DEPARTMENT OF OBSTETRICS & GYNECOLOGY / …



DEPARTMENT OF ONCOLOGY

ANNUAL REPORT 2003

DIVISION OF GYNECOLOGY - Dr. Jill Nation, Division Chief

The Division of Gynecology at the TBCC provides gynecologic cancer consultation services and treatment to the women of southern Alberta. Leadership in cervical cancer screening, as well as diagnosis and treatment of preinvasive gynecologic cancer is an important part of our mandate. Activities in gynecologic oncology education, multicentre cancer research activities, tertiary care clinical services, and cancer care administration all contribute to our overall goal. In the fall of 2003, Dr. Gavin Stuart left our group to become Dean of Medicine at the University of British Columbia.

EDUCATION

The two gynecologic oncologists were actively involved in teaching at all levels of the education continuum. The Gynecologic Oncology Fellowship Training Program is an Accreditation without Certification Royal College Program and is one of four such programs in Canada. Currently, there are three Fellows in the program. Dr. P. Ghatage took over as Program Director on Dr. Stuart's departure.

Senior residents in Obstetrics and Gynecology each spend three months on the gynecologic oncology service. Chief residents also have the opportunity to be further trained in colposcopy and laser treatment of the lower genital tract. In 2003, we also had two residents from the University of Saskatchewan who each spent three months on the GYN oncology service. Residents from medical oncology, radiation oncology, and diagnostic imaging also have mandatory rotations on the gynecologic oncology service.

Undergraduate medical students from the University of Calgary, as well as three other Canadian universities completed electives on the gynecologic oncology service during 2003. In addition, faculty were preceptors for two undergraduate medical students at the University of Calgary in research electives. The gynecologic gynecologists continue to contribute to the core curriculum in oncology, the core curriculum in Obstetrics & Gynecology residency education, small group sessions in gynecologic oncology, and in undergraduate teaching sessions in the reproductive course at the University of Calgary medical school.

RESEARCH ACTIVITIES

The Division of Gynecology contributed to a number of new National Cancer Institute of Canada trials, as well as several industry-sponsored trials in 2003. In addition, research funding was awarded for three new research studies relating to cervical pre-malignancy or malignancy. A Royal College of Physicians and Surgeons Educational Research Grant was awarded for a project in postgraduate medical education. Dr. Stuart continued to provide leadership at the National Cancer Institute of Canada, as a gynecologic site chair until his departure in September 2003.

CLINICAL SERVICES

The Division of Gynecology provides tertiary care to patients from the Calgary Health Region, and southern Alberta. Referrals from southeastern British Columbia and southwestern Saskatchewan continue. There is close collaboration with gynecologists in Calgary and southern Alberta to ensure appropriate care within the local community in addition to timely access to tertiary cancer care services and consultation. All new gynecologic cancer cases are reviewed at the multidisciplinary gynecologic tumor board in order that patients benefit from the collective experience of the participants in the tumor board. This also serves as an internal audit of clinical activities within the department.

PUBLICATIONS

Publications:

Ghatage P.. 'Pap Reports'. What now? Diagnosis, Nov 2003.

Oza A, Elit L, Swenerton K, Faught W, Ghatage P, Carey M, McIntosh L, Dorr A, Holmlund J, Eisenhauer E. Phase II Study of CGP 69846A in Recurrent Epithelial Ovarian Cancer: An NCIC Clinical Trials Group Study (NCIC IND 116). Gynecologic Oncology 89 2003; 129-133.

Duggan MA, Brasher P, Nation J. The Usefulness of the Pap Test Take at the First Colposcopy Examination in the Enhanced Detection of Cervical Neoplasia. J Lower Genital Tract Disease 2003: Oct 7(4); 264-70. Peer reviewed.

Stuart GCE, Dawson LM. Update on Granulosa Cell Tumors of the Ovary. Cur Opin Ob & Gyn. Feb 2003: 15(1); 33-37.

Mace L, Rothenberg PY, Liu P, Braly S, Wilczynski S, Hannigan E, Wadler S, Stuart GCE. Combined Intraperitoneal and Intravenous Chemotherapy for Women with Optimally Debulked Ovarian Cancer: Results from an Intergroup Phase II Trial. J Clin Onc April 1 2003: 21(7); 1313-1319.

Published Abstracts

Stuart GCE. First Line Treatment of Advanced Ovarian Cancer with Paclitaxel/Epirubicin/Carboplatin (TEC) vs Paclitaxel/Carboplatin (TC). Interim results of an NSGO-EORT-GC-NCIC-CTG Gynecological Cancer Intergroup Phase III Trial. April 8-10, 2003 European Society of Gynecological Oncology: A New Partnership - Brussels, Belgium.

Menon D, Stafinski T, Mori J, Stuart GCE. Improving Outcomes through Health Technology Assessment. International Society of Technology Assessment in Health Car (ISTAHC). Canadian Cancer Drug Formulary Review Committee Decision-Making: How Important is Evidence? Canmore, AB June 22 - 25, 2003.

Oza AM, Elit L, Eisenhauer E, Hoskins PJ, Biagi J, Carey M, dubuc-Lissoir J, Dundas G, Stuart, et al. Phase II Study of Erlotinib (Tarceva, OSI 774) in women with recurrent or metastatic endometrial cancer - NCIC IND.148. National Cancer Institute of Canada Clinical Trials Group, Kingston, ON.

Cook L, White JL, Stuart GCE, Magliocco AM. The Reliability of Telephone Interviews Compared with In-person Interviews Using Memory Aids. Ann Epi Aug 2003: 13(7); 495-501.

RESEARCH / GRANT SUPPORT

104864-557 (GSK) (2002)

A phase II trial of topotecan and cisplatin in patients

with metastatic or recurrent squamous cell

carcinoma of the cervix

Per case funding

Intermune ( 2002)

Actimmune (interferon gamma-1B) in combination

with chemotherapy (carboplatin/paclitaxel) for first

line therapy of advanced ovarian or primary peritoneal carcinoma

Per case funding

ET743 (2003)

A phase II study of efficacy and safety of in subjects with advanced ovarian cancer

(Janssen Ortho)

Per case funding

104864-A/627 - GSK

An open label, multicentre, non-comparative phase II

study of the combination of intravenous topotecan

and gemcitabine administered once weekly

for three weeks every 28 days as second-line

treatment in patients with recurrent platinum-sensitive

ovarian cancer

Per case funding

INDUSTRY - FOLLOW-UP (CLOSED)

104864-552 (GSK) (2001)

A phase II multicentre open label study of oral

topotecan and cisplatin in ovarian cancer

recurring > 6 months following initial

Per case funding

Overax 06 (2000)

A phase IIB controlled study of OvaRex Mab-

43.13 for the neoadjuvant 43.13 for the

neoadjuvant treatment of ovarian cancer

Per case funding

NCIC - OPEN STUDIES

NCIC OV.13

An international multicentre randomized phase III

study comparing upfront debulking surgery

vs neo-adjuvant chemotherapy in patients with

Stage IIIC or IV epithelial ovarian carcinoma

Per case funding

NCIC 0V.16 (2002)

A phase III study of cisplatin + topotecan followed

by paclitaxel + carboplatin vs paclitaxel +

carboplatin as first line chemotherapy in women

with newly diagnosed advanced epithelial ovarian

cancer

Per case funding

NCIC - CLOSED STUDIES (FOLLOW-UP)

NCICOV.7

Clinical trial comparing abdominal-pelvic

radiation vs cyclophosphamide + cisplatin

chemotherapy in patients with epithelial ovarian

carcinoma (84-06-48)

NCIC CX.1

A study to investigate the value of combined

cisplatin with radiotherapy in the treatment of

locally advanced cancer of the cervix

NCIC CX.2

Phase II study comparing concurrent cisplatin

and chemotherapy vs RT alone for locally advanced

squamous cell carcinoma of the cervix (90-04-18)

NCIC IND.126

A phase II study of letrozole in advanced or

Recurrent endometrial cancer

NCIC OV.14

International randomized phase III trial of

paclitaxel/epirubicin/carboplatin (TEC) vs

paclitaxel/carboplatin (TC) in the initial

treatment of women with advanced ovarian cancer

NCIC OV.6

Nonrandomized study to determine the efficacy of

surgery alone in patients with Stage IA or IB

epithelial ovarian carcinoma when extensive

surgical staging has been done to confirm limited

disease

NCIC OV.8

A randomized trial comparing cyclophosphamide/

cisplatin to cyclophosphamide/carboplatin in the

treatment of patients with ovarian cancer with

macroscopic residual disease after initial surgery

NCIC INC 106b

A phase II study of topotecan/cisplatin followed by

paclitaxel/carboplatin as first-line chemotherapy

for patients with advanced ovarian cancer

NCIC IND.74

A phase I study of biweekly Taxol/cisplatin as

Initial chemotherapy for ovarian cancer

NCIC OV.10

Intergroup phase III comparison of a combination

of Taxol-platinum and a combination of

cyclophosphamide-platinum chemotherapy in the

treatment of advanced epithelial ovarian cancer

NCIC IND.82

Randomized phase II study of 2 schedules of

topotecan in previously treated patients with

ovarian cancer

NCIC EN.4

A research study comparing surgery alone to

surgery + radiation therapy in the treatment of

localized uterine sarcoma

NCIC OV.11

A phase II trial of intraperitoneal cisplatin and

intraperitoneal paclitaxel in women with optimally

debulked Stage III epithelial cancer

NCIC 1ND.106

A phase II study of topotecan/cisplatin/paclitaxel

as first line therapy for patients with advanced

ovarian cancer

NCIC OV.12

A phase II comparison of bay 12-9566 vs placebo

as consolidation after standard consolidation after

standard chemotherapy in patients with epithelial

ovarian cancer (STR C03)

OV.15

A randomized phase III study comparing

gemcitabine + carboplatin vs carboplatin alone in

patients with advanced epithelial ovarian carcinoma

who failed first line platinum based therapy

RTOG-99-05

A phase II study of adjuvant postoperative

irradiation with or/without cisplatin/paclitaxel

chemotherapy following TAH/BSO in patients

with endometrial cancer (RTOG 99-05)

Monitoring and Evaluation of Opportunistic Cervical Cancer Screening in the Calgary Health Region

$2,850 CLS

"The Role of Opportunistic Cervical Cancer Screening and its Role in the Prevention of Invasive Cervical Cancer in the Calgary Region"

$26,329.18 ACCSP

Royal College of Physicians & Surgeons of Canada Education Research Project Grant

Co-Investigator with Dr. Harrison (University of Calgary), Dr. M. D'Eon (University of Saskatchewan), and Dr. L. Sadownik (University of British Columbia). "Residents Learning to Teach: Assessing Educational Interventions"

$10,000

INTERNATIONAL PRESENTATIONS - 2003

Stuart GCE. "First Line Treatment of Advanced Ovarian Cancer with Paclitaxel/Epirubicin/Carboplatin (TEC) vs Paclitaxel/Carboplatin (TC). Interim Results of an NSGO-EORT-NCIC-CTG Gynecological Cancer Intergroup Phase III Trial". April 8 - 10, 2003 European Society of Gynecological Oncology: A New Partnership - Brussels, Belgium.

Lee LH, Swenerton KD, Elit L, Provencher DM, Stuart GCE et al. Phase II Open-Label Study of Carboplatin and Pegylated Liposomal Doxorubicin in Uterine and Cervical Malignancies. May 31 - June 3. 39th Annual Meeting American Society of Clinical Oncology, Chicago, IL.

TRANSITIONS

Dr. Gavin Stuart left the Division of Gynecology to become Dean of the Faculty of Medicine at the University of British Columbia.

Contact Information: Dr. Jill Nation

Gynecologic Oncology

Ph: 403-944-1721

Dr. Prafull Ghatage

Gynecologic Oncology

Ph: 403-944-1721

Dr. Patricia Power

Gynecologic Oncology Fellow

Ph: 403-944-2759

Dr. Jean Gregoire

Gynecologic Oncology Fellow

Ph: 403-944-2726

Dr. Kristin Hoffmann

Gynecologic Oncology Research Fellow

Ph: 403-944-4854

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