Short Clinical Visits – Rome 2018

ENYGO Short Clinical Visit Report

POLICLINICO UNIVERSITARIO AGOSTINO GEMELLI, IRCCS

CATHOLIC UNIVERSITY OF THE SACRED HEART, ROME, ITALY

June 18–20, 2018

The Short Clinical Visit (SCV) programme is a new ENYGO project specially designed to improve patient care through education and training, research, and the sharing of experience between ESGO member nations. The main aim of the programme is to facilitate fellowship via a 3–5-day exchange programme that creates links within the gynaecological oncology community and makes it possible to share knowledge and new technologies. The programme’s clinical bases are selected from European centres of excellence that are focused on special interest areas. The SCV programme is open to ESGO members who are willing to take a fellowship in a recognised ESGO Centre of Excellence but don’t have the opportunity to complete a longer period of stay.

 

Mentors at Host Institution: Prof. Anna Fagotti and Prof. Giovanni Scambia

Institution: Policlinico Universario Agostino Gemelli IRCCS, Catholic University of the Sacred Heart, Italy, Rome, Ala N - Piano 4 (31 posti letto)

Email: anna.fagotti@unicatt.it

 

SCV Participants:

Kamil Zalewski (Poland)

Andrei Pletnev (Belarus)

Krzysztof Nowosielski (Poland)

Ilker Selcuk (Turkey)

Artur Stefanowicz (Poland)

Olena Postupalenko (Ukraine)

 

Short Clinical Visit Dates: 18.06.2018–20.06.2018

 

Detailed description:  Policlinico Universitario Agostino Gemelli is one of the biggest gynaecology clinics in Europe. The clinic campus is a huge labyrinth of connected clinics and departments; the total capacity of the Gemelli Clinic is over 2,000 beds. During the SCV, our participants visited the Department of Gynaecological Oncology (surgical wards and operating rooms), Gynaecologic Oncology Ultrasound Department and the Early Phase Clinical Trial Centre. The participants were assigned supervisors, divided into groups of two and assigned to the three clinical stations. Each group rotated daily to the other departments in order to have the opportunity to see them all.

 

The Gynaecology Oncology Department

The Gemelli Gynaecology Oncology Department is a modern, comprehensive 60-bed unit, one of the largest in the EU. It serves the central and southern regions of the Italy, which has about 20 million residents and performs more than 1,500 surgical operations annually. Gemelli is an Italian reference centre for ovarian cancer care, and the surgical treatment of endometrial, cervical, vaginal, vulva, sarcomas, rare tumours and other gynaecological malignancies are also provided. The clinic supports all of the medical institutions in Central and Southern Italy with their most complicated cases in gynaecological oncology.

The SCV participants assessed pre- and post-operative management of gynaecologic oncology patients and chemotherapy complications and palliative care in the surgical wards. The tumour board meeting was held on June 20; cases were presented in English. The great multidisciplinary team discussion and recent data review made the whole meeting very productive.

            The operating theatre supervisors were Anna Fagotti and Nicolò Bizzarri. SCV participants observed radical gynaecologic oncology surgery with minimally invasive (laparoscopic and robotic) and open access. The operating theatre has Monday to Saturday as surgical days, with two or three cases scheduled in five operating rooms every day (10–15 surgical operations per day/80–90 surgical cases weekly).

Professor Fagotti, who developed Fagotti’s score in ovarian cancer, is the actively operating surgeon. The medical staff commentated all steps during surgery, and as a result, the SCV participants learned many tips and tricks and had a lot of conversations covering the technical aspects of the surgeries for each case.

 

The Department of Gynaecologic Oncology Pathology

The Department of Gynaecologic Oncology Pathology is led by Prof. Zannoni and was a great opportunity for our participants to get insight into a modern pathology assessment of Onco/Gyn cases.

The Gynaecologic Oncology Ultrasound Department supervisors were professors Antonia Testa and Valentina Ghirardi. Our SCV participants observed ultrasound scans in gynaecologic oncology patients as part of the staging procedure/pre-operative evaluation and post-operative management of complications. In this department, staff teach courses, seminars and workshops all year for gynaecologists and ultrasound specialists from all regions of Italy. The Ultrasound department also serves as a centre of excellence for IOTA classifications in ovarian masses diagnostics. Prof. Testa provided lectures in ultrasound diagnostic procedures for participants, which made the SCV very productive. All ultrasound procedures were performed first by fellows then by supervisors, and finally by the US expert with detailed description of diagnostic findings. This was a great opportunity for our participants to improve skills and knowledge in US diagnostics.

 

Early Phase Clinical Trial Centre

The Early Phase Clinical Trial Centre supervisors were Vanda Salutari and Francesco Guida. The Gemelli centre collaborates with GCIG, ENGOT, MANGO, MITO, AGO, and GINECO. There are 24 ongoing clinical trials. We observed clinic consultations of patients recruited for phase I and II clinical trials. Later, discussion with experts on clinical trial protocols gave us a deep insight into the core elements of working process organization for clinical trials. The lectures performed by the experts and supervisors rounded out the SCV and ticked all of the boxes as to what the participants had hoped to get out of the programme.

 

Goals accomplished:

1. Participation in radical laparoscopic and other oncological procedures
2. Participation in tumour boards and discussions of complicated and rare clinical cases
3. Improved research skills in patient recruiting and research project organization
4. Improvement in multidisciplinary approach of preoperative and postoperative care, follow-up for gynaecology oncology patients, planning of adjuvant treatment
5. Achieved knowledge and tips and tricks in advanced laparoscopic and open operations
6. Established future collaboration and participation in scientific projects

 

Overall evaluation and comment: We want to express our sincere gratitude to the colleagues from Policlinico Universario Agostino Gemelli IRCCS, Catholic University of the Sacred Heart, Italy, Rome. They are wonderful people who are fantastic surgeons and true professionals in the field of gynaecologic oncology. The atmosphere during our stay in Rome was excellent and the SCV was a fantastic experience for everybody. We would like to thank Prof. Fagotti, Prof. Scambia, Prof. Testa, and Prof. Zannoni for their mentoring, teaching and support for us in Rome. Also, we would like to express our great personal appreciation to Dr. Nicolò Bizzarri, Dr. Valentina Ghirardi, Dr. Lorena Quagliozzi, Dr. Vanda Salutari, Dr. Francesco Guida, Dr. Carmine Vascone and all the rest of their colleagues for all their support and for the wonderful atmosphere during our stay in Rome.

 

It was fantastic; thank you very much!

 

 Report by Andrei Pletnev, Kamil Zalewski, Ilker Selcuk

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