4th EUTROC, Liverpool, UK
The Merseyside and Cheshire cancer network
Dr John Kirwan – Liverpool Women’s Hospital, UK
There are five gynae oncologists who work at the Women’s Hospital and we’re part of the Merseyside and Cheshire cancer network. The network is covering a population of about 2.3 million in the northwest of England. Within our cancer network there are seven hospitals with a cancer centre. The cancer centre is a virtual centre in some degrees because Clatterbridge, where radiotherapy and chemotherapy takes place, is in a different hospital and we’re the surgical centre.
The Women’s Hospital is one of the biggest stand-alone trusts in the UK. It’s purely for women, we have 8,500 deliveries so it’s the biggest stand-alone maternity unit in the UK and we have the biggest IVF and fertility unit here with over 3,000 cycles per year with a very high success rate. So overall we’re a hospital for women and we’re very proud of that.
What are some of the challenges and benefits you face?
Although the radiotherapy is delivered in a different hospital, the MDT meet here. So I understand the difference in concept and each cancer centre works slightly differently. We have a very strong MDT that meets on a Wednesday morning and we will discuss up to seventy patients going through radiology, histology etc. in the same way any MDT works, it’s just that the difference is that the radiotherapy and the chemotherapy are delivered at different sites. Over the last year and a half we’ve started to deliver chemotherapy at the Women’s Hospital for local patients and that’s part of the ethos of giving chemotherapy closer to home.
What have been the key messages from this meeting?
I think the take home message is translational research is part of every single trial going forward now. We are recruiting patients for national and international studies and getting consent for translational research and without that we’re not going to get the answers that we need, we’re not going to be able to move on with new novel therapies.
Where are the greatest needs for research in this field?
Oh, that’s a really good question; I think specifically for ovarian cancer, from a surgeon’s point of view, it’s the role of radical surgery. I still think that is the biggest unanswered question. We still haven’t got the trial which compares surgery against chemotherapy alone.
Have there been any recent trials?
There has been a GOG trial which has tried to address it in recurrent disease. We’ve got the latest DESKTOP study which is coming on-line in the UK which will be looking at surgery alone and with chemotherapy against chemotherapy alone but that’s only for recurrent disease. A lot of the trials in recurrent ovarian cancer have mirrored the effect of primary ovarian cancer, so I think we’ll learn a lot from the DESKTOP study.