Highlights from the Gynecologic Oncology Track at the 2017 Annual Meeting of the American Society of Clinical Oncology

Surgical trials: lymphadenectomy in ovarian neoplasms (LION) and Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) DESKTOP III/ENGOT ov20 trialSurgical trials have been historically difficult to execute because of the inherent complexity of standardizing surgical procedures.Differences in technique and expertise between one surgeon to the next, as well as for the difficulty with blinding within a surgical trial continue to represent the most troublesome hurdles in trial design.The above notwithstanding, two successful surgical trials where presented this year, with findings that could change the surgical management of patients with advanced/recurrent ovarian cancer.The first trial was the lymphadenectomy (LAD) in ovarian cancer, or the LION trial.This trial was a randomized, prospective study of utilizing a systemic LAD vs. no LAD in those newly diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IIB-IV ovarian cancer with clinically and radiologic negative lymph nodes (LNs) (Fig. 1).To overcome the surgeon expertise and technique variance, centers had to qualify in surgical skills prior to participation in the trial.Importantly, patients underwent randomization after complete surgical cytoreduction had been achieved, with optimal debulking defined as a complete macroscopic resection.This trial showed no improvement in overall survival (OS) (69 months with no LAD vs. 65 months with LAD; hazard ratio [HR]=1.06;95% confidence interval [CI]=0.83-1.34;