Top 5 lessons learned at SGO's Annual Meeting on Women’s Cancer

Nadeem R. Abu-Rustum, MD, chair of the program committee for the 2015 Society of Gynecologic Cancer’s Annual Meeting on Women’s Cancer, highlights key topics covered during the conference. These topics included surgical and medical approaches to ovarian cancer, sentinel node mapping for endometrial cancer, the use of tissue morcellation for uterine tissue extraction, and the efficacy of the 9-valent HPV vaccine.
“We heard presentations from various speakers on topics that have generated great excitement,” Abu-Rustum, told HemOnc Today. “We heard some encouraging findings, and some interesting debates.
The following are the top five lessons learned from the 2015 Society of Gynecologic Oncology’s (SGO) Women’s Cancer Annual Meeting.

1. The use of standard chemotherapy plus bevacizumab confers a survival benefit in patients with ovarian cancer.

At the 2015 meeting, Robert L. Coleman, MD, of the University of Texas MD Anderson Cancer Center presented preliminary findings from a phase 3 randomized study conducted by the Gynecologic Oncology Group. In the study, women were randomized to receive either a standard chemotherapy regimen of paclitaxel and carboplatin (n = 374) or this standard regimen plus bevacizumab (n = 374). The study found that the addition of bevacizumab increased survival by a median of 5 months.
“This was one of those highly-anticipated studies that has been in design for a while, and learning the findings was a highlight of the meeting,” Abu-Rustum said.

2. Laparoscopy may be a valid approach to determining the resectability of advanced ovarian cancer.

Abu-Rustum said another key topic discussed at the meeting was the use of laparoscopy to assess the resectability of advanced ovarian cancer.
“When women present with advanced ovarian cancer, we have to determine who is a good candidate to have surgery,” Abu-Rustum said. “Traditionally, we’ve used a lot of imaging and block tests, but now, more and more, the role of laparoscopy has evolved.”

3. Sentinel node mapping has emerged as an important approach to surgical staging in endometrial cancer.

The topic of sentinel node mapping for the staging of endometrial cancer was one that generated a great deal of excitement at the 2015 meeting, Abu-Rustum said. This emerging approach to staging endometrial cancer was featured in six plenary sessions, and was the topic of data presented by multiple institutions, including Sloan-Kettering, MD Anderson Cancer Center, Johns Hopkins, and more. Sentinel node mapping was also the focus of a pro/con debate, Abu-Rustum said.
“What we’re finding now is that with a simple technique of injecting dye into the cervix at the time of the hysterectomy, you can map sentinel nodes in approximately 80% or more of patients and follow a specific algorithm during surgery,” he said. “This helps detect the majority of nodular disease and make the operation more precise and much more individualized; it gives you the information to help decide if the patient is high risk, and may avoid the side effects of extensive lymphadenectomy.”

4. Morcellation and tissue fragmentation should be used with caution in malignant uterine tumors.

Abu-Rustum said several presentations were made about the use of tissue fragmentation and morcellation in patients with uterine cancer.
“Over this past year, there’s been a huge push to be very careful with the use of morcellation and tissue fragmentation,” he said. “The message was that physicians need to very careful when using this on malignant tumors of the uterus to avoid spillage of the tumor, which may potentially increase the risk of these cancers recurring, and potentially worsening the outcome of these patients.”’

5. HPV vaccination and cervical cancer screening are crucial.

Abu-Rustum said the importance of cervical cancer screening and the HPV vaccine was addressed in the meeting’s Seminal Abstract Session. This topic is particularly relevant given recent findings on the high proportions of women not screened for cervical cancer or vaccinated against HPV.
“The seminal abstracts discussed issues relating to the importance of HPV-9, the 9-valent vaccine, as well as the importance of cervical cancer screening,” he said. “They also addressed uterine transplantation, which is a rare procedure but a very interesting development.”