The GynaecologyDisease Management Group(DMG) caters to patients with gynaecological cancers. It includes members from multipledisciplines(Surgeons, Radiation Oncologists, Medical Oncologists, Pathologists, Radio-diagnosis experts, Cytologists and Scientists).
Specific domain experts are invited as and when required to advise the group on specific issues.The voluntary group members also form an inseparable and active contributor to the DMG thus facilitating improved service.
The Gynaec DMG conducts OPDs on a daily basis both in the Private and General wings. All newly registered cases are attended on the same day of registration and appropriate investigations/treatments are initiated. Joint Clinics are conducted on Mondays and Wednesdays.
Gynaecologic Oncology Working Group made a significant progress in service, education and research as is reflected by some of the completed and ongoing trials.
Robotic surgery was started in October 2014 & well established over years. A substantial proportion of patients with endometrial cancer and cervical cancers undergo surgery by minimal access route.
As a major extension to the clinical services, gynaecological patients support group activities were started in 2016. The support group services are provided by clinicians in coordination with Women’s Cancer Initiative and other non-governmental organisations. The support group services include daily availability of patient services coordinators in the OPD and socio-financial assessment. Monthly patient meetings are also organised and discussions focus on improving patient’s cancer care experience.
DMG also have dedicated account to provide financial support to underprivileged patients.
Total Three Thousand Four Hundred Ninety Three (3493) new patients were registered under Gynaecologic Oncology DMG;2328in General category and1165in Private Category(ratio 67:33). Patients registered for Referral opinion were 709.Table.1 shows the site wise diagnostic break up.
The DMG performed a total of 739 major surgeries (650 at TMH &89 in ACTREC) and 390 minor surgeries.The general: private ratio was 53:47.Major surgeries included 79for cervical cancer, 111 for endometrial cancer,409 forovarian cancer, 18 for vulval cancers and 111 miscellaneous surgeries (Table 2). 38% patients with endometrial cancer (17% lap, 21% robotic) and 44% patients with cervical cancer (16% lap, 28% robotic) underwent surgery by minimal access route.
Overall 903 cases received radiation. Radical radiotherapy was administered to 703patients and palliative radiotherapy was delivered to 200 patients. Brachytherapy procedures were performed in 2165patientsdelivering 1993 Intracavitary &172Interstitial brachytherapy procedures.Chemotherapy was administered to 1146patients with gynaecological malignancies.
Diagnosis |
Total |
Private |
General |
Ca Cervix | 1441 |
336 |
1105 |
Ca Endometrium | 331 |
154 |
177 |
Ca Ovary | 1025 |
424 |
600 |
Ca Vagina | 39 |
13 |
26 |
Ca Vulva | 33 |
12 |
21 |
Ca Vault | 59 |
17 |
42 |
Others | 312 |
109 |
203 |
No Malignancy | 129 |
68 |
61 |
Unknown | 126 |
32 |
93 |
Total | 3493 |
1165 |
2328 |
Disease sites |
No of surgeries |
Cervix |
79 |
Ovary |
409 |
Endometrium |
111 |
Uterine Sarcomas |
11 |
Vulva |
18 |
Miscellaneous |
111 |
Total |
739 |
Post-Surgical 30day Mortality was 0. 9% (6/739).Major surgical morbidity was 8% (60/739) which included 5.7% (37/739) intra-operative and 3.5% (23/739) post-operative complications.
Of patients who received curative radiotherapy, Acute grade II and grade III-IV GU-GI toxicity wereobserved in 14%,3%patients, respectively.
Grade III/IV Myelosuppressionand peripheral neuropathy was observed in 12% and 8% respectively of patients receiving Paclitaxel and carboplatin.
General OPD - Monday - Friday
Timing - 08:30 am -17:00 pm
Saturday
Timing - 08:30 am -01:00 pm
Location - Room Nos. 57-62 Ground Floor, Golden Jubilee Building, Tata Memorial Hospital
Joint Clinics - On every Monday and Wednesday
Private OPD - Monday - Friday
Timing - 08:30 am -17:00 pm
Saturday
Timing - 08:30 am -01:00 pm
Location - Room nos. 52-56, Ground Floor, Homi Bhabha Building, Tata Memorial Hospital
DMG conducts academic meetings on a weekly basis which is attended by faculty and students with various departments including Surgery, Medical Oncology, Radiation Oncology, Pathology, and Radiology. Teaching programs like journal club presentations, patient case presentations, and in-patient teaching rounds are held regularly in the DMG.
Clinico-Pathological Correlation (CPC) discussions are held once/twice a month. Clinical care guidelines are reviewed annually to ensure that practices reflect the latest standard of care.
DMG members have initiated many clinical trials. Some of them have potential to change practice.
In the year 2016, 42 scholarly and research publications were contributed in PubMed Indexed Journals by the members of DMG
The total number of new and ongoing clinical trials is summarized in the following table.
Total Number of Clinical Trials(N=43) |
Completed Trials(N=24) |
Ongoing Trials(N=19) |
Overall Patients Accrued |
|||
Investigator Initiated |
Sponsored Trials |
Investigator Initiated |
Sponsored Trials |
Investigator Initiated |
Sponsored Trials |
|
38 |
05 |
20 |
04 |
18 |
01 |
Approximately 6865 |
DMG members have initiated many clinical trials.Some potentially practice changing trials are summarized below. |
|
1. |
The preventive oncology group through its research has established itself in leadership position by doing large randomized trials of cost effective screenings for women, the results of which have been presented in ASCO meeting Plenary session in in 2014. |
2. |
CRACx trial: The results of CRACx Phase-III randomized trial were analysed in 2016. This is the first trial to clearly demonstrate the benefit of concurrent chemoradiation in patients with Ca Cervix III B. The results of the trial will be presented in Novemeber 2017 in ESGO, Austria Best Oral session and have been submitted for publication. |
3. |
NACT Trial: NACT Trial, A Phase-III randomized trial of neo-adjuvant chemotherapy followed by surgery or chemoradiation in stage IB2-IIB has completed accrual . The trial results demonstrate that chemoradiation should be the preferred approach and the final analysis was presented in ESMO, Spain 2017 as part of plenary presentation. |
4. |
PARCER Study: PARCER study is a phase-III randomized trial investigating the impact of IMRT in reducing late bowel toxicity. The interim analysis was performed in 2015 and was selected for plenary presentation in 2015 in San Diego,USA. In 2016 a sub-analysis from the study on vaginal toxicity and sexual quality of life from PARCER study was selected for Best of ASTRO series 2016-2017 and has recently been published. The research from this sub-study will be featured across all Best of ASTRO licensed meetings internationally. |
1. |
Gynecologic DMG members contributed to FIGO -Gynecological Cancer Management Guidelines mobile app |
2. |
Dr. Sudeeep Gupta presented results of Neoadjuvant chemotherapy Surgery versus concurrent chemoradiation in locally advanced cervical cancer- A phase III Randomized trial at the Presidential symposium of ESMO 2017 Conference, Spain. |
3. |
TMC was the leading contributor for IAEA HDR fractionation study that was presented at ASTRO Plenary in San Diego. |
4. |
Dr Umesh Mahantshetty has been appointed as “Course Director” of AROI ESTRO GYN Teaching Course 2017 – 2019. |
5. |
Dr Umesh Mahantshetty has been appointed as “General Secretary” Indian Brachytherapy Society: 2013 onwards. |
6. |
Dr. Supriya Sastri (Chopra) won UICC - Young Leader Programme Award 2017. |
7. |
Dr Supriya Sastri (Chopra) appointed as Asia Pacific regional lead by UICC 2017. |
8. |
“The Year that was Best of 2016 & Masterclass” (Teaching & patient celebration programme) was organized by Dr Amita Maheshwari in collaboration with Association of Gynaecologic Oncologists of India & N K Dhabhar Foundation on 7th & 8th January, 2017 in TMH. |
9. |
EBM Gynaecology session was conducted on 24th February, 2017. |
1. |
Dr. Amita Maheshwari is the Hon. Secretary General of the Association of Gynaecologic Oncologists of India. |
2. |
Dr. Amita Maheshwari is a member of SATYM Committee of Department of Science and Technology. |
3. |
Dr. Umesh Mahantshetty serves as GEC ESTRO and IAEA international faculty for gynecological cancers. |
4. |
Dr. Umesh Mahantshetty was appointed as Organizing Secretary for AROI – MS Meetings, WCI 2013, EBM 2015. |
5. |
Dr. Umesh Mahantshetty is a “Senior Editor” of Journal of Contemporary Brachytherapy (JCB) : 2016 onwards. |
6. |
Dr. Supriya Sastri(Chopra) and Dr Umesh Mahantshetty awarded India Austria Mobility grant by Department of Science and Technology. |
7. |
Dr. Supriya Sastri(Chopra) was appointed as Visiting Professor University of Tufts and Brown, Boston, USA. |
8. |
Dr. Supriya (Chopra) appointed as international coordinator of translational research within multicentric EMBRACE study and appointed as core member of the Gyn Research Group, EMBRACE studies. |
9. |
Dr. Supriya Sastri(Chopra) appointed as IAEA faculty for gynaecological cancers. |
10. |
Dr. Bharat Rekhi is an Executive Committee member of Indian Academy of Cytologists. |
11. |
Dr. Kedar Deodhar is a member of AGOIN India. |
12. |
Dr. Akshay Baheti has been appointed as an associate editor, Current Problems in Diagnostic Radiology since 2017. |
Department Office Number: +91 (22) 24177000 / Ext.No.6010, 6038,4590
Department of Gynecologic Oncology,
Private OPD- Room nos. 52-56, Ground Floor, Homi Bhabha Building, Tata Memorial Hospital
General OPD – Room nos. 57-62 Ground Floor, Golden Jubilee Building, Tata Memorial Hospital
TATA MEMORIAL HOSPITAL, Dr.E.Borges Road, Parel, Mumbai-400-012, Maharashtra, India
Hospital Fax Number: (+9122) 24101656
Email-id: dmggyn@tmc.gov.in
टाटा स्मारक अस्पताल
डॉ ई बोर्जेस रोड, परेल, मुंबई - 400 012 भारत
फ़ोन: +91-22- 24177000, 24146750 - 55
फैक्स: +91-22-24146937
ईमेल : msoffice@tmc.gov.in (रोगी देखभाल और प्रश्नों के लिए) / hrd@tmc.gov.in(प्रशासनिक के लिए - HRD मायने रखता है)
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