In this meeting I gave a talk on borderline ovarian tumours which are a very interesting group of tumours which need further research, further investigation, to have a clear idea of what is the best way of managing this unique group of tumours.
What defines them as borderline?
It’s obviously histology but what’s very important for them is that they generally have a very benign behaviour but it’s important to know that some of these tumours can behave very aggressively. The trick is to know which ones and to treat them adequately.
How is this carried out?
Obviously the key factor is histology and the remit of my talk was to make colleagues informed about changing terminology which will affect how we describe and how we treat these tumours in the future. Obviously new developmental laparoscopic surgery bringing something new, new techniques, and we need to know the right indication and right application for these techniques in the treatment of borderline tumours.
What is the main message for doctors?
The main message is that the approach to management of these tumours really needs to be multidisciplinary; it needs to be discussed among the MDT settings. A very important link in that MDT is the pathologist. And to approach every case individually.
Any further points?
What was very exciting in this meeting is new techniques in the identification of sentinel lymph glands which is a technique which probably started almost twenty years ago and now we are coming very close to introducing this very valuable technique into clinical practice. We had guests from abroad, from America, from Denmark, and we are benefitting from their experience and exchanging our own experience and hopefully coming up with the right protocols for benefit of our patients.
Can you give us detail on the technique?
The standard management for most of the cancers we treat, but first of all cervical and endometrium, is to remove the lymph glands because these are the structures which can harbour the cancer cells and that very much influences the treatment and prognosis. Removing all these lymph glands has a detrimental effect – for example swelling of the legs called lymphedema – and this new technique allows us to concentrate, not to remove all lymph glands, concentrate on only a couple of lymph glands but get the same answer which reduces the morbidity of lymphedema by tenfold in most of the cases. Then we are getting a more precise technique with less side effects, that’s the bottom line.
Final thoughts?
It’s an ideal technique to be incorporated in the laparoscopic surgery, in robotic surgery, and it’s a very exciting technique. I really sincerely hope it will get application in clinical practice very soon.
