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      ASGO 2nd International Workshop on Gynecologic Oncology

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          Abstract

          Asian Society of Gynecologic Oncology (ASGO) 2nd International Workshop on Gynecologic Oncology was held in Kyoto Tokyu Hotel, on September 28th, 2012. A total of 213 medical doctors and students from 11 countries (Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Philippines, Singapore, Taiwan, Thailand, and the USA) participated in the meeting. In this workshop, there were a total of 23 presentations in 7 sessions including two sponsored seminars (Table 1). The first session was an educational session which consisted of 3 lectures on the recent tends on gynecologic oncology. Dr. Konishi presented a multicenter study with ovarian cancer patients of which clinical information including transvaginal ultrasonography (TVS) finding of less than 12 months prior to the diagnosis of ovarian cancer was available. He concluded that approximately half of ovarian cancer develop secondarily from pre-existing, benign-appearing cysts or endometriotic cysts, whereas the remaining half, typically high-grade serous ovarian cancer, seem to develop suddenly from normal-appearing ovary. He also emphasized the limitation of screening programs using TVS. Dr. Aziz reviewed current understanding of neo-adjuvant chemotherapy (NAC) in advanced ovarian cancer and concluded that NAC prior to cytoreductive surgery was not superior to primary cytoreductive surgery, but effective in terms of less morbidity and shorter hospitalization. Dr. Devi gave a lecture on gestational trophoblastic disease (GTD) regarding diagnosis, prognostic scoring, and treatment for primary/relapse/refractory disease, placental site trophoblastic tumor, and choriocarcinoma. Notably, she underscored that a few women died from the GTD, mainly because of late presentation and drug resistance. She concluded that novel approaches with improved efficacy and reduced toxicity needed to be identified and national registries of GTD in Asia should be established. The second session comprised two symposia on the malignancies with poor prognosis, cervical adenocarcinoma and uterine sarcomas. Three each of the lectures covered various aspects of the two cancers including pathology, imaging studies, and clinical management. Dr. Mikami presented his studies about cervical mucinous adenocarcinoma with gastric immunophenotype. He proposed a concept of gastric-type adenocarcinoma (GAS) of the cervix for this tumor with a distinct morphology. He stated that GAS showed unfavorable clinical outcomes because of its aggressive behavior compared with usual-type of endocervical adenocarcinoma. In addition, he mentioned that absence of human papillomavirus (HPV) DNA in this particular type of tumor indicated that GAS arised via HPV-unrelated pathway. Thus, he concluded that special considerations might be required for GAS in terms of carcinogenesis, prevention, early detection, and treatment strategy. Dr. Shiozawa presented a multicenter study for diagnostic criteria of minimal deviation adenocarcinoma (MDA) and lobular endocervical glandular hyperplasia (LEGH) of the cervix. He concluded that the combination of MRI, Pap smears, and gastric mucin test will improve the accuracy of the preoperative diagnosis of MDA and LEGH. Next, Dr. Young-Tak Kim pointed out current problems in diagnosis and treatment of cervical adenocarcinoma by comprehensive review of his studies. He showed that adenocarcinoma differed from squamous cell carcinoma in terms of epidemiology, etiology and prognosis. Cervical adenocarcinoma is an independent prognostic indicator of poor survival in patients with early stage cervical cancer with risk factors, regardless of the type of adjuvant radiotherapy after radical hysterectomy. He concluded that novel treatment strategies specifically tailored to early stage cervical adenocarcinoma were needed. In uterine sarcoma symposium, Dr. Silverberg gave us a lecture about pathological diagnosis of leiomyosarcoma and endometrial stromal sarcoma. He pointed out the difficulties in their diagnosis. Dr. Chang presented how MRI can be used to diagnose uterine sarcomas. He showed the usefulness of diffusion-weighted MRI in differentiating between leiomyomas and malignant uterine tumors. Dr. Takano reviewed recent advances in the chemotherapeutic treatment against uterine sarcomas. He showed doxorubicin, ifosfamide, and gemcitabine plus docetaxel are the active agents against leiomyosarcoma. He also showed ifosfamide plus cisplatin, ifosfamide plus paclitaxel, and carboplatin plus paclitaxel are the active agents against uterine carcinosarcoma. Furthermore, bevacizumab and pazopanib are promising molecular-targeted agents against uterine sarcomas. The third session was about translational research for ovarian cancer. Dr. Goh presented her research about histotype-specific copy number alterations in ovarian cancer. She reported several potential drivers, including ERBB2 in mucinous, BRAF in serous, and TPM3 in endometrioid histotypes. She concluded that identification of histotype-specific copy number alterations can pave the way for histotype-specific targeted drug therapy. Dr. Chan presented his research about AMP-activated protein kinase (AMPK) in ovarian cancer. Decreased AMPK activity was significantly correlated with the up-regulation of ERK/FOXM1 signaling cascade and advanced stage. He concluded that targeting AMPK by either pharmaceutical or natural AMPK activators could be considered as an alternative therapeutic regimen in the treatment of ovarian cancer. Dr. Hamanishi showed his research about tumor immunology in ovarian cancer. He showed that a novel classification of ovarian cancers could be established through the hierarchical clustering analysis based on tumor-infiltrating immune cells and immunological suppressors. He concluded that this result might support the application of Taylor-Made therapy based on the immune status of the patients. Dr. Matsumura presented the results of expression microarray analysis for ovarian clear cell carcinoma. He concluded that sorafenib might be effective in the treatment of this disease. The following two sessions dealt with surgical films with expert lectures on updated gynecological cancer surgery including minimally invasive surgery. Dr. Tadayoshi Nagano presented a video about abdominal radical trachelectomy. He showed this technique might be feasible for women with early-stage cervical carcinoma who wanted to preserve their fertility. Dr. Wang presented a video about laparoscopic surgery for gynecological malignancies. Dr. Park presented a video about cytoreductive surgery for advanced ovarian cancer. He argued that optimal cytoreduction could be achieved even in a case with extensive upper abdomen involvement. Dr. Boggess presented a video about robotic surgery for endometrial cancer, which included simple hysterectomy and retroperitoneal lymphadenectomy. Dr. Lee presented a video about robotic radical hysterectomy for cervical cancer. Dr. Young Tae Kim presented a video about robotic assisted radical trachelectomy in early-stage cervical cancer. Between the sessions, two sponsored luncheon and evening seminars covered pertinent hot issues in the prevention and treatment of uterine cervical cancer, respectively. In the luncheon seminar, Dr. Wilailak from Thailand and Dr. Konno from Japan gave presentations on the recent movements of HPV vaccination in Asia. Dr. Wilailak presented current topics about HPV vaccination in Asia. She insisted that support from the government is necessary to increase the HPV vaccination rates. Dr. Konno presented how Japan pursued the vaccination program. He also presented the current problems in vaccination program in Japan. In the evening seminar, Dr. Takeshima and Dr. Mandai presented state of the art in the management of locally advanced cervical cancer. Dr. Takeshima presented the recent clinical trial that he conducted to evaluate the effectiveness of NAC followed by radical hysterectomy plus postoperative chemotherapy without radiotherapy for stage IB2-IIB cervical cancer. He concluded that this treatment strategy would offer the advantage of minimizing radiation-induced morbidity, reserving radiotherapy for the possible pelvic recurrence. Dr. Mandai presented current problems in treating stage IIB cervical cancer. He emphasized the utility of "super-radical" hysterectomy and showed a video of the surgery. This workshop was successful with active discussions after every presentation. Unfortunately, Chinese doctors were not able to attend the workshop due to the political issue that Chinese and Japanese governments are facing. I hope that every member of the ASGO will intimately communicate with each other for promoting both academic and social achievements in the near future.

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          Author and article information

          Journal
          J Gynecol Oncol
          J Gynecol Oncol
          JGO
          Journal of Gynecologic Oncology
          Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology
          2005-0380
          2005-0399
          January 2013
          08 January 2013
          : 24
          : 1
          : 3-6
          Affiliations
          Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.
          Author notes
          Correspondence to Ikuo Konishi. Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan. Tel: +81-75-751-3267, Fax: +81-75-761-3967, konishi@ 123456kuhp.kyoto-u.ac.jp
          Article
          10.3802/jgo.2013.24.1.3
          3549505
          b61e4a4f-903c-4ed3-9fad-471cd632515c
          Copyright © 2013. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology

          This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

          History
          : 30 October 2012
          : 16 November 2012
          Categories
          Meeting Report

          Oncology & Radiotherapy
          Oncology & Radiotherapy

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