Progress in endometrial cancer: Contributions of the former Gynecologic Oncology GroupFor over forty years, the Gynecologic Oncology Group drove progress in treating endometrial cancer. The first decades of investigation began with a meticulous prospective, surgicopathologic staging study that was the platform for development of all subsequent trials. The resultant statistical model of low risk, intermediate risk, and high-risk groups of patients led to trials where therapeutic modalities were best targeted at disease spread. A clear role for chemotherapy was established. It was realized that greater advances might be achieved with the advent of newer anti-neoplastic agents and these agents were subjected to extensive phase II testing.
Pathway to the Papanicolaou smear: The development of cervical cytology in twentieth-century America and implications in the present dayGeorge Papanicolaou, a Greek immigrant and cytopathologist, was responsible for what is now colloquially known as the “Pap smear”—undoubtedly one of the greatest advances in medicine and public health of the last century. However, his landmark research on the development of cervical cytology for the detection of precancerous lesions of the cervix (“New Cancer Diagnosis,” 1928) made a rather inauspicious debut in an unlikely venue: John Harvey Kellogg's Third Race Betterment Conference—a meeting devoted to the furtherance of the concept and implementation of eugenics.
Meigs to modern times: The evolution of debulking surgery in advanced ovarian cancerJoe V. Meigs was a visionary clinician and an early adopter of radical techniques in the surgical treatment of ovarian cancer. His 1934 textbook “Tumors of the Female Pelvic Organs”, consolidated his approach to this “hopeless” disease, with pearls on diagnosis, outcomes, and even speculations about the benefits of minimally invasive surgery. Decades before adjuvant chemotherapy would prove of value, and in an era when sophisticated statistics were unheard of, he nonetheless tried to eke out what benefits he could using the methods available in his time.
An NRG Oncology/GOG study of molecular classification for risk prediction in endometrioid endometrial cancerThe purpose of this study was to assess the prognostic significance of a simplified, clinically accessible classification system for endometrioid endometrial cancers combining Lynch syndrome screening and molecular risk stratification.
The Wertheim hysterectomy: Development, modifications, and impact in the present dayErnst Wertheim was a pioneer in the history of the surgical treatment of cervical cancer. His English-language manuscript “The extended abdominal operation for carcinoma uteri (based on 500 operative cases),” which was published in 1912, detailed his standardization of the radical hysterectomy and formed the basis of the current treatment for early stage cervical cancer. We contextualize the Wertheim hysterectomy, emphasizing medical advances that allowed for its development and subsequent modification.
Bokhman Redux: Endometrial cancer “types” in the 21st centuryIn 1983 Jan V. Bokhman, M.D. published a landmark paper entitled “Two Pathogenetic Types of Endometrial Carcinoma” in which an enduring dualistic view of endometrial cancer was first proposed. “Type I” cancers are thought to represent estrogen driven mostly low grade endometrioid tumors strongly associated with obesity and other components of the metabolic syndrome. “Type II” cancers represent higher grade non-endometrioid tumors for which the latter associations are less significant. Basic tenets of this dichotomy including significant prognostic differences have been abundantly confirmed by later literature.