, and staging procedures- Fertility-sparing and quality-of-life–preserving surgeries in reproductive-age patients- Enhanced recovery after surgery (ERAS), perioperative optimization, and management of surgical complications- Disparities in access to advanced surgical care, global surgery, and implementation in low-resource settingsPlease note: manuscripts consisting solely of bioinformatics or computational analysis of public databases, without validation using an independent cohort or biological validation in vitro or in vivo, are out of scope for this section and will not be accepted as part of this Research Topic. Topic editors: Stefano Cianci, Carlo Ronsini, CANIO MARTINELLI Source: https://www.frontiersin.org/research-topics/76306/innovations-and-challenges-in-surgical-management-of-gynecological-cancers