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Techniques like ‘diaphragmatic stripping’ achieve the complete removal of the visible tumor – an aim that should be the reason for any surgical procedure on ovarian cancer.

  • The clinical results of treatment combinations with anti-angiogenics and PARP inhibitors that could avoid the need for chemotherapy in high-grade serous ovarian cancer

Breast, endometrial, ovarian and cervical cancer are currently among the six most common cancers in the country, according to data from the Spanish Society of Medical Oncology (SEOM). That is why meetings like the 33rd National Meeting of the Gynecologic Oncology and Breast Disease Section of the Spanish Society of Gynecology and Obstetrics (SEGO), to be held between November 3 and 5 in San Sebastian, are so important. “In addition to spreading knowledge and updating action guidelines in gynecologic and breast cancer, it is an important occasion on which gynecologists with a special interest in or dedication to gynecologic cancer gather”, points out Dr. Javier de Santiago, head of the Gynecologic Oncology Service at MD Anderson Cancer Center Madrid and president of the Gynecologic Oncology and Breast Disease Section of the ‘SEGO’.

From the meeting, held every two years, the specialist highlights the chance to ‘learn first hand and from a multidisciplinary point of view of the profound changes that are taking place in the specialty’, amongst which are advances in molecular testing, genetic diagnostics, minimally invasive general surgery, preservation of fertility, localization of the sentinel gland or personalization of treatments.

Amongst the techniques to be discussed at the meeting is ‘diaphragmatic stripping’, a complex surgical procedure consisting of the removal of the peritoneum which covers one or two of the diaphragmatic cupola and which is indicated, explains Dr. de Santiago, “when the tumor affects the diaphragmatic peritoneum in any type of cancer associated with peritoneal carcinomatosis”.

In gynecology, it is mainly used with ovarian cancer to achieve complete cyto-reduction, that is, removal of the complete visible tumor when treated surgically. This goal is fundamental in ovarian cancer because “it is an essential factor in prolonging the survival of these patients, which should always be the aim in ovarian cancer”. The technique, not very commonplace, as it must be performed in specialized centers and by professionals with experience in the surgical treatment of advanced ovarian cancer, is also used in endometrial cancer, although less commonly.

Also contributing to the scientific meeting is Dr. Santiago Gonzalez Moreno, head of the Gastrointestinal Surgical Oncology Service and Medical Director of MD Anderson Madrid, who will share his extensive experience in cytoreductive surgery combined with the application of hyperthermic intraperitoneal chemotherapy (HIPEC) in malignant peritoneal diseases. Dr. Gonzalez Moreno and Dr. Sonsoles Alonso, specialist with the Gynecologic Oncology Service at MD Anderson Madrid, will debate a subject that is as interesting as it is controversial: peritonectomy and HIPEC to treat ovarian cancer.

New combinations of treatments for ovarian cancer


Despite constant research into chemotherapy-free treatments, the reality is that it “continues to play a crucial role in various stages and moments in the treatment of ovarian cancer”, states Dr. Antonio Gonzalez, head of the Medical Oncology Service at MD Anderson Madrid, who also mentions positive results in this line. In fact, during his presentation at the meeting, Dr. Gonzalez is charged with speaking of the latest results on efficiency available with the combination of anti-angiogenics and PARP inhibitors without chemotherapy.

Specifically, Dr. Gonzalez refers to a study on the combination of cedinarib (anti-angiogenic) and olaparib (PARP inhibitor) without chemotherapy, which have given very promising results in high-grade serous ovarian cancer. “Results with relatively few patients we are trying to confirm by means of various international studies”, says the specialist.

Future challenges for ONCOSEGO


Since May, Dr. Javier de Santiago has been the new president of ONCOSEGO, the Gynecologic Oncology and Breast Disease Section of SEGO. For that reason precisely, one of his presentations at the meeting is to speak on the challenges of the future facing the section beyond spreading knowledge and research, objectives of most scientific societies.

Amongst the most interesting projects mentioned by Dr. Javier de Santiago are the creation of collaborative research groups and the acknowledgement of the accreditation required of healthcare professionals to enable them to focus locally on gynecologic oncology, in addition to promoting the presence and participation of young gynecologic oncologists in the activities of the section.

In the opinion of Dr. Santiago Gonzalez, the fact that the head of the Gynecologic Oncology Service at MD Anderson Madrid is currently the president of ONCOSEGO, together with the fact that up to four speakers from the center are taking part in a congress such as this “gives an idea of the leadership of MD Anderson Madrid in gynecologic oncology and surgical oncology in this country”.