1
|
Kim MS, Lee AJ, Shim SH, Jang EB, Kim NK, Kim MK, Suh DH, Kim J, Son JH, Kong TW, Chang SJ, Hwang DW, Park SJ, Kim HS, Yoo JG, Lee SJ, Lee YY. Comparison of Outcomes in Bowel Resections by Gynecologic Oncologists Versus General Surgeons During Maximal Cytoreductive Surgery for Advanced Ovarian Cancer: Gynecologic Oncology Research Investigators Collaboration Study (GORILLA-3006). Ann Surg Oncol 2024; 31:6040-6047. [PMID: 38961041 DOI: 10.1245/s10434-024-15643-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/06/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND This report describes the oncologic outcomes for patients with advanced ovarian cancer who had bowel surgery performed by gynecologic oncologists (GOs) and compares the outcomes with those for bowel surgery performed by general surgeons (GSs) during maximal cytoreductive surgery. METHODS Patients from six academic institutions who had FIGO stage III or IV ovarian cancer and underwent any bowel surgeries during maximal cytoreductive surgery were eligible for the study. The patients were divided into two groups according to whether bowel surgery was performed by a GO or a GS. In both groups, the GOs were mainly involved in extra bowel debulking procedures. Perioperative and survival outcomes were compared between the two groups. RESULTS The 761 patients in this study included 113 patients who underwent bowel surgery by a GO and 648 who had bowel surgery by a GS. No discernible differences were observed in age, American Society of Anesthesiology (ASA) score, FIGO stage, histologic type, timing of cytoreductive surgery (primary or interval debulking surgery), or complications between the two groups. The GO group exhibited a shorter operation time than the GS group. Kaplan-Meier analysis showed no survival differences between the two groups. In the Cox analysis, non-serous cell types and gross residual diseases were associated with adverse effects on overall survival. However, performance of bowel surgery by a GO did not have an impact on survival. CONCLUSION Performance of bowel surgery by a GO during maximal cytoreductive surgery is both feasible and safe. These results should be reflected in the training system for GOs regarding bowel surgery, and further research is needed to confirm that GOs can play a more leading role in performing extra-uterine procedures.
Collapse
Affiliation(s)
- Myeong-Seon Kim
- Department of Obstetrics and Gynecology, Chung-Ang University Gwangmyeong Hospital, College of Medicine Chung-Ang University, Seoul, Republic of Korea
| | - A Jin Lee
- Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Seung-Hyuk Shim
- Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Eun Bi Jang
- Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Nam Kyeong Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Min Kyung Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Dong Hoon Suh
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jeeyeon Kim
- Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Joo-Hyuk Son
- Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Tae-Wook Kong
- Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Suk-Joon Chang
- Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Dong Won Hwang
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soo Jin Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hee Seung Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ji Geun Yoo
- Department of Obstetrics and Gynecology, Daejeon St Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Sung Jong Lee
- Department of Obstetrics and Gynecology, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo-Young Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
2
|
Kemah BL, Bhagat N, Pandya A, Sullivan R, Sundar SS. Training the gynecologic oncologists of the future - challenges and opportunities. Int J Gynecol Cancer 2024; 34:619-626. [PMID: 37989477 DOI: 10.1136/ijgc-2023-004557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023] Open
Abstract
Several recent advances in gynecologic cancer care have improved patient outcomes. These include national screening and vaccination programs for cervical cancer as well as neoadjuvant chemotherapy for ovarian cancer. Conversely, these advances have cumulatively reduced surgical opportunities for training creating a need to supplement existing training strategies with evidence-based adjuncts. Technologies such as virtual reality and augmented reality, if properly evaluated and validated, have transformative potential to support training. Given the changing landscape of surgical training in gynecologic oncology, we were keen to summarize the evidence underpinning current training in gynecologic oncology.In this review, we undertook a literature search of Medline, Google, Google Scholar, Embase and Scopus to gather evidence on the current state of training in gynecologic oncology and to highlight existing evidence on the best methods to teach surgical skills. Drawing from the experiences of other surgical specialties we examined the use of training adjuncts such as cadaveric dissection, animation and 3D models as well as simulation training in surgical skills acquisition. Specifically, we looked at the use of training adjuncts in gynecologic oncology training as well as the evidence behind simulation training modalities such as low fidelity box trainers, virtual and augmented reality simulation in laparoscopic training. Finally, we provided context by looking at how training curriculums varied internationally.Whereas some evidence to the reliability and validity of simulation training exists in other surgical specialties, our literature review did not find such evidence in gynecologic oncology. It is important that well conducted trials are used to ascertain the utility of simulation training modalities before integrating them into training curricula.
Collapse
Affiliation(s)
- Ben-Lawrence Kemah
- Department of Obstetrics and Gynaecology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
- Department of Health Research, Health Education and Research Organisation (HERO), Buea, Cameroon
| | - Nanak Bhagat
- Department of Gynaecological Oncology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Aayushi Pandya
- Department of Obstetrics and Gynaecology, Barts Health NHS Trust, London, UK
| | - Richard Sullivan
- Department of Cancer and Global Health, King's College London, London, UK
| | - Sudha S Sundar
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- Pan Birmingham Gynaecological Cancer Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| |
Collapse
|
3
|
Wickenheisser NE, Dillon M, Broadwater G, Zacherl K, Bixel K, Levine M, Newton M, Thel H, Tucker K, Gehrig P, Khetan VU, Brunette-Masi LL, Matsuo K, Khouri OR, Duhon A, Gowthaman D, Cowan M, Mojdehbakhsh R, Rose S, Olawaiye A, Davidson BA, Moss HA, Havrilesky LJ. Radical hysterectomy case volume and cervical cancer treatment in the era of COVID-19: A multi-site analysis of National Cancer Institute-designated Comprehensive Cancer Centers. Gynecol Oncol 2023; 179:70-78. [PMID: 37944328 DOI: 10.1016/j.ygyno.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE To compare radical hysterectomy case volume, cancer stage, and biopsy-to-treatment time of invasive cervical cancer diagnosed before and after onset of the COVID-19 pandemic. METHODS In a multi-institution retrospective cohort study conducted at 6 large, geographically diverse National Cancer Institute-designated cancer centers, patients treated for newly diagnosed invasive cervical cancer were classified into 2 temporal cohorts based on date of first gynecologic oncology encounter: (1) Pre-Pandemic: 3/1/2018-2/28/2020; (2) Pandemic & Recovery: 4/1/2020-12/31/2021. The primary outcome was total monthly radical hysterectomy case volume. Secondary outcomes were stage at diagnosis and diagnosis-to-treatment time. Statistical analyses used chi-squared and two sample t-tests. RESULTS Between 3/1/2018-12/31/2021, 561 patients were diagnosed with cervical cancer. The Pre-Pandemic and Pandemic & Recovery cohorts had similar age, race, ethnicity, smoking status, and Body Mass Index (BMI). During Pandemic & Recovery, the mean monthly radical hysterectomy case volume decreased from 7[SD 2.8] to 5[SD 2.0] (p = 0.001), the proportion of patients diagnosed with Stage I disease dropped from 278/561 (49.5%) to 155/381 (40.7%), and diagnosis of stage II-IV disease increased from 281/561 (50.1%) to 224/381 (58.8%). Primary surgical management was less frequent (38.3% Pandemic & Recovery versus 46.7% Pre-Pandemic, p = 0.013) and fewer surgically-treated patients received surgery within 6 weeks of diagnosis (27.4% versus 38.9%; p = 0.025). CONCLUSIONS Lower radical hysterectomy case volume, a shift to higher cervical cancer stage, and delay in surgical therapy were observed across the United States following the COVID-19 outbreak. Decreased surgical volume may result from lower detection of early-stage disease or other factors.
Collapse
Affiliation(s)
- Natalie E Wickenheisser
- Department of Obstetrics & Gynecology, Duke University Health System, Durham, NC, United States of America
| | - Mairead Dillon
- Biostatistics Shared Resources, Duke Cancer Institute, Durham, NC, United States of America
| | - Gloria Broadwater
- Biostatistics Shared Resources, Duke Cancer Institute, Durham, NC, United States of America
| | - Kathleen Zacherl
- Department of Obstetrics & Gynecology, Duke University Health System, Durham, NC, United States of America
| | - Kristin Bixel
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Ohio State University Wexner Medical Center, Columbus, OH, United States of America
| | - Monica Levine
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Ohio State University Wexner Medical Center, Columbus, OH, United States of America
| | - Meredith Newton
- Divison of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of North Carolina Medical Center, Chapel Hill, NC, United States of America
| | - Hannah Thel
- University of North Carolina School of Medicine, Chapel Hill, NC, United States of America
| | - Katherine Tucker
- Divison of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of North Carolina Medical Center, Chapel Hill, NC, United States of America
| | - Paola Gehrig
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Virginia School of Medicine, Charlottesville, VA, United States of America
| | - Varun U Khetan
- Divison of Gynecologic Oncology, Department of Obstetrics & Gynecology, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States of America
| | - Laurie L Brunette-Masi
- Divison of Gynecologic Oncology, Department of Obstetrics & Gynecology, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States of America
| | - Koji Matsuo
- Divison of Gynecologic Oncology, Department of Obstetrics & Gynecology, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States of America
| | - Olivia R Khouri
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Montefiore Medical Center, Bronx, NY, United States of America
| | - Ashley Duhon
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Montefiore Medical Center, Bronx, NY, United States of America
| | - Divya Gowthaman
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Montefiore Medical Center, Bronx, NY, United States of America
| | - Matthew Cowan
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Montefiore Medical Center, Bronx, NY, United States of America
| | - Rachel Mojdehbakhsh
- Divison of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Wisconsin Health, Madison, WI, United States of America
| | - Stephen Rose
- Divison of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Wisconsin Health, Madison, WI, United States of America
| | - Alexander Olawaiye
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States of America
| | - Brittany A Davidson
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Duke University Health System, Durham, NC, United States of America
| | - Haley A Moss
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Duke University Health System, Durham, NC, United States of America
| | - Laura J Havrilesky
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Duke University Health System, Durham, NC, United States of America.
| |
Collapse
|
4
|
Lokuhetty N, Mohan HM, Kong JC, Heriot AG, Warrier SK. Lateral pelvic sidewall dissection in rectal cancer: case selection and training to optimize outcomes. Br J Surg 2022; 109:306-307. [DOI: 10.1093/bjs/znab446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/20/2021] [Accepted: 12/05/2021] [Indexed: 11/14/2022]
Affiliation(s)
- Naradha Lokuhetty
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, Australia
- Department of General Surgery, The Alfred Hospital, Melbourne, Victoria 3004, Australia
| | - Helen M. Mohan
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, Australia
| | - Joseph C. Kong
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, Australia
- Department of General Surgery, The Alfred Hospital, Melbourne, Victoria 3004, Australia
- Department of Surgery, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Alexander G. Heriot
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, Australia
- Department of Surgery, University of Melbourne, Melbourne, Victoria 3010, Australia
- Department of General Surgery, Epworth Healthcare, Melbourne, Victoria 3121, Australia
| | - Satish K. Warrier
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, Australia
- Department of General Surgery, The Alfred Hospital, Melbourne, Victoria 3004, Australia
- Department of Surgery, University of Melbourne, Melbourne, Victoria 3010, Australia
- Department of General Surgery, Epworth Healthcare, Melbourne, Victoria 3121, Australia
| |
Collapse
|
5
|
Bouchard-Fortier G, Gien LT, Sutradhar R, Chan WC, Krzyzanowska MK, Liu S(L, Ferguson SE. Impact of care by gynecologic oncologists on primary ovarian cancer survival: A population-based study. Gynecol Oncol 2022; 164:522-528. [DOI: 10.1016/j.ygyno.2022.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/16/2021] [Accepted: 01/03/2022] [Indexed: 11/04/2022]
|
6
|
Shim JE, Kim MK, Kim YH, Kim SC. Effect of Quality Control Program in Surgical Management of Early Cervical Cancer. J Korean Med Sci 2021; 36:e316. [PMID: 34811979 PMCID: PMC8608925 DOI: 10.3346/jkms.2021.36.e316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/28/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Regular assessments of clinical performance in gynecologic cancer surgery is important for the safety of patients. We evaluated the effects of quality control (QC) program on the treatment pattern and clinical outcomes of early cervical cancer. METHODS Medical records of cervical cancer patients who received operation in our institution from January 2007 to December 2018 were retrospectively reviewed. Cases were divided into 2 groups, before and after the initiation of QC program, group 1 (2007-2013) and group 2 (2014-2018), based on the operation date. Two groups were compared in clinicopathologic variables, surgical methods, operative details, adjuvant treatments, recurrence and survival. RESULTS A total of 305 cervical cancer patients were included in the analysis, 210 in group 1 and 95 in group 2. In group 2, minimally invasive surgery (MIS) was more frequently performed (60.0% vs. 76.8%, P = 0.004), especially in earlier stages (stage IA, 72.6% vs. 100.0%; stage IB, 52.2% vs. 69.5%). However, the median tumor size treated by MIS was decreased in stage IB (20 mm vs. 17 mm, P = 0.015). Frequency of adjuvant treatment was also reduced in stage IB (56.5% vs. 37.3%, P = 0.016). Recurrence within 3 years, 3-year disease free survival and overall survival did not show significant difference; however, 3-year recurrence after MIS was significantly reduced in stage IB. CONCLUSION QC program enforced stricter patient selection criteria for MIS and positively affected clinical outcomes in cervical cancer patients who underwent surgery. Systemic monitoring should be considered for patient safety.
Collapse
Affiliation(s)
- Ji Eun Shim
- Department of Obstetrics and Gynecology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Mi-Kyung Kim
- Department of Obstetrics and Gynecology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Yun Hwan Kim
- Department of Obstetrics and Gynecology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
| | - Seung Cheol Kim
- Department of Obstetrics and Gynecology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| |
Collapse
|
7
|
Akladios C, Daraï É, Golfier F, Lecuru F, Collinet P, Uzan C, Lavoué V, Guyon F, Ferron G, Querleu D. [A curriculum based certification of competence in gynaecologic surgical oncology]. ACTA ACUST UNITED AC 2021; 50:26-32. [PMID: 34774853 DOI: 10.1016/j.gofs.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/04/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE In France, we are lacking an identified pathway for training in gynaecological cancer surgery. The four competent French learned societies, the SFOG, the CNGOF, the SFCO and the SCGP, supported by the CNU of Obstetrics &Gynaecology- and UNICANCER, agreed to materialize this course and attest it by a certification awarded by a national jury. MATERIAL AND METHODS The national committee of certification in gynaecological oncology made up of 10 members, representing the 6 concerned organizations, set itself 5 objectives: the definition of the eligibility criteria for training centres; the determination of a check-list to be filled by the candidate; the determination of a targeted curriculum for the training in gynecological oncological surgery; the determination of the assets necessary for the certification of a candidate already in practice; and the practical organization of the certification. RESULTS Criteria for approval of centres for training included 150 gynaecological cancer cases per year, among which 100 excisional surgeries, including 20 advanced-stage ovarian cancers. For certification of candidate who followed the curriculum established by the committee or by validation of prior experience for an actual practitioner, a candidate must validate a logbook and fill out a checklist including 4 parts: theoretical and practical training; research and publications; teaching and subscription to a continuing education program. The accomplished elements of the logbook and the checklist will be evaluated by a score. The first certification session is planned for the end of 2021. CONCLUSION The optimisation of the surgical management of patients treated for gynaecological cancer is achieved through the identification of a training course and the certification, by a national jury, of the skills of surgeons who have completed it.
Collapse
Affiliation(s)
- C Akladios
- Hôpitaux universitaires de Strasbourg, CHU de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France.
| | - É Daraï
- Hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - F Golfier
- Centre hospitalier Lyon Sud CHEM Grand Revoyet, hôpital Lyon Sud-Lyon, 69310 Pierre-Bénite, France
| | - F Lecuru
- Institut Curie-Paris, institut Curie Ensemble hospitalier - site de Paris, 26, rue d'Ulm, 75005 Paris, France
| | - P Collinet
- Hôpital Jeanne-de-Flandre-Lille, avenue Eugene-Avinée, 59000 Lille, France
| | - C Uzan
- Hôpital de la Pitié Salpêtrière, Hôpital Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - V Lavoué
- Centre Eugène-Marquis, hôpital Sud, CHU de Rennes, avenue Bataille Flandres-Dunkerque C S 44229, 35042 Rennes, France
| | - F Guyon
- Institut Bergonié, centre de lutte contre le cancer (CLCC) de la région Nouvelle-Aquitaine, 229, cours de l'Argonne, 33000 Bordeaux, France
| | - G Ferron
- Institut universitaire du cancer de Toulouse ONCOPOLE Iuct O, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France
| | - D Querleu
- Société européenne d'oncologie gynécologique, 7, allée du Niger, 31000 Toulouse, France
| |
Collapse
|
8
|
Datta A, Sebastian A, Chandy RG, Thomas V, Thomas DS, Karuppusami R, Thomas A, Peedicayil A. Complications and Outcomes of Diaphragm Surgeries in Epithelial Ovarian Malignancies. Indian J Surg Oncol 2021; 12:822-829. [DOI: 10.1007/s13193-021-01438-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/01/2021] [Indexed: 12/24/2022] Open
|
9
|
Akladios C, Daraï É, Golfier F, Lecuru F, Collinet P, Uzan C, Lavoué V, Guyon F, Ferron G, Querleu D. [National certification for gynecological cancer surgery]. Bull Cancer 2021; 108:806-812. [PMID: 34217437 DOI: 10.1016/j.bulcan.2021.03.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 03/30/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE In France, we are lacking an identified pathway for training in gynaecological cancer surgery. The four competent French learned societies: the SFOG, the CNGOF, the SFCO and the SCGP supported by the CNU of Obstetrics & Gynaecology, and UNICANCER agreed to materialize this course and attest it by a certification awarded by a national jury. MATERIAL AND METHODS The national committee of certification in gynaecological oncology made up of ten members, representing the 6 concerned organizations, set itself five objectives: the definition of the eligibility criteria for training centres; the determination of a check-list to be filled by the candidate; the determination of a targeted curriculum for the training in gynecological oncological surgery; the determination of the assets necessary for the certification of a candidate already in practice; and the practical organization of the certification. RESULTS Criteria for approval of centres for training included 150 gynaecological cancer cases per year, among which 100 excisional surgeries, including twenty advanced-stage ovarian cancers. For certification of candidate who followed the curriculum established by the committee or by validation of prior experience for an actual practitioner, a candidate must validate a logbook and fill out a checklist including four parts: theoretical and practical training; research and publications; teaching and subscription to a continuing education program. The accomplished elements of the logbook and the checklist will be evaluated by a score. The first certification session is planned for the end of 2021.
Collapse
Affiliation(s)
- Cherif Akladios
- Hôpitaux universitaires de Strasbourg, CHU de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France.
| | - Émile Daraï
- AP-HP, Hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - François Golfier
- Hôpital Lyon Sud-Lyon, centre hospitalier Lyon Sud CHEM Grand Revoyet, 69310 Pierre-Bénite, France
| | - Fabrice Lecuru
- Institut Curie-Paris, Institut Curie Ensemble hospitalier - Site de Paris, 26, rue d'Ulm, 75005 Paris, France
| | - Pierre Collinet
- Hôpital Jeanne-de-Flandre-Lille, avenue Eugene-Avinée, 59000 Lille, France
| | - Catherine Uzan
- AP-HP, Hôpital de la Pitié Salpêtrière, Hôpital Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - Vincent Lavoué
- Hôpital Sud Centre Eugène-Marquis, CHU de Rennes, avenue Bataille Flandres-Dunkerque C S 44229, 35042 Rennes, France
| | - Frederic Guyon
- Institut Bergonié, centre de lutte contre le cancer (CLCC) de la région Nouvelle-Aquitaine, 229, cours de l'Argonne, 33000 Bordeaux, France
| | - Gwenael Ferron
- Institut universitaire du cancer de Toulouse ONCOPOLE Iuct O, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France
| | - Denis Querleu
- Société européenne d'oncologie gynécologique, 7, allée du Niger, 31000 Toulouse, France
| |
Collapse
|
10
|
Son JH, Chang SJ. Extrapelvic bowel resection and anastomosis in cytoreductive surgery for ovarian cancer. Gland Surg 2021; 10:1207-1211. [PMID: 33842266 DOI: 10.21037/gs-2019-ursoc-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Ovarian cancer is known as the second most common cause of death among gynecologic cancers. Survival outcome has been reported to be significantly associated with the efforts to minimize residual disease after cytoreductive surgery. As ovarian cancer often invades the small and large bowel without boundary, bowel surgery has been a crucial part of the cytoreductive surgery to achieve complete tumor removal. The scope of surgical resections has progressively expanded to include small and large bowel resections, making advanced surgical skills essential for gynecologic oncologists. In this review, we discuss the extra-pelvic bowel resection in cytoreductive surgery, with a focus on the regional anatomy and surgical techniques.
Collapse
Affiliation(s)
- Joo-Hyuk Son
- Division of Gynecologic Oncology, Ajou University School of Medicine, Suwon, Korea.,Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea
| | - Suk-Joon Chang
- Division of Gynecologic Oncology, Ajou University School of Medicine, Suwon, Korea.,Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea
| |
Collapse
|