First International Consensus Report on Adnexal Masses: Management Recommendations.

The First International Consensus Conference on Adnexal Masses was convened to thoroughly examine the state of the science and to formulate recommendations for clinical assessment and management. The panel included representatives of societies in the fields of gynecology, gynecologic oncology, radiology, and pathology and clinicians from Europe, Canada, and the United States. In the United States, there are approximately 9.

Gestational Trophoblastic Disease: Opportunities for a National Registry Collaboration.

Objective: In rare entities such as gestational trophoblastic disease (GTD), only multi-institutional registries can gather significant number of patients to build up valuable clinical databases. No Canada-wide GTD registry currently exists. We conducted a survey among members of the Canadian Society of Gynecologic Oncology (GOC) to investigate their interest in a pan-Canadian GTD registry.

Malignant Melanoma of Vulva and Vagina: A Histomorphological Review and Mutation Analysis--A Single-Center Study.

Objectives: The aim of this work was to determine molecular characteristics and specifically, the frequency of BRAF, C-KIT, and NRAS mutations in vulvar and vaginal melanomas.

Methods: A retrospective review of all cases of vulvar and vaginal melanoma between 2002 and 2013 was performed. We reviewed the clinical and histological characteristics of all cases and performed genotyping studies on cases that had tissue available for the study, using next-generation sequencing.

Placental Molar Disease: What are the Benefits and Barriers to the Adoption of a Comprehensive Diagnostic Service?

The molecular cytogenetic analysis of specimens (genotyping) suspicious for hydatidiform mole (HM) significantly improves diagnostic accuracy over histopathology and immunohistochemical analysis alone, particularly in the classification of partial mole. However, the implementation of this advance in diagnostics has been slow. This study sought to identify the major benefit and potential barriers to the adoption of genotyping.

The impacts of neoadjuvant chemotherapy and of debulking surgery on survival from advanced ovarian cancer.

Objectives: Women with advanced ovarian cancer are treated with chemotherapy either before (neoadjuvant) or after surgery (primary debulking). The goal is to leave no residual disease post-surgery; for women treated with primary debulking surgery this has been associated with an improvement in survival. It has not been shown that the survival advantage conferred by having no residual disease post-surgery is present for women who receive neoadjuvant chemotherapy.

Surgical management of a suspicious adnexal mass: a systematic review.

Objective: To systematically review the existing literature in order to determine the optimal recommended protocols for the surgical management of adnexal masses suspicious for apparent early stage malignancy.

Methods: A review of all systematic reviews and guidelines published between 1999 and 2009 was conducted as a first step. After the identification of two systematic reviews on the topic, searches of MEDLINE for studies published since 2004 were also conducted to update and supplement the evidentiary base.

Preoperative identification of a suspicious adnexal mass: a systematic review and meta-analysis.

Objective: To systematically review the existing literature in order to determine the optimal strategy for preoperative identification of the adnexal mass suspicious for ovarian cancer.

Methods: A review of all systematic reviews and guidelines published between 1999 and 2009 was conducted as a first step. After the identification of a 2004 AHRQ systematic review on the topic, searches of MEDLINE for studies published since 2004 was also conducted to update and supplement the evidentiary base.

Teaching cervical cancer surgery in low- or middle-resource countries.

Background: With the widespread implementation of screening programs internationally, there will be an increase in early stage cervical cancer cases. In response to this, the Ministry of Health in each country will need to plan strategies to provide care such as radical surgery or radiation for this potentially curable group of women.

Methods: The Gynaecologic Oncologists of Canada created a teaching module to intensively train a small number of locally identified gynecologists to perform radical hysterectomy and pelvic lymphadenectomy.

Multicentre study on factors affecting the gynaecologic oncology career choice of canadian residents in obstetrics and gynaecology.

Introduction: The provision of optimal care for women with gynaecologic cancer may be threatened due to the changing demographics of patients and the projected increasing shortage of gynaecologic oncologists in Canada. We evaluated the career plans of Canadian residents in obstetrics and gynaecology to determine the proportion of residents currently considering a career in gynaecologic oncology (GO) and to explore factors that may affect their career decisions.

Methods: Following institutional ethics approval, all residents at 13 participating Canadian obstetrics and gynaecology residency training programs were contacted by email to complete a 20-item confidential questionnaire examining career plans.

Evaluation of an intraperitoneal chemotherapy program implemented at the Princess Margaret Hospital for patients with epithelial ovarian carcinoma.

Objective: A prospective evaluation of an ambulatory intraperitoneal (IP) /intravenous (IV) chemotherapy regimen for women with epithelial ovarian carcinoma (EOC).

Methods: Cisplatin 100 mg/m(2) (option for 75 mg/m(2)) IP combined with paclitaxel 175 mg/m(2) IV (3 h infusion) administered every 21 days was adopted by our institution as a single day, outpatient regimen for women with stage III EOC who had undergone optimal cytoreductive ( View Article and Find Full Text PDF

Maternal luteoma of pregnancy presenting with virilization of the female infant.

Background: Virilization in female newborns typically results from congenital adrenal hyperplasia, requiring immediate diagnosis and treatment. We report a rare cause of virilization, maternal pregnancy luteoma, responsible for virilization of both a newborn and the mother. Luteomas are usually asymptomatic tumour-like ovarian lesions of pregnancy that secrete androgens in only 25% of cases.

Epithelial ovarian cancer surgical staging by Ontario gynaecologic surgeons: is there a gap between current practice and the Canadian clinical practice guidelines?

Objectives: By determining, through self-report, Ontario gynaecologic surgeons' practices regarding surgical staging for epithelial ovarian cancer, this study aimed to quantify the gap between current practice and the ideal practice of surgical staging for ovarian cancer, as defined by the corresponding Canadian clinical practice guidelines.

Methods: All 711 active Ontario gynaecologic surgeons identified from the website of the College of Physicians and Surgeons of Ontario were confidentially surveyed by mail, using a structured questionnaire to explore individuals' surgical management of an adnexal mass suspicious for epithelial ovarian cancer, using a clinical case simulation. Specifically, gynaecologic surgeons' adherence to the CPGs was determined by self-report, and various physician characteristics were explored for potential associations with adherence to the CPGs in the clinical case simulation using the Fisher exact test.

Follow-up after primary therapy for endometrial cancer: a systematic review.

Objective: To determine the optimum follow-up of women who are clinically disease-free following potentially curative treatment for endometrial cancer.

Methods: A systematic search of MEDLINE, EMBASE and the Cochrane Library databases (1980 to October 2005) was conducted. Data were pooled across trials to determine overall estimates of recurrence patterns.

Who should operate on patients with ovarian cancer? An evidence-based review.

Objective: To evaluate the relationship between surgical specialty and survival in patients receiving initial surgical management for ovarian epithelial cancer.

Study Methods: An analytic framework was constructed to address the principle question 'does the type of surgeon operating on patients with newly diagnosed ovarian epithelial cancer influence survival?' A literature search addressing the components of this analytic framework was carried out using the Cochrane Library, Medline, EMBASE, and HealthSTAR databases. Relevant articles were selected and graded using U.

Identifying educationally influential specialists: issues arising from the use of "classic" criteria.

Introduction: Educationally influential physicians (EIPs) are identified by their colleagues as people who (1) encourage learning and enjoy sharing their knowledge, (2) are clinical experts and always seem up to date, and (3) treat others as equals. We aimed to identify surgical and pathologist EIPs for colorectal cancer (CRC) in Ontario as part of a blended knowledge transfer program.

Methods: A population-based cohort of surgeons (n = 794) and pathologists (n = 449) were sent surveys modeled on the Hiss method for identifying EIPs.

Slide review in gynecologic oncology ensures completeness of reporting and diagnostic accuracy.

Objective: We reviewed patient records in our tertiary care teaching hospital to assess the value of the mandatory slide review policy in gynecologic oncology with emphasis on completeness of reports.

Methods: Cases reviewed between October 2001 to September 2002 were studied. Clinical information was gathered from discussions at the weekly tumor board and from chart review.