IJGC Podcast

IJGC EiC Summer Podcasts: ESGO-ESTRO-ESP Endometrial Cancer Guidelines with Nicole Concin

In this rebroadcasted episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Nicole Concin to discuss the ESGO-ESTRO-ESP Endometrial Cancer Guidelines.
Original release date: January 4, 2021

IJGC EiC Summer Podcasts: Updates on Role of HIPEC in Ovarian Cancer with Oliver Zivanovic

In this rebroadcasted episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Oliver Zivanovic to discuss updates on role of HIPEC in ovarian cancer. Dr. Zivanovic is a Gynecologic Cancer Surgeon at Memorial Sloan Kettering Cancer Center, with the goal to advance the early detection and treatment of women with gynecologic cancers. His special interests include the treatment of patients with advanced stage ovarian cancer and electronic patient-reported symptom monitoring after cancer surgery.
Original release date: August 30, 2021

IJGC EiC Summer Podcasts: ConCerv Trial with Kathleen Schmeler

In this rebroadcasted episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Kathleen Schmeler to discuss the ConCerv Trial. Dr. Schmeler is the lead author of “ConCerv: a prospective trial of conservative surgery for low-risk early-stage cervical cancer,” which was the Lead Article of IJGC’s October 2021 issue. Dr. Schmeler is a Professor in Gynecologic Oncology at The University of Texas MD Anderson Cancer Center. She provides care to women with gynecologic malignancies including surgery, chemotherapy and preventive services. Dr. Schmeler is also the Executive Director of Global Oncology for the MD Anderson Cancer Network. Her research interest is in cervical cancer prevention and treatment, particularly for resource-constrained countries and medically underserved communities in the US.
Original release date: October 4, 2021
Highlights:
- The ConCerv trial is the first prospective study of conservative surgery in women with low-risk cervical cancer. It included 14 sites in 9 countries.
- Findings from the ConCerv Trial offer prospective data supporting a more conservative approach to low-risk patients, sparing them the early and late morbidity associated with radical procedures.
- It will also allow for safer cervical cancer surgery in low- and middle-income countries, where the burden of cervical cancer is highest.
- In our study, conservative surgery was associated with a 3.5% recurrence rate in women with low-risk cervical cancer. In addition, the rate of positive lymph nodes was 5%, with lymph node assessment recommended in this low-risk population.
- Further study is needed to determine long term outcomes and optimal pathologic criteria for conservative surgery.

Chemotherapy Response Score in Ovarian Cancer with Alejandra Martinez

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Professor Alejandra Martinez to discuss the Chemotherapy Response Score (CRS) in ovarian cancer. Prof. Martinez has been the Deputy Head of the Surgical Oncology Department at Toulouse University Cancer Center (Institut Universitaire du Cancer de Toulouse) since 2016. She has served as the Director of the ESGO fellowship program of the IUCTO since 2017 and as a professor in oncology since 2021.
Highlights:
- CRS is an easy and reproductible biomarker that can help to stratify a patient's treatment.
- CRS 1-2 is associated with higher tumor load, more extensive surgical procedures, residual tumor after cytoreduction, and early relapse.
- Pathology response measured by the CRS is associated with disease-free and overall survival in patients with stage IIIC/IV treated with neoadjuvant chemotherapy irrespective of the number of cycles.

Updates on Overall Survival PARP Inhibitors

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Robert Coleman and Shannon Westin to discuss updates on overall survival PARP inhibitors. Robert L. Coleman, MD, is a gynecologic oncologist is Houston Texas and serves as SVP and Chief Scientific Officer for US Oncology Research. His primary research interests are in drug development for gynecological cancers and clinical trial management; he has authored more than 350 peer-reviewed publications. Dr. Shannon Westin focuses on developmental therapeutics and the use of biomarkers to predict response and recurrence in gynecologic malignancies. She currently serves as the Director of Early Drug Development and Phase I trials in her department and is a Co-Director of the Ovarian Cancer Moonshot. She is currently the PI or co-PI for greater than 30 novel treatment trials in gynecologic malignancies.

Opportunistic Salpingectomy to Prevent Ovarian Cancer with Dr. Gillian Hanley

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Gillian Hanley to discuss opportunistic salpingectomy for the prevention of ovarian cancer. Gillian Hanley, PhD, is an Associate Professor in the department of Obstetrics & Gynaecology at the University of British Columbia and a Canada Research Chair in Population-based Gynecologic and Perinatal outcomes. She does health services research in gynecology, primarily in the area of ovarian cancer prevention.
Highlights:
1. Opportunistic salpingectomy, the removal of fallopian tubes during a hysterectomy with ovarian preservation or instead of tubal ligation, has been recommended as ovarian cancer prevention following evidence that the fallopian tube is the tissue of origin for most high grade serous ovarian cancers.
2. We recently published the first data comparing observed to expected numbers of serous and epithelial ovarian cancers following opportunistic salpingectomy done for the purposes of ovarian cancer prevention in British Columbia, Canada.
3.Our data strongly suggest that opportunistic salpingectomy is effective in preventing serous ovarian cancers. There were 0 serous cancers in the opportunistic salpingectomy, and if they had been arising at the same rate as in the control groups (hysterectomy alone and tubal ligation), we would have expected 5.3. 0 is below the low end of the 95% confidence interval.

Reviewing the June issue with Katherine Hicks-Courant and Christina Uwins

In this episode of the IJGC Podcast, Editorial Fellows Katherine Hicks-Courant and Christina Uwins discuss the contents of the June issue of IJGC.

Consensus Statement on Pre-Invasive Vulvar Disease with Mario Preti

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Mario Preti to discuss the ESGO, ISSVD, ECSVD, and EFC consensus statements on pre-invasive vulvar lesions. Dr. Preti received his Specialization in Gynecology and Obstetrics and Specialization in Medical Oncology at the University of Torino. He is Associate Professor at the Department of Surgical Sciences, University of Torino, Italy, and the Immediate Past President of the ISSVD (International Society for the Study of Vulvo-vaginal disease). Dr. Preti is the author of 4 books on vulvo-vaginal diseases, and as of June 2022, he has published 108 papers indexed in Scopus/Pubmed, with 2,014 citations and an H-index of 23.
Highlights:
Epidemiological data show no decrease in vulvar invasive cancer incidence. This means that accurate diagnosis and treatment of pre-invasive vulvar disease must be improved: these are among the ESGO-ISSVD-ECSVD aims.
The two carcinogenic pathways of vulvar squamous neoplasia recognize as precursors two vulvar intraepithelial neoplasia (VIN): HPV-associated squamous intraepithelial lesions (High Grade VIN) and HPV-independent VIN (mainly differentiated VIN). These precursors have different clinical approach, treatment and oncological risk. Their histologic features can be subtle, and the histological diagnosis may be further complicated by coexisting conditions.
For differentiated VIN, an excisional procedure must always be adopted. Medical treatment (imiquimod or cidofovir) and ablative treatment can be considered for high grade VIN to preserve anatomy and function. These conservative approaches must be preceded by representative biopsies to exclude invasive disease.
Follow up should be modulated according to the risk of recurrence (type of lesion, patient age and immunological conditions, other associated lower genital tract lesions).
Pre-invasive vulvar lesions deserve specific attention because they affect not only functionality and body image, but also psychosexual factors.

Imiquimod vs Surgery RCT in Vulvar VIN

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Gerda Trutnovsky to discuss the use of imiquimod versus surgery for the treatment of vHSIL. Dr. Trutnovsky studied at the University of Graz/Austria and the University of Sydney/Australia. She works as an associate professor in the Department of Obstetrics and Gynecology at the Medical University of Graz/Austria, with a special interest in vulvar disease.
Highlights:
This was the first prospective trial of imiquimod versus surgery for the treatment of vulvar high grade squamous intraepithelial lesions (vHSIL).
Complete clinical response at 6 months was observed in 80% of patients using imiquimod per-protocol, compared to 79% in women who had one surgical intervention.
Imiquimod was used in a slowly escalating dosage scheme up to 3 times a week and reduced in case of side effects – local toxicity was mostly mild to moderate.
Imiquimod is a safe, effective and well accepted alternative to surgery and can be considered a first-line treatment option.

Surgical Staging Advanced Cervical Cancer

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Dimitrios Nasioudis. Dr. Nasioudis is a Gynecologic Oncology Fellow at the University of Pennsylvania. His current research focuses on translational therapeutics and population-based research.
Highlights:
The utility of surgical staging for patients with locally advanced cervical cancer has not been established.
While PET-CT is the most sensitive imaging modality to detect para-aortic metastases, the false negative rate can be as high as 20%.
In the United States, surgical staging for locally advanced cervical cancer is rarely performed with a decreasing utilization.
The impact of surgical staging on the oncologic outcomes is not clear.