European Society Of Gynaecological Oncology Research Articles

Roadmap for the European Network of Gynaecological Trial Groups (ENGOT) Trials

The European Network for Gynaecological Oncological Trial groups (ENGOT) is a research network of the European Society of Gynaecological Oncology and was founded in Berlin in October 2007. Earlier, we reported on the ENGOT minimal requirements for trials between academic groups and pharmaceutical companies. In this paper, we summarize the roadmap for performing trials in the ENGOT framework. In this roadmap, we define how an ENGOT trial should be set up and discuss the following items: What are the conditions to classify a study as an ENGOT trial? What is an ENGOT protocol? How are an ENGOT protocol, informed consent (ICF), and case report form (CRF) produced? How is the center selection and feasibility performed in ENGOT trials? How are regulatory and operational tasks handled? How should a confidentiality agreement between the industry and the whole ENGOT network be negotiated? How are contracts made between the industry and ENGOT and between ENGOT groups? How are funding, insurance, and communication flow arranged in ENGOT trials? What are the requirements for conducting substudies and what are the tasks for the leading group in an ENGOT trial? A template of a confidentiality agreement, a checklist of ENGOT criteria for new study proposals, and guidelines for authorship are also provided.

The Need for More Workshops in Laparoscopic Surgery and Surgical Anatomy for European Gynaecological Oncology Trainees

The objective of this study was to highlight the relative preference of European gynecologic oncology trainees for workshops that could support and supplement their training needs. A Web-based survey was sent to 900 trainees on the European Network of Young Gynaecological Oncologists database in November 2011. Respondents were asked to rate a 13-item questionnaire (using a 1- to 5-point Likert scale) on workshop topics they felt would most benefit their training requirements. Free text space for additional topics was also provided. Descriptive analysis was used to describe the mean scores reported for different items. A complete linkage hierarchical cluster analysis with Dendron plot was used to assess any clustering of data, and Cronbach α was used to assess the internal reliability of the questionnaire. One hundred ninety trainees from 37 countries responded to the survey, giving a 21% response rate. The 3 most important topics reported were laparoscopic surgery; surgical anatomy, and imaging techniques in gynecologic oncology. The Dendron plot indicated 4 different clusters of workshops (research related skills, supportive ancillary skills, related nonsurgical subspecialties, and core surgical skills) reflecting different competencies trainees need to meet. There was no significant association between individual country of training and workshop preference. The mean duration of the workshop preferred by 71% of respondents was 2 days. Cronbach α of the 13-item questionnaire was 0.78, which suggests good internal consistency/reliability. This report for the first time highlights the relative importance and significance European trainees attach to some of their training needs in gynecologic oncology. Laparoscopic surgery, surgical anatomy, and imaging appear to be the 3 areas of greatest need. The European Society of Gynaecological Oncology, other national specialist societies, and institutions should direct additional training efforts at these areas.

Follow‐up of gynecological cancer patients after treatment – the views of European experts in gynecologic oncology

Follow-up after treatment for gynecological cancer demands large resources. There is a lack of evidence of efficacy. The aim of this survey was to explore follow-up routines and views on follow-up care among European experts in gynecological oncology. Web-based structured survey. Survey distributed to members of the European Society of Gynecological Oncology (ESGO) and the Nordic Society of Gynecologic Oncology (NSGO). The study population comprised members of NSGO and ESGO. An anonymous e-survey was sent with two additional reminders by e-mail through an electronic web-link to all members of both societies. Surveillance routines. The clinical experts' evaluation of evidence and view of follow-up in hospitals vs. at general practitioners (GPs). The number of visits recommended by a majority of the responders was in line with current guidelines. The use of surveillance tests varied considerably. Significantly more responders from low economy countries preferred conventional hospital follow-up for all patients compared with responders from high economy countries, who considered follow-up by GPs adequate in low-risk groups (p < 0.001). Follow-up routines after gynecological cancer vary in Europe. According to the majority of the responders of this survey targeting European experts in gynecological oncology, follow-up by GPs may be an option for low-risk patients. New follow-up routines should preferentially be based on prospective trials comparing conventional follow-up of gynecological cancer patients with alternative methods of care, assessing survival, detection of recurrence, and quality of life.

Fertility-Sparing Approaches in Gynecologic Cancers: A Review of ESGO Task Force Activities

Preservation of fertility has become a very important issue in gynecologic oncology of the young. Owing to the clinical importance of appropriate management of young patients with gynecologic cancer, the European Society of Gynecological Oncology (ESGO) decided in 2007 to launch the Task Force for Fertility Preservation in Gynecologic Cancer. This task force is supposed to promote knowledge of infertility induced by treatment of gynecologic cancers among health care workers and the public through national and international collaboration among oncologists, reproductive specialists, and allied health workers to promote research and education and to develop new strategies for fertility preservation. This article summarizes all the past and current activities of this task force.

The European Society of Gynaecological Oncology: Update on Objectives and Educational and Research Activities

The European Society of Gynaecological Oncology (ESGO) is the principal European society contributing to the study, prevention, and treatment of gynecologic cancers. Founded in 1983, ESGO has more than 1,300 members in more than 40 European countries and worldwide who benefit from ESGO's innovative education and research initiatives and networking opportunities. ESGO objectives have been recently identified through a strategic planning process and include education, care, research, collaboration, awareness, and sustainability. As a leading gynecologic oncology society, ESGO holds biennial meetings where experts meet to discuss latest advances in gynecologic treatment and care. The 17(th) International Meeting of ESGO (ESGO 17) proved to be a resounding success, with 2,700 delegates and speakers who gathered from around the world in the cultured city of Milan, Italy. The structure of the congress included keynote lectures, debates, state-of-the art sessions, and focused sunrise sessions, together with oral and poster presentations and satellite symposia sponsored by pharmaceutical companies. For the first time, during ESGO 17 the Society organized a seminar for European patient groups with an interest in gynecologic cancers with the aim of facilitating different patientrelated activities across Europe. Moreover, The European Network of Young Gynaecologic Oncologists (ENYGO), the European Network of Gynaecologic Oncology Trial Groups (ENGOT), and the European Network of Translational Research in Gynaecological Oncology (ENTRIGO) had their own section during ESGO 17. ESGO also holds numerous workshops throughout the calendar year and provides clinical and research grants, online educational materials, webcasts, and numerous networking opportunities.

Role of Neoadjuvant Chemotherapy in the Management of Stage IIIC–IV Ovarian Cancer: Survey Results from the Members of the European Society of Gynecological Oncology

The aim of this study is to evaluate the current opinion of the members of the European Society of Gynecological Oncology (ESGO) on the use of neoadjuvant chemotherapy (NACT) in stage IIIC and IV ovarian cancer. A link to a 21-item questionnaire, with questions about the management of patients with stage IIIC and IV ovarian cancer, was sent 3 times to the ESGO members (N = 1177). Of the 469 (40%) responding members, 70.2% believe there is sufficient evidence to use NACT followed by interval debulking for the treatment of stage IIIC and IV ovarian cancer. On the basis of a multivariable logistic regression analysis, no relationships between the belief in evidence for NACT and practice type (P = 0.15) or level of experience (P = 0.41) were observed. Only 5.3% of respondents never use NACT, and 30% uses NACT in less than 10% of their patients. Optimal debulking, defined as "no macroscopic residual tumor," is reported in more than 60% of the patients by 20% of the respondents at primary debulking, and by 34.6% of the respondents when interval debulking is performed. Whether a patient can be optimally primarily debulked is impossible to determine preoperatively according to 51.1% of the respondents. Computed tomographic scan (79.4%) and clinical examination (72.5%) are regarded as the most important modalities to predict operability. Diagnostic laparoscopy is used by 46.3% of the respondents. The most important reasons for choosing NACT are bulky disease in the upper abdomen (64.7%) and stage IV disease (58.7%). Of the responding ESGO members, 70% believe there is sufficient evidence to treat patients with stage IIIC-IV ovarian cancer with NACT, and 30% uses NACT in less than 10% of their patients.

Frédéric Amant: leading the agenda on cancer in pregnancy

Frédéric Amant: leading the agenda on cancer in pregnancy

The Journal of Gynecologic Oncology and the Asian Society of Gynecologic Oncology: the history, the present and the future

The Journal of Gynecologic Oncology and the Asian Society of Gynecologic Oncology: the history, the present and the future

Psycho-Oncology: Structure and Profiles of European Centers Treating Patients With Gynecological Cancer

Psycho-oncological counseling should be an integrated part of modern cancer therapy. The aim of this study was to assess the structures and interests of psycho-oncology services within European Society of Gynecological Oncology (ESGO) centers. In 2010, a survey, which consisted of 15 questions regarding organization of psycho-oncological services and interests in training and research, was sent to all ESGO-accredited centers (n = 41). The response rate was 65.8% (27 centers). 96.3% (n = 26) of the surveys came from universities, and 3.7% (n = 1) came from nonacademic institutions. Most of the institutions (92.6%, n = 25) offer psycho-oncological care, mainly by psychologists (64%, n = 16) or psycho-oncologists (48%, n = 12). Fifty-two percent of patients are evaluated for sexual dysfunction as sequelae of their disease or treatment-related adverse effects. Fifty-two percent (n = 14) of institutions offer psychological support for cancer care providers. Eighty-five percent (n = 23) of all centers are interested in psycho-oncological training, and the preferred teaching tools are educational workshops (87%). The main issues of interest are sexual problems in patients with cancer, communication and interpersonal skills, responses of patients and their families, anxiety and adjustment disorders, and palliative care. Eighty-five percent (n = 17) of the 20 institutions look for research in the field of psycho-oncology, and 55% (n = 11) of those are already involved in some kind of research. Although psycho-oncological care is provided in most of the consulted ESGO accredited centers, almost 50% of women lack information about sexual problems. The results of the survey show the need for and interest in psycho-oncology training and research, including sexual dysfunction. Furthermore, psychological support should be offered to all cancer care providers.

Abstracts presented at the 17th International Meeting of the European Society of Gynaecological Oncology

Abstracts presented at the 17th International Meeting of the European Society of Gynaecological Oncology

Pharmacotherapy of cervical cancer

Importance of the field: Cervical cancer (CC) remains an important health problem. It is the second most frequent malignancy in women worldwide, with one-third of patients dying from pharmacoresistant disease.Areas covered in this review: We reviewed pharmacotherapy approaches in the medical and multidisciplinary management of CC and conducted a systematic search of Pubmed for clinical trials, reviews and meta-analysis published in the last 20 years. s of the American Society of Clinical Oncology, European Society of Gynecological Oncology and International Gynecologic Cancer Society were also searched, together with the US National Institutes of Health clinical trial database.What the reader will gain: The state-of-the art of cytotoxic and biologically targeted therapies in early, locally advanced and metastatic/recurrent CC is discussed.Take home message: Until recently, the role of pharmacotherapy in CC was restricted to palliation of advanced/metastatic or recurrent disease. During the past two decades, this reluctant attitude towards chemotherapy has been modified after a series of randomized trials demonstrated its beneficial contribution as an adjunct to radiotherapy or surgery in early and locally advanced CC. Moreover, new combinations of cytotoxics, together with novel molecular target agents, open new perspectives in the treatment of primary and recurrent CC.

Surgical education and training in gynecologic oncology I: European perspective

Post-graduate training in oncogynecological surgery should be based on a comprehensive system with three main components: training centers, trainers and trainees. For each of these components, clearly defined requirements should be established. An international consensus on classification, terminology, and performance of standard procedures in gynecological oncology would further improve postgraduate training. One of the key features of this system should be continuous assessment of surgical and non-surgical skills that would make possible the evaluation of individual trainees' progress, as well as the quality of training centers and trainers. Special attention should be paid to the development of tailored educational tools. Internet databases of video presentations should be available to trainees, demonstrating standard procedures as well as atypical situations, including the management of complications. In Europe, the already available programs for postgraduate training and accreditation of centers developed by the European Society of Gynecological Oncology (ESGO) should become the basis for harmonization of postgraduate training in gynecological oncology.

ASGO's First Biennial Meeting, Nov. 22, 2009

With words of congratulations from International Gynecologic Cancer Society (IGCS), Society of Gynecologic Oncologists (SGO) and European Society of Gynecological Oncology (ESGO), the first Biennial Meeting of Asian Society of Gynecologic Oncology (ASGO) was held in Toshi Center Hotel, Tokyo, November 22, 2009, during the 47th annual meeting of Japan Society of Gynecologic Oncology (JSGO). This biennial meeting emphasized on three aspects of cervical cancer: 1) epidemiology and diagnosis; 2) HPV vaccines and prevention; and 3) new trend of treatment. Eighty-two abstracts were presented at the ASGO inaugurating meeting (Table 1), including 12 speeches on cervical cancer, 69 posters (Korea, 38; Taiwan, 15; Japan, 8; Indonesia, 4; Kazakhstan, 3; and Singapore, 1), and a commemoration lecture from IGCS and SGO entitled Global cooperation in gynecologic by Dr. Edward L. Trimble (National Cancer Institute, USA). Table 1 Symposium on cervical cancer Approximately one-half of all global cancer mortalities were observed in Asia.1,2 The majority of current clinical practices in cancer prevention and management are based on the studies in Western patients.1 However, the most appropriate clinical practice for Asian women may not be exactly the same as the clinical practice for Western women. Asian differs from Western people in constitution, genetic background, characteristics of disease, and especially, socio-cultural environment.1 With purposes to the facilitation of scientific exchange, international collaboration for clinical studies and basic research, provision of educational opportunities for doctors in developing countries, and deepening friendship between members in Asia, ultimately to improve the standard of practice and the outcomes of patients with gynecologic cancers, ASGO was initiated in the 7th Japan-Korea Joint Conference of Gynecologic Oncology Group (JKGOG) in Seoul on November 27, 2008 to expand the spirit of cooperation of JKGOG to all Asian countries.4 ASGO now has members in over 10 Asian countries. The first and the current president of the society is Dr. Soon-Beom Kang (Seoul National University, Korea). The president-elect (also the congress president of the first biennial meeting of ASGO) is Dr. Toshiharu Kamura (Kurume University, Japan) (Fig. 1). The initiating council members (Fig. 2) came from 9 countries including China (Chinese Society of Gynecological Oncology, Hong Kong Society for Colposcopy and Cervical Pathology), India, Indonesia (Indonesian Society of Gynecologic Oncology), Japan (Japan Society of Gynecologic Oncology), Korea (Korean Society of Gynecologic Oncology and Colposcopy), Philippine (Society of Gynecologic Oncologists of the Philippines), Singapore (Society for Colposcopy & Cervical Pathology of Singapore), Thailand (Thai Gynecologic Cancer Society), and Taiwan (Taiwan Association of Gynecologic Oncologists). Fig. 1 Photo of Dr. Soon-Beom Kang, the first and the current president of the society, from the 1st Biennial Meeting of ASGO, held in Tokyo on November 22, 2009. Fig. 2 Photo from the 2nd council meeting of the ASGO, held in Tokyo on November 21, 2009. The second biennial meeting of ASGO will be held in November, 2011 in Seoul, Korea. With thanks to the effort of Japanese and Korean doctors in establishing ASGO, gynecologic oncologists in other Asian countries will follow these pioneers' steps and dedicate themselves with powerful support. ASGO is expected to an essential role in understanding, investigating, and resolving regional health problems like other regional societies such as the Society of Gynecologic Oncologists (SGO) and the European Society of Gynecologic Oncology (ESGO).1 Asia is the most populous land in the world, containing highly developed cities on the cutting edge of medical care, and also containing poor rural areas which have almost no any medical resource. In the future, ASGO may play the role of the polestar that guides the prevention, treatment, and holistic health care of gynecologic cancers in this vast land of diversity, culture, history, and tribulation.

EBCOG Newsletter September 2006

These are important times for EBCOG. We have had an outstandingly successful start to 2006 and are now in the process of planning actively for an exciting future. That we are in a strong position to do so is in large part due to the great success of the European Congress of Obstetrics and Gynaecology held in Torino in April. I must pay tribute to the enormous efforts made on behalf of EBCOG by the Presidents of the Congress, Professor Chiara Benedetto and Professor Andre Van Assche, as well as the Chair of the Scientific Committee, Professor Ziva Novak Antolic, and the Chair of the Italian Committee, Professor Marco Massobrio. The meeting was a huge success on every level, scientifically, socially and financially. It was attended by almost 1,500 European obstetricians and gynaecologists, more than ever before, and covered a vast range of topics. Particularly successful were the sessions involving colleagues in our affiliated European subspecialty societies, the European Society of Gynaecological Oncology, the European Society for Human Reproduction and Embryology, the European Association of Perinatal Medicine and the European Urogynaecology Association. Links with these societies are of great value in keeping EBCOG up to date with developments in the subspecialties that they represent. Amongst the most popular sessions were the hands-on training sessions, several of which were organised by other European societies, such as the European Society for Gynaecological Endoscopy, European Federation for Colposcopy and International Society of Ultrasound in Obstetrics and Gynaecology. Other organisations involved in the special symposia included International Society of Psychosomatic Obstetrics and Gynaecology, European Menopause and Andropause Society and European Society of Contraception. Ours is rapidly becoming the most important European meeting for general obstetricians and gynaecologists, and we intend to build on the outstanding success, which has been achieved. The next European Congress will take place in Lisboa, the capital of Portugal, slated on 5–8 March 2008. Plans are already well under way to arrange a joint meeting with the Portuguese Federation of Obstetrics and Gynaecology. Further information about the Congress can be found currently at http://www.mundiconvenius.pt/2008/ ebcog2008/ and will soon be available also on the EBCOG web site. Please put these dates in your diary now. It is already time to start planning the 2010 Congress. National Societies are invited to submit bids now, so that they can be considered at the EBCOG Council meeting on 2–3 December 2006. I know that there will be great competition to hold this prestigious event and I look forward with enthusiasm to receiving the applications. The EBCOG Council met immediately after the Congress in Torino. This was the last meeting as SecretaryGeneral for Professor Juriy Wladimiroff and as President of the Union Europeenne des Medecins Specialistes (UEMS) Section of Obstetrics and Gynaecology for Professor Antolic Van Assche. Professor Eeva Marja Rutanen had also come to the end of her term on the Executive group. We thanked them all for their outstanding contributions to the development of European obstetrics and gynaecology in Europe. Professor Wolfgang Holzgreve from Basel was elected Secretary-General and Professor Jacques Lansac from Tours was elected to the Executive group. Professor Lansac is currently President of the College National des Gynecologues et Obstetriciens Francais and has already Eur Clinics Obstet Gynaecol (2007) 2:223–224 DOI 10.1007/s11296-006-0049-2

The relation of EBCOG and the UEMS section with the scientific organisations in Europe

The European Board and College of Obstetrics and Gynecology (EBCOG) is the board of the European Union of Medical Specialists (UEMS) section of Obstetrics and Gynaecology. EBCOG is represented by 33 National Societies of Obstetrics and Gynaecology. Two national delegates per society constitutes EBCOG and Section Council. Council is the decision-making organ and elects the EBCOG and section officers and executive members. EBCOG has a close relation with the European Network of Trainees in Obstetrics and Gynaecology (ENTOG). ENTOG is represented in council and executive and in major committees of EBCOG. EBCOG and the UEMS section have recognised four subspecialties in Obstetrics and Gynaecology: Maternal Fetal Medicine, Gynaecological Oncology, Reproductive Medicine and Urogynaecology. These subspecialties are represented in the EBCOG council and executive and also in the major committees by the scientific organisations: the European Association of Perinatal Medicine (EAPM), the European Society of Gynaecological Oncology (ESGO), the European Society of Human Reproduction and Embryology (ESHRE) and the European Urogynaecology Association (EUGA). The most important aim of EBCOG is the harmonisation and the improvement of the training and care in Obstetrics and Gynaecology in Europe for the profit of the women and the unborn and newborn child. Two important permanent committees are responsible for reaching these goals: The Hospital Recognition Committee (HRC) and the Standing Committee for Training and Assessment (SCTA). The HTC has visited already 70 departments for basic training in nearly all the European countries. The departments which have a successful visit receive an EBCOG accreditation as a training centre. The final purpose is that the National Societies take over this task and perform visits in their own country. Recently, EBCOG, together with the subspecialties, have started visits in units dealing with subspecialist formation.Visits are jointly done by EBCOG and the Subspecialist Scientific Organisations. Accreditation has been forwarded in centres of Gynaecological Oncology and Urogynaecology. Maternal Fetal medicine and Reproductive medicine will follow shortly. A second permanent committee is the SCTA. The SCTA is composed of EBCOG delegates, ENTOG, the four subspecialties and three other scientific organizations: the European Society of Contraception (ESC), the European Society of Gynaecologic Endoscopy (ESGE) and the European Federation of Colposcopy (EFC). The SCTA has produced training programmes and logbooks for basic training and subspecialist training. These training programmes are accepted by the national societies and are used when visits are performed in departments and subspecialist units. Recently, the SCTA has started a programme on “Training the Trainers (TTT)”. The subspecialist societies and the three other European Scientific organisations are involved in this programme.

Weiterbildungsmöglichkeiten in der Gynäkologischen Onkologie

The German Medical Association (Bundesärztekammer) has launched a new organisational structure in the curriculum of medical qualification. Beside the field of obstetrics and gynecology this has led to three specialisation. The newly established specialisation is that of gynecological oncology. Therewith in the future the treatment and care for women with genital or breast cancer will be focused to those centers having the necessary qualification. In addition the German qualification is identical to that of the European Society of Gynecological Oncology (ESGO). So German fellows can obtain a national and international qualification at qualified centers.

13th International Meeting of the European Society of Gynaecological Oncology (EGO)

13th International Meeting of the European Society of Gynaecological Oncology (EGO)

European Society of Gynaecological Oncology (ESGO)

Die European Society of Gynaecological Oncology (ESGO) versteht sich als wissenschaftliche, unpolitische und nicht profitorientierte Gesellschaft ohne geographische Grenzen, deren offizielle Zeitschrift das European Journal of Gynaecological Oncology ist. Ihr Ziel ist die Forderung der Fortbildung und Forschung in der gynakologischen Onkologie sowie der Kooperation mit internationalen Organisationen.

How to organize gynecologic oncology in the future: Results of an internationalquestionnaire

Vergote IB, de Oliveira CF, Dargent D. How to organize gynecologic oncologyin the future: Results of an international questionnaire. Int J GynecolCancer 1997; 7: 368–375. A questionnaire was sent to 93 gynecologic oncologists from 54 countriesabout the way in which gynecologic oncology was organized in their country, orif the (sub)speciality wasnot yet recognized, how they thought it should be organized. The questionnairewas answered by 64 persons from 42 different countries. The subspecialty wasrecognised in 17 (41%) of the countries. Fifty-five respondents (86%) thought thatgynecologic oncology should be a subspecialty of obstetrics and gynecology. Themedian duration of the gynecologiconcologic fellowship program was 30 months. Diagnosis and surgery accounted forabout 58% of the duration of the program. In 52% of the answersfrom countries with boardcertification, the fellows had to pass a theoretical and practical examination,and in addition 22% of the candidates had to defend a thesis to qualifyfor certification.Training centers in countries that recognized gynecologic oncology had amedian number of 142 new cases per year (for 1 fellow). The median number ofgynecologic oncologogistsand fellows per 10(7) inhabitants in countries with boardcertification in gynecologic oncology was 42 and 6, respectively. Finally, theimportant role of internationalsocieties (like the International Gynecologic Cancer Society and the EuropeanSociety of Gynaecological Oncology) in supporting the countries withoutrecognized GynecologicOncology was stressed by the respondents. The setting up of internationalstandards for training programs, training centers, board certification, and theorganization ofinternational exchange programs for fellows seemed to be equally important,according to the questionnaire responses.