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78 results

Page 1 of 4

  • Debate 11B - Should an Attempt at Aggressive Cytoreduction be Made for all Surgical Candidates with Advanced Ovarian Cancer prior to Treatment with Adjuvant Chemotherapy?

  • from Section III - Ovarian Cancer
  • Edited by Dennis S. Chi, Memorial Sloan-Kettering Cancer Center, New York, Nisha Lakhi, Richmond University Medical Center, Staten Island, Nicoletta Colombo, University of Milan-Bicocca
  • Book:
    50 Big Debates in Gynecologic Oncology
    Published online:
    20 July 2023
    Print publication:
    03 August 2023, pp 61-63

  • Summary

    The concept that aggressive cytoreduction attempts be made for all surgical candidates does not seem to be a realistic goal as evidenced by recent publications. There is no doubt that primary surgery has an important role, but equally so does neo-adjuvant chemotherapy. The latter approach is evidence based, showing similar survival patterns but less morbidities and postsurgical in-patient stay. However, randomized trials where the evidence is contrary to accepted practise often generate heated criticisms, others fitting beliefs are applauded. It is welcome that there is an ongoing trial addressing primary surgery, and hopefully this will contribute in identifying those where aggressive primary surgery is best employed. The survival for advanced ovarian cancer remains poor, and rather than considering a single approach as optimum, strategies to individualize treatments and examine novel therapeutic approaches seems a more logical way to improve survival rates.

Cancer and Reproductive Health
  • Edited by Sean Kehoe, Eric Jauniaux, Pierre Martin-Hirsch, Philip Savage
  • Published online:
    05 October 2014
    Print publication:
    01 November 2008
  • While cancer affects primarily the elderly, it also occurs in younger age groups, with different implications specifically relating to reproduction. Cancer can also occur during pregnancy itself. This brings together two diverse areas of medicine, encompassing the complexity of cancer and its varied biology and the equally challenging areas of fertility, conception and pregnancy. The 55th RCOG Study Group brought together a range of experts to examine these issues. This book presents the findings of the Study Group, with sections covering:epidemiology, genetics and basic principles of chemotherapy and radiotherapyfertility issues and paediatric cancersgynaecological cancers and precancerdiagnostic dilemmasthe placentanon-gynaecological cancersmultidisciplinary care and service provision.

Renal Disease in Pregnancy
  • Edited by John Davison, Catherine Nelson-Piercy, Sean Kehoe, Philip Baker
  • Published online:
    05 September 2014
    Print publication:
    01 June 2008
  • The 54th RCOG Study Group brought together a range of experts from across many disciplines to examine the most up-to-date evidence on all aspects of diagnosis and management in women with renal problems before, during and after pregnancy. This book presents the findings of the Study Group, describing many of the issues likely to be faced in clinical practice and providing valuable information for all healthcare professionals working in this field. General principles for optimal management are clearly defined and separate chapters are devoted to specific disease entities and/or clinical situations. Many controversial areas - such as management of hypertension, diagnosis of pre-eclampsia, assisted conception, rationalisation of the many medications used in nephrology practice, renal biopsy, surgical emergencies, patient input and responsibilities - are carefully considered.

Current Management of Polycystic Ovary Syndrome
  • Edited by Adam Balen, Stephen Franks, Roy Homburg, Sean Kehoe
  • Published online:
    05 July 2014
    Print publication:
    01 October 2010
  • Polycystic ovary syndrome (PCOS) is the most common endocrine disturbance, affecting 10-15% of women in the UK. The definition of PCOS has been much debated, while its pathophysiology appears to be multifactorial and is still being actively researched. There is no doubt that PCOS has a significant effect on quality of life and psychological morbidity and, as many specialists are involved in its management, a multidisciplinary approach is required. The 59th RCOG Study Group brought together a range of experts who treat women with PCOS. This book presents the findings of the Study Group, including:A definition of PCOSThe accuracy of diagnostic interventionsThe particular challenges of adolescent diagnosis and managementThe correlation to ethnicityCurrent approaches to therapyThe potential individualisation of therapy The role of the alternative therapies used to manage some aspects of PCOS.

Maternal and Infant Deaths
  • Chasing Millennium Development Goals 4 and 5
  • Edited by Sean Kehoe, James Neilson, Jane Norman
  • Published online:
    05 February 2014
    Print publication:
    01 June 2010
  • Millennium Development Goals (MDGs) 4 and 5, created under the auspices of the United Nations, challenged political, financial, medical and civil society leaders to improve both child and maternal health. The 58th RCOG Study Group brought together a range of experts - including midwives, obstetricians and gynaecologists, anaesthetists and paediatricians - to provide an up-to-date review of progress to date and the challenges around meeting these MDGs. This book presents the findings of the Study Group, with sections covering:the size of the problemclinical problems and solutions - maternalclinical problems and solutions - neonataltraining and developmentspecific challenges in specific countries (Afghanistan, Zimbabwe, Egypt and Sri Lanka).

Gynaecological Cancers
  • Biology and Therapeutics
  • Edited by Sean Kehoe, Richard J. Edmondson, Martin Gore, Iain A. McNeish
  • Published online:
    05 February 2014
    Print publication:
    01 June 2011
  • Gynaecological cancers are categorised as 'rare' diseases, although collectively they affect over 16,000 women each year in the UK alone. There is a lack of real understanding of these conditions compared with other malignancies, possibly owing to their relative rarity when viewed as individual diseases. The 60th RCOG Study Group brought together a range of experts to examine as many biological aspects of gynaecological cancers as possible, including both surgical and non-surgical therapies. This book presents the findings of the Study Group, with contents including:current understanding of the biology of gynaecological cancerstranslation of biology to the clinicstate of the art in imaging and therapycurrent clinical trialsadvances in multimodal therapyindividualised treatment.

Reproductive Genetics
  • Edited by Sean Kehoe, Lyn Chitty, Tessa Homfray
  • Published online:
    05 February 2014
    Print publication:
    01 November 2009
  • Great progress has been made in genetics in recent years, with significant consequences for the field of reproductive genetics. The ability to identify genetic defects before implantation, to diagnose fetal abnormalities and to introduce screening programmes means that genetic testing now has a major role in preventive medicine. The 57th RCOG Study Group brought together a range of experts to examine the many clinical, ethical and societal issues around reproductive genetics. This book presents the findings of the Study Group, covering a range of disorders, advances in treatments and techniques, as well as the importance of educating the public and the potential ethical dilemmas that may arise as a result of new scientific findings and new methodologies.

  • 18 - Consensus views arising from the 60th Study Group: Gynaecological Cancers: Biology and therapeutics

  • from SECTION 5 - CONSENSUS VIEWS
  • Edited by Sean Kehoe, Richard J. Edmondson, Martin Gore, Iain A. McNeish
  • Book:
    Gynaecological Cancers
    Published online:
    05 February 2014
    Print publication:
    01 June 2011, pp 245-248

  • Summary

    This chapter discusses the biology of and therapeutics for gynaecological cancers such as vulval cancer, cervical cancer and ovarian cancer. The most common type of ovarian cancer, high-grade serous cancer, is characterised by mutation of the p53 (TP53) gene. All women with newly diagnosed high-grade serous ovarian carcinoma should have an accurate family history taken, and be referred for genetic assessment and considered for BRCA1 and BRCA2 mutation testing if appropriate. Within clinical trials, central pathological review is needed when treatment depends on morphological sub-type or other pathological parameters. Functional imaging in multicentre trials should be implemented with strict quality control to ensure standardisation and reproducibility. Evaluation of novel surgical strategies, such as robotics, should occur through well-conducted clinical trials. In surgery for ovarian cancer, whether carried out as a primary or a delayed procedure, the aim should be to remove all visible disease.

  • Preface

  • Edited by Sean Kehoe, Richard J. Edmondson, Martin Gore, Iain A. McNeish
  • Book:
    Gynaecological Cancers
    Published online:
    05 February 2014
    Print publication:
    01 June 2011, pp xi-xii

  • Summary

    The 60th RCOG Study Group focused on gynaecological cancers, a spectrum of cancers affecting over 16000 women each year in the UK alone. There is a lack of real understanding of these conditions compared with other malignancies, possibly owing to their relative rarity when viewed as individual diseases, which can influence the desire to invest in research.

    The objective of the Study Group was to try to examine as many biological aspects of these cancers as possible, including therapies, both surgical and non-surgical. A wide remit, without doubt, and inevitably not all aspects could be covered in the desired detail.

    While a great deal of research is still needed, it is also clear that progress in therapy is occurring, with new agents such as PARP inhibitors targeting specific defects found only in the cancer cell. This is an approach that is opening a new route to therapy besides the normal direct approach to cell destruction. The knowledge that some pathologies previously considered as a primary ovarian disease are in fact of primary fallopian tube origin may not immediately have an effect on patient care but does have implications for research and clinical trials that will ultimately result in better directed therapies.

    Advances in multimodal therapies, imaging and targeted and individualised treatments, as well as the role of surgical approaches, are all also covered in this book.

    Experts from the UK and abroad have dedicated their time to discuss the varied aspects of these malignancies and I am grateful to all involved.

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