IJGC Podcast

SCCAN Study: Hospital Volume and Radical Hysterectomy

In this episode of the IJGC podcast, Editor-in-Chief, Dr. Pedro Ramirez, is joined by Dr. Nicolò Bizzarri to discuss the SCCAN study. Dr. Bizzarri is a former IJGC Editorial Fellow under the mentorship of Prof. Pedro Ramirez. He is a Gynecologic Oncologist at Policlinico Agostino Gemelli in Rome, president of the European Network of Young Gynecologic Oncologists (ENYGO), and he happily serves on the IJGC Early Career Editorial Board.
Highlights:
- Women with early-stage cervical cancer treated with primary radical hysterectomy had improved disease free survival if treated in hospitals with a higher number of radical hysterectomies per year.
- Surgical volume of centers represented an independent prognostic factor affecting disease-free survival.
- Increasing number of radical hysterectomies performed in each center every year was associated with improved disease-free survival.

Special Issue: Novel Therapies Leading to a New Landscape in Gynecologic Tumors

In this episode of the IJGC podcast, Editor-in-Chief, Dr. Pedro Ramirez, is joined by Drs. Ainhoa Madariaga and Robert Coleman, two of the Guest Editors for this month’s special issue entitled “Novel Therapies Leading to a New Landscape in Gynecologic Tumors”. Dr. Madariaga is a Medical Oncologist in the Gynecologic Cancer Unit at 12 de Octubre University Hospital in Madrid, Spain. She is the chair of the Young and Early Career Investigator - EORTC Gynecological Cancer Group. Her research interests include patient reported outcomes and drug development. Dr. Coleman is a Gynecologic Oncologist and Chief Medical Officer at Sarah Cannon Research Institute (SCRI) in Nashville, TN. His research interests include drug development, clinical trial design and global medical education in gynecologic oncology.
Highlights:
- The alignment of cancer biology and novel treatment approaches are significantly extending the lives of patients with gynecologic malignancies, particularly with agents such as antibody drug conjugates, immunotherapy, and targeted agents.
- The evolving therapeutic landscape is escalating the need for a clearer understanding of how precision medicine can most efficiently be implemented.
- Emergence of drug resistance provides new challenges and opportunities through creative and strategic investigation of novel treatment and combinations.
- Advances in testing platforms in bringing genomic testing to the global audience.
- Clinical trial interpretation requires critical evaluation of analytical primary and hypothesis-generating secondary endpoints – strategies to make appropriate inference is key to clinical trial design.

Mentor’s Podcast: Robert Coleman

In this episode of the IJGC podcast, Editor-in-Chief, Dr. Pedro Ramirez, is joined by Dr. Robert Coleman. Dr. Coleman is a Gynecologic Oncologist and Chief Medical Officer at Sarah Cannon Research Institute (SCRI) in Nashville, TN. His research interests include drug development, clinical trial design and global medical education in gynecologic oncology.
Highlights:
- Strong mentorship is vital to personal and academic development. However, it is a two-way street. True synergy will come from bilateral engagement.
- Remember your clinic is your “laboratory” – keep a keen eye for clinical relationships, build hypotheses, and practice the exercise of how to best test it. Even in resource-constrained situations, the process of discovery and hypothesis testing will arm one to be a better investigator and to most appropriately interrogate the literature.
- A strong balance between personal and professional responsibilities will provide the environment for sustainability – this is the long game!

Updates on Germ Cell Tumors with David Gershenson

In this episode of the IJGC podcast, Editor-in-Chief, Dr. Pedro Ramirez, is joined by Dr. David M. Gershenson to discuss updates on germ cell tumors. Dr. Gershenson is Professor and former Chair of the Department of Gynecologic Oncology and Reproductive Medicine at The University of Texas MD Anderson Cancer Center. His major focus is on the clinical and translational research or rare ovarian cancers.
Highlights:
- The treatment of malignant ovarian germ cell tumor has evolved over the last 5 decades to represent one of our most remarkable success stories, with cure in 95+% of patients with stage I/II and approximately 75% of patients with stage III/IV.
- AGCT1531 is a very important trial, which, if positive, will reduce toxicity by extending surveillance to patients with stage IA or IB malignant ovarian germ cell tumors, including grade 2 and 3 immature teratomas, yolk sac tumors, and non-gestational choriocarcinomas and will result in the substitution of carboplatin for cisplatin in the regimen for treatment of stage IC-III.
- Fertility-sparing surgery is possible in the majority of young patients with malignant ovarian germ cell tumor, related to the following: a) 95% are confined to one ovary ; b) approximately 2/3s are stage I; and c) most patients are in their teenage years, 20s, and 30s and have not completed childbearing.
- Major controversies differentiating the treatment of children and adults by pediatric oncologists/pediatric surgeons and gynecologic oncologists, respectively, include the extent of surgical staging and the role of postoperative chemotherapy in patients with pure immature teratoma.
- For patients with malignant ovarian germ cell tumors who recur following primary therapy, BEP is recommended for those who have been treated with surgery alone. For those who have previously received BEP, standard management generally includes high-dose chemotherapy with stem cell rescue.
- Aspects of management of malignant ovarian germ cell tumors that require further study include the role of neoadjuvant chemotherapy and the role of secondary cytoreductive surgery.

Molecular Classification and Risk Stratification Endometrial Cancer

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Jenny Mueller and Bill Zammarrelli to discuss molecular classification and risk stratification in endometrial cancer. Jenny Mueller, MD, is a gynecologic oncologist and assistant attending in the department of surgery at Memorial Sloan Kettering Cancer Center. She leads the endometrial cancer research team at MSKCC with an emphasis on prospective, translational, and collaborative efforts within and across institutions. Bill Zammarrelli, MD, currently works as a gynecologic oncology fellow at Memorial Sloan Kettering Cancer Center. He is a commissioned officer in the US Army and completed his residency at Walter Reed National Military Medical Center. His current research focuses on the genetics of endometrial cancer.
Highlights:
- PORTEC-1 and GOG-99 risk classifications are discordant for stage I grade 3 endometrioid endometrial carcinoma (EEC).
- Stage I grade 3 EECs of CN-high molecular subtype have a worse 3-year progression-free survival compared to non-CN-high molecular subtypes.
- Molecular classification in combination with clinicopathologic factors may provide improved prognostic information.

MIS in Recurrent Ovarian Cancer

In this episode of the IJGC podcast, Editor-in-Chief, Dr. Pedro Ramirez, is joined by Professor Giovanni Scambia and Dr. Carmine Conte to discuss mildly invasive surgery in ovarian cancer. Prof. Scambia is the Director of the Gynecologic Oncology Unit and the Scientific Director of Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome, Italy. He is Full Professor of Obstetrics and Gynaecology, at Catholic University in Rome, and Member of Consiglio Superiore di Sanità, Ministry of Health Italy and Vice President 1st Section of Consiglio Superiore di Sanità. He is President Elect of E.S.G.E. (European Society for Gynaecological Endoscopy), and Past President of the Italian Society of Obstetrics and Gynecology (S.I.G.O.). Prof. Scambia is specialized in gynaecological cancer treatment and research. He has studied and developed innovative surgical approaches for the cure of gynecological cancers and has been invited professor in several academic hospitals both in Europe and outside Europe, and he is considered an opinion leader in the field of gynecologic oncology. Dr. Carmine Conte works at the Gynecologic Oncology Unit at Fondazione Policlinico Universitario A. Gemelli IRCCS in Rome, Italy. He got the ESGO Fellowship diploma and is recognized as a certified European Gynaecological Oncologist. Dr. Conte is a surgeon and researcher with special interest in minimally invasive surgery (laparoscopy and robotic) to treat cancerous and noncancerous diseases of the female reproductive system.
Highlights:
- The patients with oligometastatic recurrent disease had a higher likelihood of minimally invasive secondary cytoreductive surgery.
- Lymphnodal recurrences can be easily approached by MIS.
- Propensity-matched analysis showed no differences in survival between the MIS and open groups, with a higher rate of overall and severe early complications in the open group.
- Diagnostic laparoscopy and PET/CT scan should be considered complementary because of the potential of each one to identify a different disease setting.
- A diagnostic laparoscopy before secondary cytoreductive surgery may prevent unnecessary laparotomies.

Reviewing the January Issue with Andrea Rosati and Anisa Mburu

In this episode of the IJGC Podcast, Editorial Fellows Andrea Rosati and Anisa Mburu discuss the contents of the January issue of IJGC.

Prolonged Maintenance with Bevacizumab (BOOST Trial) with Jacobus Pfisterer and Philipp Harter

In this episode of the IJGC podcast, Editor-in-Chief, Dr. Pedro Ramirez, is joined by Professors Jacobus Pfisterer and Philipp Harter to discuss prolonged maintenance with bevacizumab. Prof. Philipp Harter is the director of the Department of Gynecology & Gynecologic Oncology at Kliniken Essen-Mitte in Essen, Germany and the chair of the AGO Study Group. Prof. Jacobus Pfisterer is Director of the Gynecologic Oncology Center in Kiel Germany and former chair of the AGO Study Group.
Highlights:
- 30-month bevacizumb maintenance does not improve progression-free survival nor overall survival in advanced ovarian cancer.
- 30-month bevacizumb maintenance is associated with more adverse events compared to 15 months.
- 15-month bevacizumb maintenance remains standard of care.

Precursors of Ovarian Cancer with Elvio Silva

In this episode of the IJGC podcast, Editor-in-Chief, Dr. Pedro Ramirez, is joined by Dr. Elvio Silva to discuss precursors of ovarian cancer. Dr. Silva received a medical degree from the Universidad de La Plata and has been a faculty member at M.D. Anderson Cancer Center since 1980. He had pathology residences in Buenos Aires, Argentina, and University of Toronto, Canada and is the former President of the International Society of Gynecological Pathologists.
Highlights:
- Most ovarian serous tumors originate in the ovarian stroma.
- Ovarian serous tumors originate in the epithelium of inclusion cysts or in epithelial areas that appear in the stroma due to mesenchymal-epithelial transition.
- Mesenchymal-epithelial transition in serous tumors mimics the development of the Mullerian duct from the celomic mesenchyma.

Hormone Replacement Therapy after Cervical Cancer with Jason Wright

In this episode of the IJGC podcast, Editor-in-Chief, Dr. Pedro Ramirez, is joined by Dr. Jason Wright to discuss hormone replacement therapy after cervical cancer. Dr. Wright is the Sol Goldman Associate Professor and Chief of the Division of Gynecologic Oncology at Columbia University.
Highlights:
- Among cervical cancer patients - Black patients were significantly less likely to receive estrogen replacement therapy than White patients.