IJGC Podcast BMJ Podcasts

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.

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

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. 

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

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Domenica Lorusso to discuss the survival analysis of the PAOLA1 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:
Bevacizumab plus olaparib has reported to increase PFS and OS in advanced stage III-IV, newly diagnosed, high grade serous and endometrioid HRD positive ovarian cancer in the maintenance setting 
Exploratory analysis suggest that the advantage is particularly high in low risk patients (stage III withour residual tumor at primary surgery) where  a 5-year OS more  than 90% has been reported suggesting some of these patients may be cured
In the HRp population the combination of olaparib-bevacizumab did non increase PFS and OS in comparison to bevacizumab alone
The toxicity profile of the combination is in line with what expected with the single drugs

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Ana Luzarraga to discuss molecular profiles as predictors of endometrial recurrence. Dr. Luzarraga is a Gynecologic Oncologist currently working in the Vall d'Hebron University Hospital in Barcelona, Spain. She has completed her two years ESGO fellowship in 2023 and is currently finishing her PhD programme about molecular profile in endometrial cancer.
 
Highlights:
Molecular subgroups of endometrial cancer present distinctive recurrence patterns: p53-abn tumors relapse mostly with peritoneal and distant disease and NSMP tumors at distance.
Molecular profile is a stronger independent predictor for vaginal, peritoneal, and distant recurrence than classic histologic factors.
P53-abn is the sole independent predictor of peritoneal relapse.
P53-abn and NSMP are independent predictors of distant recurrence.