Editor’s Pick: Paradigm Shift in the Management of Gynaecological Cancers

My paper selection is ‘Paradigm shift in the management of gynaecological cancers’ by Sap and Van Trappen. This paper is of interest because it summarises the advances in the management of gynaecological cancers. More importantly it emphasises a multidisciplinary approach to  these tumours, which not only improves the outcome but also increases the diagnostic  accuracy and decreases morbidity. Prof Ahmad Awada

Katelijn Sap, *Philippe Van Trappen

Department of Gynaecological Oncology and Department of Obstetrics  and Gynaecology, AZ St. Jan Hospital Bruges, Bruges, Belgium
*Correspondence to philippe.vantrappen@gmail.com

Disclosure: No potential conflict of interest.
Received: 03.12.14 Accepted: 07.01.15
Citation: EMJ Oncol. 2015;3[1]:12-18.


In this review we highlight novel aspects of diagnostic imaging in gynaecological cancers, the paradigm shift in the surgical management of certain female pelvic cancers, as well as potential new molecular targeted therapies. In the last decade, ultra-radical surgery has been shown to increase survival in  advanced ovarian cancer (OVC) when extended surgical procedures are included during primary  cytoreductive surgery or at interval debulking procedures after neoadjuvant chemotherapy. In cervical  cancer (CVC) and endometrial cancer (EMC) endoscopic (laparoscopic or robotic) operations have been shown to significantly reduce the morbidity without altering the cancer-related survival. Although the  sentinel lymph node concept is already established in early-stage vulvar cancer, its diagnostic accuracy in  EMC and CVC is still under debate. Novel molecular targeted therapies including blocking agents against new blood vessel formation (anti-angiogenesis) and polyadenosine diphosphate ribose polymerase inhibitors have been shown to prolong the progression-free survival in advanced OVC. Other molecular therapies, single or combined, are under investigation in OVC and EMC.

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