IJGC Podcast

Fagotti Score at Interval Surgery in Ovarian Cancer with Flurina Saner

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Flurina Saner to discuss the Fagotti Score at interval surgery in ovarian cancer. Dr. Saner, gynecologist and obstetrician, is a gynae oncology fellow at the University Hospital Inselspital Bern, Switzerland. Her research focuses on patients with ovarian cancer and clinical and molecular determinants for long-term survival.
 
Highlights:
The Fagotti score after neoadjuvant treatment shows a strong correlation with resection status, progression-free and overall survival of patients with advanced ovarian cancer
ΔFagotti – indicating the change of the score during neoadjuvant chemotherapy - tracks with outcome after neoadjuvant chemotherapy for ovarian cancer
Fagotti scores are valuable for an individualized patient treatment planning and should be routinely assessed at time of interval debulking surgery.
The prognostic value of the Fagotti score after neoadjuvant therapy should be further validated in a prospective study, f.e. the LANCE trial.

Hormonal Therapy in Advanced or Recurrent Endometrial Cancer with Brian Slomovitz

 In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Brian Slomovitz to discuss hormonal therapy in advanced or recurrent endometrial cancer. Dr. Slomovitz is a Gynecologic Oncologist at Mount Sinai Medical Center in Miami Beach, Florida, and Professor of Obstetrics and Gynecology at the Wertheim College of Medicine at Florida International University. He is an internationally recognized leader in gynecologic oncology clinical trials, specifically in immunotherapy and novel biomarker therapeutics. He also is a leader in sentinel lymph node detection for gynecologic malignancies.
Highlights:
While current recommendations include chemotherapy as first-line treatment for metastatic or recurrent endometrial cancer, emerging evidence suggests that hormonal therapy, particularly in combination with other treatment regimens guided by biomarkers, could be efficacious in selected subtypes (low-grade endometrioid carcinoma of the endometrium).
Hormonal therapy offers many benefits, including oral dosing and fewer side effects.
If there is progression after hormonal therapy, patients would still be eligible for other trials, and use of hormonal therapy does not preclude the use or limit the benefits of future chemotherapy.
 
 

Ovarian Cancer Global Survey with Marc Algera

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Marc Algera to discuss the Ovarian Cancer Global Survey. Marc Algera is a medical doctor currently pursuing a PhD in Gynecological Oncology at the Dutch Institute for Clinical Auditing. His research focuses on improving the quality of gynecological cancer healthcare, both in the Netherlands and on a global scale.
 
Highlights:
The podcast discusses the first global expert-opinion survey report on ovarian cancer care organization, including data from high, middle, and low-income countries.
Data were provided by over one-thousand ovarian cancer specialists from 115 countries, which makes the current study the most extensive expert-opinion survey study in gynecological oncology.
Disparities in care organization were observed across income categories, revealing opportunities to improve care.
Income category-specific barriers were identified, such as the lack of access to chemotherapy and other systemic agents in lower-middle and low-income countries.
The time for action is now. The research team plans to conduct region-specific analyses using the current dataset, involving regional representatives and pharmaceutical companies, in order to work towards achieving global equality and equity in ovarian cancer care.

“CHIPOR Trial: HIPEC in Recurrent Ovarian Cancer” with Jean-Marc Classe

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Jean-Marc Classe to discuss the CHIPOR Trial. Dr. Classe is a surgeon and former head of the surgical department of the Institute of Surgical Oncology of Nantes, France. He is a professor in oncology and president of the French Society of Surgical Oncology.
 
Highlights:
The CHIPOR phase III RCT studied the use of HIPEC in 1st PSROC who underwent complete cytoreductive op after 2nd-line platinum-based chemo. Randomization was performed during complete cytoreductive surgery.
The primary endpoint was OS. Results showed HIPEC significantly improved OS, HR 0.69, p=0.020.
This study suggests that HIPEC can be a beneficial addition to the tx strategy for women with 1st PSROC when used in conjunction with 2nd-line platinum-based chemo and complete cytoreductive surgery.

Neoadjuvant Chemotherapy in Rare Ovarian Tumors with David Gershenson and Koji Matsuo

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. David Gershenson and Koji Matsuo. 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. Dr. Matsuo is a clinician-scientist in the area of gynecologic oncology. Equally attentive to patient care, he devotes his work to scholarly activity related to patient outcomes, quality improvement, and healthcare service research in gynecologic malignancies.
 
Highlights:
Role and effectiveness of neoadjuvant chemotherapy have been understudied in less common epithelial ovarian cancer, including clear cell, mucinous, and low-grade serous histologies.
In this retrospective analysis of two U.S. tumor registries, utilization of neoadjuvant chemotherapy has increased for these less common epithelial ovarian cancers in recent years.
Neoadjuvant chemotherapy was associated with decreased overall survival in low-grade serous ovarian cancer, and this association was particularly observed in historically favorable groups (younger, healthier, and earlier disease).
The results of current investigation endorse the importance of being aware of histology-specific survival effects of neoadjuvant chemotherapy in epithelial ovarian cancer.
In advanced low-grade serous ovarian cancer, data suggest that primary cytoreduction may be beneficial even optimal cytoreduction is not achievable in certain patients (younger, healthier, and earlier disease).
 

Thromboembolic Events in ERAS Program with Jolyn S. Taylor

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Jolyn Taylor to discuss thromboembolic events in the ERAS program. Dr. Taylor is an Associate Professor of Gynecologic Oncology at MD Anderson Cancer Center. She also serves as the Patient Safety Quality Officer for the Division of Surgery and focuses her research on ways to improve the quality of patient care.
 
Highlights:
-The overall rate of venous thromboembolism within 30 days of surgery on an ERAS pathway for laparotomy and minimally invasive surgery is low at 0.6%.
-The rate of venous thromboembolism within 30 days of laparotomy is 1.1% and 0.3% after minimally invasive surgery.
-Omission of preoperative heparin prophylaxis and postoperative extended venous thromboembolism prophylaxis appears to be safe for patients undergoing minimally invasive surgery though further studies are needed.

SLN Mapping in Ovarian Cancer with Núria Agustí

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Núria Agustí to discuss SLN mapping in ovarian cancer. Dr. Agustí specializes in gynecologic oncology at Hospital Clinic of Barcelona. She is currently a PhD researcher at the University of Barcelona and engaged in a postdoctoral fellowship at MD Anderson Cancer Center, USA. She recently completed the IJGC Editorial Fellowship program.
Highlights:
There is a high heterogeneity in SLN mapping techniques,  emphasizing the need for standardized protocols and further research in this area.
The study reports a sentinel lymph node detection rate of 93.3% in patients with early-stage ovarian cancer with a 100% negative predictive value.
The study suggests that the combination of radiotracer and indocyanine green for tracer injection into the utero-ovarian and infundibulo-pelvic ligaments may yield the best detection rates for SLNs in ovarian cancer.
Additional ongoing and well-defined studies and consideration of oncologic outcomes before implementing SLN detection as a routine practice for ovarian cancer staging is highly needed.

Mentor’s Podcast: Dennis Chi

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Dennis Chi. Dr. Chi is the incumbent of the Ronald O. Perelman Chair in Gynecologic Surgery, Deputy Chief of the Gynecology Service, and Head of Ovarian Cancer Surgery at Memorial Sloan Kettering Cancer Center (MSKCC).  He has been a faculty member at MSKCC since graduating from fellowship there in 1997.
 
Highlights: Dr. Chi discusses the evolution of gynecologic surgery and the current state of the field, talks about finding a niche in the planning of one’s career, and outlines difficulties in planning a surgical trial along with ways to overcome them.

FIGO Endometrial Staging 2023 with Mario M. Leitao, Jr. and Andreas Obermair

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Mario Leitao and Andreas Obermair to discuss FIGO endometrial staging. Dr. Mario Leitao is currently an Attending Surgeon in the Department of Surgery at Memorial Sloan Kettering Cancer Center and a Professor in the Department of Obstetrics and Gynecology at Weill Cornell Medical College. He currently serves as Program Director for the Gynecologic Oncology Fellowship. Dr. Leitao is also the Director for the Minimal Access and Robotic Surgery Program in the Department of Surgery for MSKCC. Dr. Andreas Obermair is an active gynaecological oncologist in public and private practice and a Professor of Gynaecological Oncology at The University of Queensland in Brisbane, Australia. He leads the Queensland Centre for Gynaecological Cancer Research to achieve less invasive and more effective treatments for gynaecological cancer.
 
Highlights:
The new FIGO (staging) system is no longer a staging system to determine the extent of endometrial cancer
Histology and other prognostic factors should not be part of a staging system
We need much more investigation and validation before we can apply a molecular classification to the care of our patients and then it should not be part of a staging system
An international staging system is likely best if kept reproducible, and if it can be applied worldwide
There is poor correlation now with this new system and the AJCC TNM system

ESGO/ESTRO Quality Indicators for Radiation Therapy for Cervical Cancer – with Cyrus Chargari and Christina Fotopoulou

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Cyrus Chargari and Christina Fotopoulou to discuss the ESGO/ESTRO quality indicators for radiation therapy for cervical cancer. Dr. Chargari is a radiation oncologist at Pitié Salpêtrière University Hospital – Sorbonne University, Paris, France. He is full professor of oncology and serves as the Secretary-General of the French Society of Radiation Oncology. He is an active member of ESTRO. Dr. Fotopoulou is the Chair of Gynaecological Cancer Surgery at the Department of Surgery and Cancer at Imperial College London, UK. She has served as an elected ESGO council member and Chair of the ESGO and BGCS guidelines committee.
 
Highlights:
Multidisciplinary quality indicators jointly with ESGO and ESTRO about the radiotherapeutic management of cervical cancer.
The objective was to provide practitioners and administrators with quantifiable metrics for enhancing clinical care and organizational processes, particularly considering the complexities of modern radiotherapy techniques.
The indicators were established through a combination of scientific evidence and expert consensus.
The development process involved literature review, expert meetings, validation, and external review by clinicians.
The resulting set of 19 indicators covers pre-treatment, treatment, and outcomes, and aims to standardize radiation therapy quality, with the next step being the accreditation of centers for cervical cancer management in the quality assurance process.