Blogger's Note: follows to prior posting/correspondence/dialogue; worthwhile reading this discussion/debate, note the common denominator in references
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Reply to W.R. Robinson
Reply to W.R. Robinson
- Corresponding author: Dennis S. Chi, MD, Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; e-mail: gynbreast@mskcc.org.
+ Author Affiliations
We thank Robinson1 for his comments on our editorial, “Is the Easier Way Ever the Better Way?”2
Robinson disagreed with our article on two points. First, he stated
that it is “both disingenuous and unrealistic to… suggest
that fellowship-trained, Board-certified gynecologic
oncologists are not capable of operating on women with advanced ovarian
cancer.” Robinson also expressed concern that we were
suggesting that neoadjuvant chemotherapy (NACT) “somehow represents
a failure on the part of the physicians who are taking
‘the easy way out.'”
To the first point, we did not say that
fellowship-trained, Board-certified gynecologic oncologists are not
capable of operating
on women with advanced ovarian cancer. Rather, we
wanted to highlight that the number of patients who receive suboptimal
debulking
could be reduced by collaboration with other surgical
colleagues. Many gynecologic oncologists partner with urologists for
complex continent urinary conduits after pelvic
exenteration and with plastic surgeons for a myocutaneous flap after
radical
pelvic surgery, for example, and we believe that
patients with ovarian cancer should also be offered the potential
benefit
of subspecialty surgical consultation if it will
improve their overall survival. The complexity of preplanning surgical
consultations
for advanced ovarian cancer debulking surgery should
not be any different than for these other surgical collaborations.
It is incumbent on the gynecologic oncologist to ensure that pressures to minimize operating room and intensive care unit
usage do not compromise the surgical outcome for our patients.........
The author(s) indicated no potential conflicts of interest.