Vandré Cabral Gomes Carneiro

Cancer risk‐reducing surgery: Brazilian society of surgical oncology guideline part 1 (gynecology and breast)

AbstractBackgroundRisk‐reducing operations are an important part of the management of hereditary predisposition to cancer. In selected cases, they can considerably reduce the morbidity and mortality associated with cancer in this population.ObjectivesThe Brazilian Society of Surgical Oncology (BSSO) developed this guideline to establish national benchmarks for cancer risk‐reducing operations.MethodsThe guideline was prepared from May to December 2021 by a multidisciplinary team of experts to discuss the surgical management of cancer predisposition syndromes. Fourteen questions were defined and assigned to expert groups that reviewed the literature and drafted preliminary recommendations. Following a review by the coordinators and a second review by all participants, the groups made final adjustments, classified the level of evidence, and voted on the recommendations.ResultsFor all questions including risk‐reduction bilateral salpingo‐oophorectomy, hysterectomy, and mastectomy, major agreement was achieved by the participants, always using accessible alternatives.ConclusionThis and its accompanying article represent the first guideline in cancer risk reduction surgery developed by the BSSO, and it should serve as an important reference for the management of families with cancer predisposition.

Brazilian Society of Surgical Oncology consensus on fertility‐sparing surgery for cervical cancer

AbstractObjectiveSeveral controversies remain on conservative management of cervical cancer. Our aim was to develop a consensus recommendation on important and novel topics of fertility‐sparing treatment of cervical cancer.MethodsThe consensus was sponsored by the Brazilian Society of Surgical Oncology (BSSO) from March 2020 to September 2020 and included a multidisciplinary team of 55 specialists. A total of 21 questions were addressed and they were assigned to specialists' groups that reviewed the literature and drafted preliminary recommendations. Further, the coordinators evaluated the recommendations that were classified by the level of evidence, and finally, they were voted by all participants.ResultsThe questions included controversial topics on tumor assessment, surgical treatment, and surveillance in conservative management of cervical cancer. The two topics with lower agreement rates were the role of minimally invasive approach in radical trachelectomy and parametrial preservation. Additionally, only three recommendations had <90% of agreement (fertility preservation in Stage Ib2, anti‐stenosis device, and uterine transposition).ConclusionsAs very few clinical trials have been developed in surgery for cervical cancer, most recommendations were supported by low levels of evidence. We addressed important and novel topics in conservative management of cervical cancer and our study may contribute to literature.