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 Mab43.13 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