Case Data A 62-year-old female patient. Family history: No family history of ovarian cancer, breast cancer or colorectal cancer. Gynecological examination: Married-type vulva, unobstructed vagina, empty pelvic cavity. Auxiliary Examinations Preoperative enhanced whole abdominal MRI indicated recurrent lymph nodes adjacent to the left psoas major muscle. A ureteral stent was placed preoperatively to prevent ureteral injury. Treatment Status Initial Treatment Surgery In February 2022, the patient underwent laparoscopic total hysterectomy plus bilateral adnexectomy for a "pelvic mass" at a local county hospital. Postoperative pathology: malignant tumor of the left fallopian tube, measuring 8.5cm×4.5cm. On March 16, 2022, the patient received a complementary surgery at the Zhongda Hospital Affiliated to Southeast University, undergoing laparoscopic high ligation of bilateral infundibulopelvic ligaments, greater omentectomy, pelvic lymph node dissection, para-aortic lymph node dissection, multiple biopsies of pelvic and abdominal peritoneum, and appendectomy. Postoperative pathology: No cancer was found in all specimens. Peritoneal lavage fluid: a small amount of atypical cells were seen. The patient received 3 cycles of chemotherapy with paclitaxel 210mg plus carboplatin 450mg postoperatively. First-line Treatment for Recurrence In June 2023, whole abdominal magnetic resonance imaging indicated lymph node metastasis adjacent to the abdominal aorta at the left renal hilum. On June 14, 2023, the patient underwent laparoscopic para-aortic lymph node resection. Postoperative pathology combined with immunohistochemistry results was consistent with the origin of high-grade serous carcinoma of the fallopian tube. From July to October 2023, the patient received chemotherapy with paclitaxel 210mg plus carboplatin 450mg, followed by maintenance therapy with niraparib 100mg on day 1 and 200mg on day 2 up to now. Second-line Treatment for Recurrence On July 22, 2024, the patient's CA125 level was 52U/L, and whole abdominal computed tomography indicated enlarged lymph nodes adjacent to the left common iliac artery. On July 31, 2024, the patient underwent single-port laparoscopic resection of recurrent pelvic lymph nodes at the Zhongda Hospital Affiliated to Southeast University. Gene detection: BRCA negative, HRD positive.

Surgeon Profile Shen Yang

Member of the Party Committee and Vice President of Zhongda Hospital Affiliated to Southeast University, Doctor of Medicine, Professor, Chief Physician, Supervisor of Doctoral Candidates and Postdoctoral Fellows. Director of the Department of Obstetrics and Gynecology and Director of the Institute of Women's Life and Health of Southeast University. National Health Defender, Honored Physician (Specialty Elite), the second-level talent of the Jiangsu 333 Project. Standing Member of the Gynecologic Oncology Committee of the Chinese Society of Clinical Oncology (CSCO). Deputy Director of the Integrated Screening and Prevention Committee for Cervical Cancer of the Chinese Anti-Cancer Association. Member of the Obstetrics and Gynecology Physicians Branch/Endoscopic Physicians Branch of the Chinese Medical Doctor Association. Director of the Gynecologic Oncology Committee of the China Association of Geriatric Health Care. Deputy Director of the Obstetrics and Gynecology Branch of the Jiangsu Medical Association. Director of the Gynecologic Artificial Intelligence and Minimally Invasive and Non-invasive Committee of the Jiangsu Research-oriented Hospital Association. He is proficient in the surgical and comprehensive treatment of complex gynecologic tumors, and focuses on the interdisciplinary research of medicine and engineering in gynecologic oncology. He has undertaken 1 national major science and technology project, 3 general projects of the National Natural Science Foundation of China, and more than 10 projects at other levels. He has published more than 100 SCI papers in journals such as Advanced Materials (IF 29.4), Photonix (IF 19.1), Advanced Functional Materials (IF 19.0), Advances in Science (IF 17.5), Journal of Controlled Release (IF 11.5), and Briefings in Bioinformatics (IF 9.5), with an H-index of 20.