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The 1st International Workshop on Gynecologic Oncology organized by Asian Society of Gynecologic Oncology (ASGO) was held at Clinical Research Institute of Seoul National University Hospital in Seoul, Korea, July 31st and August 1st, 2010 (Fig. 1). On behalf of the members of Asian Society of Gynecologic Oncology, I would appreciate President of ASGO, Soon-Beom Kang and Korean colleagues for organizing the 1st International Workshop on Gynecologic Oncology. The aim of this workshop was to give an opportunity to young colleagues to know the present status of gynecologic oncology in Asia. Here I would like to review the workshop. The workshop comprised of five sessions, prevention of cervical cancer, new trends of cervical cancer management, surgical technique, endometrial cancer, special lecture concerning clinical trial, and ovarian cancer. In the first session, cervical cancer prevention was highlighted. First professor Mohamad F. Aziz from Indonesia presented an overview about cervical cancer screening in Asia. He stressed that in few countries in South Eastern Regions cervical cancer screening program that have fully support by their government, and in less developed countries most of cervical intraepithelial neoplasia (CIN) lesions are treated with cryotherapy following visual inspection with acetic acid (VIA). Next professor Uma Devi impressed us her great effort to screen for cervical cancer in India. She also stressed VIA would be a suitable screening method in low resource setting. However, since it is difficult ensure screening at regular intervals, she recommend human papillomavirus (HPV) test at ten years intervals as another alternative screening method. Lastly professor Hextan YS Ngan updated our knowledge about HPV vaccine. Both bivalent and quadrivalent vaccines showed more than 90% of efficacy in preventing CIN2/3. And she concluded that both vaccines are effective and safe, and should be considered population vaccination of girls before sexual debut. An importance of cervical cancer screening is stressed as the protection after vaccination is not complete.
In the second session, treatment of cervical cancer was discussed. professor Jong Hyeok Kim overviewed the history of radical hysterectomy. Professor Seung Cheol Kim talked about fertility-sparing radical tracherectomy and less radical surgery that takes in neoadjuvant chemotherapy. Dr. Tomoyasu Kato presented how to preserve autonomic nerves in Okabayashi method. Professor Hee-Sug Ryu reviewed historical studies concurrent chemoradiotherapy (CCRT) for locally advanced cervical cancer. He introduced the ongoing prospective study conducted by KGOG in attempt to ascertain the effectiveness of paclitaxel and carboplatin as a CCRT regimen for patients with high risk factors for recurrent disease after radical hysterectomy. We look forward to seeing the final results of the study.
As a luncheon seminar, professor Young-Tak Kim mentioned cost-effectiveness of HPV vaccination and proposed that ASGO should contribute in building a consensus to urge inclusion of HPV vaccination in National Immunization Programs in Asia.
In the third session was a film session of various surgical techniques presented by the experts; nerve sparing radical hysterectomy by professor Shingo Fujii, optimal staging in early ovarian cancer by professor Dae Gy Hong, laparoscopic radical hysterectomy by professor Jong Hyeok Kim, one-port surgery by professor Tae Joong Kim, and robotic surgery by Young Tae Kim. Every technique should be understood by young doctors who will become leaders in the future.
The fourth session was focused on endometrial cancer. Professor Kung-Liahng Wang, introduced meta-analysis of four randomized studies comparing laparoscopy versus laparotomy in endometrial cancer, and concluded that until mature data from GOG and LACE trials become available, the role of laparoscopy as a standard treatment for endometrial cancer is still debatable. Regarding a role of lymphadenectomy in the management of endometrial cancer, professor Taek Sang Lee suggested that systematic lymphadenectomy is effective in detecting micro or occult metastasis, and thus improve surgical staging and make it possible to accurately predict the prognosis. Professor Kimio Ushijima presented the multi-institutional prospective phase II study regarding high dose medroxyprogesterone acetate (MPA) therapy for early endometrial cancer in the patients who desire for baby. The results shown were that CR rate for stage Ia endometrial cancer is 55% and that for atypical hyperplasia is 82%.
For special lecture, professor Sang-Goo Shin gave us a very interesting lecture that highlighted past historical experience of globalization and current status of clinical trials especially in northwest Asian countries, and stressed that Asian market is growing and promising for pharmaceutical companies.
The final session was assigned to ovarian cancer. Professor Yin Nin Chia talked about a history of first-line chemotherapy and the promising results of resent studies such as ip chemotherapy, dose-dense chemotherapy and Bevacizumab-added chemotherapy. Professor Sarikapan Wilailak reviewed neoadjuvant chemotherapy about rationale, meta-analysis, and prospective randomized studies. She concluded that neoadjuvant is best suited for patients with medical co-morbidities not able to undergo cytoreductive surgeries and for patients deemed to have unresectable disease. Professor Sang Yoon Park highlighted the procedure of surgical cytoreduction for advanced-stage ovarian cancer as well as recurrent ovarian cancer. He reminded us that gynecologic oncologist would live surgery. Professor Hidetaka Katabuchi was reviewed characteristics of ovarian cancer from the molecular aspect. His talk gave us a better understanding about translational research regarding ovarian cancer treatment.
In conclusion, this workshop was a great success in educating young colleagues by reviewing state of the art technology and indicating future direction for the treatment of gynecologic cancer. I would like to thank Korean colleagues again for their hard work to prepare this workshop and look forward to the 2nd biennial meeting of ASGO.