IJGC Podcast

Reviewing the July Issue with Melis Canturk and Osnat Elyashiv

In this episode of the IJGC Podcast, Editorial Fellows Melis Canturk and Osnat Elyashiv discuss the contents of the July issue of IJGC.

MIRRORS Trial: MIS in Ovarian Cancer with Christina Uwins

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Christina Uwins to discuss the MIRRORS trial. Christina Uwins is a final year Subspecialty Fellow in Gynaecological Oncology, working together with Mr Simon Butler-Manuel on the MIRRORS study based at Royal Surrey NHS Foundation Trust, Guildford, UK.  Christina has clinical, research and teaching experience and is enthusiastic about continuing her work in Gynaecological Oncology.
Highlights:
Retrospective studies have suggested that minimally invasive interval debulking surgery is feasible. 
There are no prospective trials on robotic interval debulking surgery for advanced ovarian cancer. 
MIRRORS is a prospective cohort study assessing the feasibility of robotic interval debulking surgery for advanced-stage ovarian cancer. 
MIRRORS demonstrated the feasibility and safety of robotic interval debulking surgery in advanced-stage ovarian cancer. MIRRORS is the first in a series of three planned trials culminating in a multicenter international randomized controlled trial of MIRRORS protocol -versus standard open interval debulking surgery (MIRRORS-RCT). 
In the UK and Europe, the majority of patients with advanced ovarian cancer have interval debulking surgery performed through an open approach. If non-inferiority of robotic interval debulking surgery with regards to survival (overall and progression free) is confirmed by an adequately powered randomized controlled trial, this could lead to a significant change in practice.

Lymphadenectomy at the Time of Interval Cytoreduction for Ovarian Cancer with Dimitrios Nasioudis

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Dimitrios Nasioudis to discuss lymphadenectomy at the time of interval cytoreduction for ovarian cancer. Dimitrios Nasioudis is a gynecologic oncologist at the University of Pennsylvania. Following medical training at the Aristotle University of Thessaloniki, and a research fellowship at the Weill Cornell Medical College he completed his residency and fellowship training at the Hospital of the University of Pennsylvania. His current area of research is translational therapeutics with a focus on low-grade serous ovarian carcinoma. His research interests also include population science and surgical outcomes research.
Highlights:
The study aimed to evaluate the role of systematic lymphadenectomy during interval cytoreductive surgery in advanced-stage epithelial ovarian carcinoma patients who achieved complete gross resection.
An analysis of data from 1060 patients found that those who underwent systematic lymphadenectomy had higher rates of unplanned readmissions and longer hospital stays, with no significant difference in overall survival.
Systematic lymphadenectomy was rarely performed and did not provide a survival benefit for these patients.

Reviewing the June Issue with Anna Luzarraga and Natalia Palasz

In this episode of the IJGC Podcast, Editorial Fellows Anna Luzarraga and Natalia Palasz discuss the contents of the June issue of IJGC.

ChatGPT-fabricated Abstracts in Gynecologic Oncology with Gabriel Levin and Behrouz Zand

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Gabriel Levin and Behrouz Zand to discuss ChatGPT-fabricated abstracts in gynecologic oncology. Dr. Gabriel Levin is a gynecologic oncology Fellow at McGill University. His research encompasses population database studies with clinical implication and  innovations in medical education and health care. He has published more than 180 peer reviewed original articles.. Dr. Behrouz Zand is a gynecologic oncologist at Houston Methodist Hospital's Neal Cancer Center and Department of Obstetrics and Gynecology, and an assistant professor at Weill Cornell College at Houston Methodist Academic Institute. Specializing in innovative cancer care and clinical trials, he is passionate about integrating AI in medicine, a recent alumnus of the physician program at MIT for AI integration in healthcare. Dr. Zand combines cutting-edge research with compassionate patient care to advance the field.
 
Highlights:
 
Reviewers had difficulty in discriminating ChatGPT-written abstracts. Reviewers correctly identified only 46.3% of ChatGPT-generated abstracts, with human-written abstracts slightly higher at 53.7%. 
Senior reviewers and those familiar with AI had higher correct identification rates, with senior reviewers at 60% and juniors/residents at 45%. Experience and familiarity with AI were independently associated with higher correct identification rates.
ChatGPT assists researchers by generating reviews, summaries, and enhancing writing clarity, but it raises ethical concerns and could diminish human expertise. For non-English speaking authors, it improves writing quality and clarity. In scientific writing, it enhances clarity, summarizes concisely, brainstorms ideas, assists with terminology, and offers data interpretation, augmenting human expertise.
ChatGPT and AI in scientific writing can lead to ethical issues, factual inaccuracies, and may eventually diminish human expertise and critical thinking.

KEYNOTE A18-Addition of Pembrolizumab to Chemoradiation in Cervical Cancer with Domenica Lorusso

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Domenica Lorusso to discuss the KEYNOTE A18 clinical trial. Dr. Domenica Lorusso, MD, PhD, directs the Gynaecological Oncology Unit at Humanitas Hospital, Milan, and holds a Full Professorship in Obstetrics and Gynaecology at Humanitas University, Rozzano, Milan. She has led/participated in approximately 250 phase I-IV clinical trials. Currently overseeing more than 60 studies as Principal Investigator, Dr. Lorusso also chairs the Clinical Trials Committee of the MITO Group. She serves on the Board of Directors of the GCIG and is an active member of ENGOT, where she chairs the Gynecological Cancer Academy. Additionally, she sits on the Board of Directors of the ESGO. With around 300 international oncology publications and contributions to national and international treatment guidelines, her primary objectives are to ensure optimal patient care, foster clinical research, and advance international collaborations and education in the field.
 
Highlights:
- Concurrent chemoradiation plus brachiterapy represent the standard of care treatment in locally advanced cervical cancer providing up to 70% 5 years OS
- Modern radiotherapy technique (IMRT and VMAT) has reported to further increase OS and reduce toxicity 
- Immunotherapy has reported to increase OS in advanced or recurrent cervical cancer when compared to standard treatment
- Immunotherapy in combination with concurrent high quality chemoradiation in the treatment of locally advanced high risk cervical cancer further increase PFS and OS with respect to standard chemoradiotherapy and should be considered the new standard of care
- The combination appears manageable and no substanciad additional toxicity has been reported

Molecular Classification in Ovarian Preservation for Uterine Cancer with Jennifer Mueller and Beryl Manning-Geist

Podcast Description: In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Mueller and Manning-Geist to discuss molecular classification in ovarian preservation for uterine cancer. Jenny Mueller MD is a gynecologic oncologist and an associate 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. Beryl Manning-Geist is a Gynecologic surgery fellow at Memorial Sloan Kettering Cancer Center and will be joining Emory University Division of Gynecologic Oncology in 2024 as an assistant professor. Her research focuses on how to leverage the molecular underpinnings of gynecologic cancers for tailored treatment.
Highlights:
-Patients with microsatellite instability-high/mismatch repair-deficient or copy number-high/TP53abnormal endometrial cancer were at increased risk of concurrent ovarian disease.
-The presence of lymphovascular space invasion and positive cytology were also associated with an increased risk of concurrent ovarian disease.
-Integrating molecular tumor profiling with pathologic characteristics of disease may help to better risk stratify pre-menopausal patients with endometrial cancer for ovarian preservation.

Radical Vaginal Trachelectomy with Drs. Christhardt Köhler and Achim Schneider

Podcast Description: In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Christhardt Köhler and Achim Schneider to discuss radical vaginal trachelectomy. Prof. Christhardt Köhler is a highly accomplished gynecologist and obstetrician specializing in oncological gynecology. He is the Chief Physician of the Department of Gynecology at Asklepios Hospital Altona Hamburg and has won the Briker Award and the Robert B. Hunt Endowed Award. Dr. Kohler is a member of several professional associations, including the German Society for Gynecology and Obstetrics. His expertise is recognized worldwide, and he is listed in the FOCUS top list of physicians for gynecological operations and tumors. He has 1381 scientific publications focusing on spinal muscular atrophy, cervical cancer, and innovative gynecological surgery approaches. Achim Schneider, born on September 17, 1950, in Augsburg, is a distinguished German gynecologist and obstetrician. He earned his doctorate in 1975 and has since made significant contributions to the field, including pioneering new laparoscopic surgical techniques in gynecological oncology in Germany. Schneider held prestigious professorships at the Friedrich Schiller University in Jena and the Charité in Berlin. He has focused on the diagnosis and treatment of genital neoplasms, HPV-associated ano-genital neoplasms, and fertility-preserving surgery for cervical cancer patients. Currently, he heads the dysplasia consultation at the Medical Care Center in Berlin, continuing his impactful work in minimally invasive procedures and cancer prevention.
Highlights:
Radical vaginal trachelectomy is a fertility-preserving treatment for early cervical cancer, but large studies on its outcomes are lacking.
In a study of 471 patients (median age 33), 62% sought pregnancy with a 73% success rate, and 46% experienced pre-term delivery; recurrences occurred in 3.4% of cases, with a 2.1% mortality rate.
The study confirms the oncologic safety of the procedure and suggests that high pre-term delivery rates may be due to cervical volume loss, providing a benchmark for future surgical modifications

Endometrial Cancer New FIGO Stage IA3 vs IIIA1 with Koji Matsuo

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Koji Matsuo to discuss new FIGO staging of endometrial cancer. Dr. Matsuo is a clinician-scientist in the area of gynecologic oncology in the United States. His research interest is population-based, heath service outcome research for gynecologic malignancies.
Highlights:
(1) Survival effect of adjuvant therapy differed between stage IA3 and IIIA1.
(2) In new stage IA3 disease, omission of adjuvant therapy had comparable overall survival compared to combination chemotherapy and external beam radiotherapy or chemotherapy alone.
(3) In stage IIIA1, omission of adjuvant therapy was associated with decreased overall survival compared to chemotherapy-based approach.
(4) 5-year overall survival of adjuvant therapy omission group in new stage IA3 was nearly 90%.
(5) These hypothesis-generating observation suggested that treatment de-escalation of well-staged stage IA3 may not adversely affect survival. 

Small Bites to Prevention Incisional Hernias with Shitanshu Uppal

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Shitanshu Uppal to discuss the impact of closure of small fascial bites on incisional hernia rates in gynecologic oncology patients. Dr. Uppal is the George W. Morley Collegiate Professor of Obstetrics and Gynecology and the Division Chief of Gynecologic Oncology at the University of Michigan. Dr. Uppal is recognized for his research in surgical outcomes and quality improvement, alongside his pivotal role in leading educational initiatives for Gynecologic Oncology.
 
Highlights:
 
- This quality improvement study validates prior RCT data in gynecologic oncology population
- Adoption of Small-Bite Fascial Closure Reduced Hernia rates by 50%
- Obesity and adjuvant chemotherapy are independent risk factors for hernia development