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“Given these two studies, we believe that we can no longer recommend minimally invasive radical hysterectomies for our patients with early-stage cervical cancer.” As a result of the studies’ findings, MD Anderson gynecologic oncologists made the decision to no longer perform minimally invasive radical hysterectomies on cervical cancer patients. Our physicians recommend that these patients undergo open abdominal radical hysterectomies instead. The research has impacted national treatment guidelines for the management of the disease. Building on discovery Sentinel lymph node biopsy is a surgical technique used to determine how far cancer has spread. MD Anderson has been one of the leaders in the use of sentinel node evaluation in gynecologic cancer patients. In 2018, Michael Frumovitz, M.D., professor of Gynecologic Oncology and Reproductive Medicine, published a study examining how we could improve that very technique. In a Phase III noninferiority trial known as Fluorescence Imaging for Lymphatic Mapping (FILM), published in the Lancet, Frumovitz and his colleagues found that using an indocyanine green dye that uses nearinfrared fluorescence imaging made it easier to track the lymphatic system than the traditionally used isosulfan blue dye. The green dye is approved by the US Food and Drug Administration and commercially available for mapping heart, liver and eye function. And now, the maker of the indocyanine green dye has FDA approval to use the dye in lymphatic mapping based on the study’s results. “This could become the new standard of care for lymphatic mapping and sentinel lymph node biopsy in women with cervical and uterine cancers, and potentially, across subspecialties in surgical oncology,” Frumotvitz says. Grant-funded research Gynecologic Oncology and Reproductive Medicine physicians are international leaders focused on providing exceptional patient care while linking basic science with clinical and translational research to develop the nextgeneration of innovative approaches to treatment and prevention of gynecologic cancers. Investigators in Gynecologic Oncology and Reproductive Medicine have been awarded two Specialized Programs of Research Excellence, or SPORE, grants from the NCI. One grant focuses on ovarian cancer and the other grant focuses on endometrial cancer. These large research grants aim to understand the molecular mechanisms underlying these cancers and then rapidly translate this new knowledge into clinical trials for improved treatment or prevention strategies within five years. The Endometrial SPORE team has made significant advances in novel therapeutics and improved prevention strategies. These include an innovative treatment that delivers siRNA, a synthetic molecule, using a nanoliposome formulation; studying the poly (ADP-ribose) polymerase (PARP) inhibitor as a targeted therapy; and identification of the molecular mechanisms that link obesity with increased endometrial cancer risk. The Ovarian SPORE team has led the field in improving early detection methods and targeted therapeutics for ovarian cancer subtypes. Early detection studies have resulted in expanded diagnostic markers and development of “point of service” screening assays. Exciting clinical studies of anti-angiogenic treatments have shown great promise, as have studies for personalized treatment of lowgrade and high-grade ovarian cancers. As our gynecologic oncologists look to the future, they’re focusing on building and strengthening our newly established Center for Rare Gynecologic Malignancies. By concentrating a large volume of patients with rare gynecologic malignancies in one center, we are able to build true expertise, allowing patients to be treated by providers experienced with their specific disease. Our multidisciplinary team of gynecologic oncologists, radiation oncologists, radiologists and pathologists are dedicated solely to gynecologic malignancies. They’re also dedicated to bringing their expertise beyond MD Anderson, including to our Houston-area locations and the LBJ Hospital Oncology Service, which in partnership with Harris Health System, serves low-income and medically underserved patients who otherwise might not have access to specialized cancer services such as oncology therapies and surgeries, colposcopy, inpatient care, research participation and education. Division of Surgery | Surgical Outcomes FY18 21 Volumes Gynecologic Oncology case volumes FY18 1921 245 146 TMC HAL LBJ Total Patients - Oncofertility patients 463 501 FY2017 FY2018 Surgical approach for abdominal surgery FY18 44% OPEN 47% LAPAROSCOPY 9% ROBOT Core surgeries by disease site FY18 41% UTERINE 42% OVARIAN 9% 4% CERVICAL VULVA & VAGINAL 463 501 22 MD Anderson Cancer Center HEAD AND NECK SURGERY Randal Weber, M.D. Jeffery N. Myers, M.D., Ph.D. Department chair Thomas Campbell Division of Surgery | Surgical Outcomes FY18 23 Treating cancers that occur in the intricate sections of the head and neck region require extraordinary skill to achieve the best possible outcome. Head and Neck Surgery at MD Anderson serves as a model of excellence in head and neck oncologic medicine and surgery, providing value-based, patient-centric cancer care that promotes discovery in research, education and cancer prevention – while keeping