International perspective on the global advances in gynecologic oncology

The treatment of gynecologic cancer has evolved over the years, with greater emphasis on tailored surgery and reducing morbidity and mortality related to surgery, particularly in the management of vulvar and cervical cancer. The addition of concurrent chemotherapy to radiation regimens has improved survival of patients with cervical cancer in developed countries; however, most women with cancer in developing countries have advanced, untreatable disease and minimal access to anticancer therapies. In the past 15 years there has been intense research into alternatives to cervical cytologic testing, particularly in low resourced regions but also in an attempt to improve on cytologic testing in developed countries. Surgical staging in endometrial cancer has enabled the use of adjuvant radiation to be individualized to the patient's particular risk factors for recurrence. The management of ovarian cancer, long stagnant since the introduction of platinum and paclitaxel as chemotherapeutic agents, is set to change with the onset of molecular and genetic profiling and the introduction of novel therapies.