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Cervical cancer represents a major public health issue for Latin American countries, with an estimate of 63 056 new cases and 33 443 deaths annually, according to recent GLOBOCAN reports. Unfortunately, most patients are diagnosed with locally advanced stages.
In Perú, the Instituto Nacional de Enfermedades Neoplásicas (INEN), a national tertiary care center, takes care of more than 1500 new patients annually. Only 5% are candidates for surgery with curative intent. The number of radical hysterectomies for cervical cancer at the INEN has remained relatively stable for the last 10 years with 70 cases annually.
Considering these numbers, the call for advanced training to provide cancer care for women living in Latin America is needed because of the regional inequity faced by patients and clinicians in this low- and middle-income region. The disparity in training strategies for gynecologic oncologists in settings where patients suffer from an increased burden of cancer was the leading motivation for developing an in-person academic course, with the aim of showing several surgical techniques used for treatment of cervical cancer. The event took place in the institutional auditorium and in the operating rooms of the INEN in February 2024 (Figure 1).
INEN auditorium with live broadcasts from room 4 radical hysterectomy and room 3 radical hysterectomy with indocyanine green sentinel lymph node.
The course instructors were two professors from Europe and seven from Latin America, and also four physician assistants from the Department of Gynecology Oncology at INEN. There were 24 students (most of whom were gynecologic oncologists) from seven Latin American countries who participated as attendees, but also as surgical assistants in at least one of the surgeries. Ten residents and six fellows of the institute also participated in the course (Figure 2).
Faculty of course and students.
A total of 15 live surgeries were performed and broadcast to the auditorium: eight radical hysterectomies (type B2–C1), one laparoscopic neovagina with sigmoid colon (Figure 3), one total pelvic exenteration, two transperitoneal and one extraperitoneal para-aortic lymphadenectomy, one simple trachelectomy, and one radical trachelectomy. Some of the procedures included sentinel node detection with indocyanine green. Fourteen lectures were also given.
Surgical room, laparoscopic neovagina reconstruction (Dr Ribeiro and Dr Sanchez).
The workshop was endorsed by the European Society of Gynaecological Oncology (ESGO) and the Cancer Society of Perú. This hands-on workshop generated a historical precedent in the region, capable of encouraging new generations to learn the proper management of cervical cancer, which is an important step in promoting local training programs and improving gynecological oncology.
We consider it necessary to hold these meetings on an annual basis, possibly with a broader attendance using online transmission.
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Footnotes
Contributors JFPV: data collection, editing the work to adapt it to a format, searching for information. AL: general supervision of the research group. MSS: intellectual or material support of any kind provided to the work in the research stage or in the article writing. AMG: intellectual or material support of any kind provided to the work in the research stage or in the article writing. VV: design and drawing of photos, critical review.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.