Society of Gynecologic Oncology Publications
Molecular testing for endometrial cancer: An SGO clinical practice statementThe Cancer Genome Atlas publication first described the genomic landscape of endometrial cancer and characterized these cancers into four molecular subtypes with different prognoses. The Proactive Molecular Classifier for Endometrial Cancer was developed to more easily and inexpensively classify endometrial cancers into four similar molecular subtypes which are termed POLE, mismatch repair deficient, p53 abnormal and no specific molecular profile. Beyond these four subtypes, other molecular biomarkers may influence clinical behavior and response to targeted therapies and include beta-catenin, Her2 amplification, PI3K/mTOR/AKT alterations, L1CAM, hormone receptor expression, tumor mutational burden, and ARID1A.
Creating work environments where people of all genders in gynecologic oncology can thrive: An SGO evidence-based reviewEquality, equity, and parity in the workplace are necessary to optimize patient care across all aspects of medicine. Gender-based inequities remain an obstacle to quality of care, including within the now majority women subspecialty of gynecologic oncology. The results of the 2020 SGO State of the Society Survey prompted this evidence-based review. Evidence related to relevant aspects of the clinical care model by which women with malignancies are cared for is summarized. Recommendations are made that include ways to create work environments where all members of a gynecologic oncology clinical care team, regardless of gender, can thrive.
Secondary cytoreductive surgery for recurrent ovarian cancer: An SGO clinical practice statementIn 2020, nearly 314,000 women worldwide were diagnosed with epithelial ovarian, fallopian tube and primary peritoneal carcinoma (“ovarian cancer”) and nearly 207,000 succumbed to this disease . Surgical cytoreduction and systemic chemotherapy are the cornerstones of frontline treatment for patients with advanced disease . Aggressive surgical efforts aimed at resection of all macroscopic disease and advances in systemic therapy have improved the survival of patients with advanced ovarian cancer.
Society of Gynecologic Oncology (SGO) 2021 meeting report: Scaling new heights with innovative cancer careThe Society of Gynecologic Oncology (SGO) 2021 Annual Meeting from March 19–26, 2021 was the first fully virtual meeting and allowed for novel interactive research presentations from around the world. The virtual platform provided an incredible opportunity to connect and interact with record-breaking attendance and representation from 52 countries. The theme of the meeting was Innovation Technology: Scaling New Heights focusing on innovative novel therapeutics, surgery, translational research, health equity research, office practice and practice during the COVID-19 pandemic.
Overcoming the barriers to HPV vaccination in high-risk populations in the U.S.: A Society of Gynecologic Oncology (SGO) ReviewThe human papilloma virus (HPV) vaccine was first approved by the Federal Drug Administration (FDA) in 2006 for prevention of cervical and lower genital tract cancer and genital warts. In June 2020, the HPV vaccine received accelerated approval from the FDA to add prevention of HPV-related oropharyngeal and other head and neck cancers as a vaccine indication . Results from population-based studies in the United States (US) and abroad demonstrate clinical vaccine efficacy with decreases in prevalence of genital warts, cervical dysplasia and cancer.
Direct oral anticoagulant use in gynecologic oncology: A Society of Gynecologic Oncology Clinical Practice StatementVenous thromboembolism (VTE) is a common cause of morbidity and mortality in women with gynecologic malignancies. This practice statement provides clinical data and overall quality of evidence regarding the use of direct oral anticoagulants (DOACs) in this patient population. Specifically, it reviews patient selection, safety measures, and nuances of perioperative use of these medications. The scope of this document is limited to DOAC use in gynecologic oncology rather than a broad discussion of VTE prophylaxis and management in general.
Uterine serous carcinoma: Molecular features, clinical management, and new and future therapiesUterine serous carcinoma (USC) is an aggressive subtype of endometrial cancer. Multimodality treatment with surgery, radiotherapy, and chemotherapy is commonly used, given its propensity for extrauterine spread, distant recurrences, and poor prognosis. However, the use of molecularly-based therapy is expanding. Here, we review key molecular features of USC, discuss current management, and assess the landscape of novel therapies and combinations.
Frontline PARP inhibitor maintenance therapy in ovarian cancer: A Society of Gynecologic Oncology practice statementPARP inhibitors (PARPi) have shown have activity in the treatment of ovarian cancer. Previous studies documented activity in patients with germline (gBRCA) and tumor (tBRCA) BRCA mutations (BRCAm) for treatment in lieu of chemotherapy as well as in recurrent ovarian cancer as maintenance therapy. The recent data from four randomized phase 3 trials have established an important role for frontline PARPi maintenance therapy in ovarian cancer. While SOLO-1 only included BRCAm patients, PRIMA, VELIA, and PAOLA-1 enrolled broader patient populations.
Social needs in gynecologic oncology: A Society of Gynecologic Oncology (SGO) clinical practice statementThe World Health Organization defines a patient's social determinants of health to be “the conditions in which people are born, grow, live, work, and age. These circumstances are inextricably linked to their unmet social needs and are shaped by the distribution of money, power, and resources”. Unmet social needs include financial distress, psychological and spiritual concerns, job security, food, housing and transportation needs, problems with communication and health literacy, and caregiver impact.
Patient reported outcomes measures in gynecologic oncology: A primer for clinical use, Part IIIn December 2018, the Policy, Quality, and Outcomes Taskforce of the SGO convened a daylong seminar including experts in the field of PROs to further SGO's vision of integrating PROMs into routine clinical practice as a component of patient-centric care. Recognizing our role in managing cancer patients across the entire continuum of surgical and medical care, we believe gynecologic oncologists are uniquely positioned to make important contributions to this field and influence the delivery of care in the wider discipline of oncology.
Patient reported outcomes measures in gynecologic oncology: A primer for clinical use, part IHealth-related quality of life (HRQoL) has been increasingly recognized as a critical metric to ensure delivery of high quality, patient-centered cancer care. HRQoL can be measured in several ways, but often involves collecting patient reported outcomes (PROs). PROs collected on validated questionnaires are known as patient reported outcome measures (PROMs).
Principles of ethics and critical communication during the COVID-19 pandemicThe COVID-19 pandemic has prompted dramatic changes in the clinical care environment. These changes substantially affect how patients with gynecologic cancers interact with the health care system, and may require gynecologic cancer professionals to alter their approach to providing medical and surgical care. Additionally, healthcare institutions may call on gynecologic oncologists to represent the interests of their patients during deliberations regarding institutional allocation of scarce healthcare resources.
When to Operate, Hesitate and Reintegrate: Society of Gynecologic Oncology Surgical Considerations during the COVID-19 PandemicThe COVID-19 pandemic has challenged our ability to provide timely surgical care for our patients. In response, the U.S. Surgeon General, the American College of Srugeons, and other surgical professional societies recommended postponing elective surgical procedures and proceeding cautiously with cancer procedures that may require significant hospital resources and expose vulnerable patients to the virus. These challenges have particularly distressing for women with a gynecologic cancer diagnosis and their providers.
Anti-cancer therapy and clinical trial considerations for gynecologic oncology patients during the COVID-19 pandemic crisisThe COVID-19 pandemic has consumed considerable resources and has impacted the delivery of cancer care. Patients with cancer may have factors which place them at high risk for COVID 19 morbidity or mortality. Highly immunosuppressive chemotherapy regimens and possible exposure to COVID-19 during treatment may put patients at additional risk. The Society of Gynecologic Oncology convened an expert panel to address recommendations for best practices during this crisis to minimize risk to patients from deviations in cancer care and from COVID-19 morbidity.
Managing opioid use in the acute surgical setting: A society of gynecologic oncology clinical practice statementGynecologic oncologists have the unique opportunity of caring for patients in a broad range of surgical and medical settings. With increasing awareness of the opioid epidemic and the various factors that contribute to chronic opioid use, gynecologic oncologists must also better understand how to best address acute postoperative pain without unknowingly placing patients at risk for opioid misuse. This article examines the use of opioids in the acute surgical setting and provides clinical guidelines and various strategies to reduce opioid misuse.
Hormone therapy (HT) in women with gynecologic cancers and in women at high risk for developing a gynecologic cancer: A Society of Gynecologic Oncology (SGO) clinical practice statement: This practice statement has been endorsed by The North American Menopause SocietyApproximately 40% of women with gynecologic malignancies are pre- or perimenopausal at the time of diagnosis [1,2]. Combined multimodality therapy including surgery, chemotherapy and/or radiation often results in induced menopause. The Society of Gynecologic Oncology and NCCN recommend prophylactic risk reducing surgery between ages 35–45, or at the completion of child bearing, depending on the specific germline mutation for women with Lynch syndrome, BRCA1 or BRCA2 mutations [3–5]. Induced menopause is defined by The North American Menopause Society as the cessation of menstruation following bilateral oophorectomy or iatrogenic ablation of ovarian function due to chemotherapy or pelvic radiation .
Use of cannabinoids in cancer patients: A Society of Gynecologic Oncology (SGO) clinical practice statementCannabis has been used for medicinal purposes across the world for centuries. It was included in the U.S. Pharmacopeia (Extractum Cannabis) in the mid-1800s and prescribed for a variety of conditions . By the early 20th century, states began to individually outlaw cannabis. This was at least in part due to racism in that the smoked form of the drug was introduced by Mexican immigrants . The federal government developed a series of statutes banning cannabis beginning in the 1930s. Medical cannabis was removed from the U.S.
Society of gynecologic oncology future of physician payment reform task force: Lessons learned in developing and implementing surgical alternative payment modelsThe total cost of cancer care in the United States continues to rise and is estimated to range from 172 to 206 billion dollars per year by 2020 . This has important implications for our healthcare system's sustainability as well as for cancer patients who are at increased risk for experiencing significant financial strain due to out-of-pocket costs [1–3]. The National Academy of Medicine (formerly Institute of Medicine) endorses efforts to “improve the affordability of cancer care by leveraging existing efforts to reform payment and eliminate waste” .
The Society of Gynecologic Oncology wellness curriculum pilot: A groundbreaking initiative for fellowship trainingTrainee well-being is a core component of ACGME program requirements and the SGO has recognized the high incidence of burnout among gynecologic oncologists and its negative impact. To foster a culture of wellness throughout the SGO community we sought to engage current fellows along with fellowship directors in a structured didactic program designed to teach wellness. We evaluated the feasibility of and preliminary responses to a pilot curriculum designed to teach skills that promote wellness and prevent burnout.
The Society of Gynecologic Oncology wellness curriculum pilot: A groundbreaking initiative for fellowship trainingObjective: Trainee well-being is a core component of Accreditation Council for Graduate Medical Education (ACGME) program requirements, and the Society of Gynecology Oncology (SGO) has recognized the high incidence of burnout and its negative impact. To foster a culture of wellness throughout the SGO community, we sought to engage current fellows along with the fellowship directors in wellness initiatives. We evaluated the feasibility of a pilot curriculum designed to teach skills that promote wellness and prevent burnout.
Society of Gynecologic Oncology Future of Physician Payment Reform Task Force report: The Endometrial Cancer Alternative Payment Model (ECAP)The practice of gynecologic oncology is facing significant changes in reimbursement practices and health care delivery in the United States. As the only physicians trained to provide both complex surgical and medical treatment for women with gynecologic cancers, gynecologic oncologists are the ideal leaders for developing best practice models and outcome measures for women with gynecologic cancers. The Society of Gynecologic Oncology (SGO) created the Health Policy and SocioEconomic Committee (HPSC) in 2015 to spearhead society-based efforts to ensure leadership and participation in navigating this era of health care reform.