Saurabh Phadnis

Barts Health NHS Trust · Gynaecological Oncology

Background : Parallel panel germline and somatic genetic testing of all patients with ovarian cancer (OC) can identify more pathogenic variants (PVs) that would benefit from PARP inhibitor (PARPi) therapy, and allow for precision prevention in unaffected relatives with PVs. In this study, we estimate the cost-effectiveness and population impact of...

Introduction/Background Cervical Glandular Intraepithelial Neoplasia (CGIN) is a premalignant glandular lesion, commonly regarded as multifocal HPV-associated entity. Due to its higher risk of recurrence, rigorous follow-up is required. We audit the outcomes of CGIN treatment in the outpatient setting in a tertiary cancer centre. Methodology We in...

Introduction/Background P-POSSUM scale has been widely used in predicting peri-operative morbidity and mortality. There is paucity of evidence on P-POSSUM performance in OC cytoreductive surgery. We evaluate P-POSSUM performance in predicting morbidity for OC cytoreductive surgery. We also improve PPSOSSUM performance using a new model incorporatin...

For women achieving clinical remission after the completion of initial treatment for epithelial ovarian cancer, 80% with advanced-stage disease will develop recurrence. However, the standard treatment of women with recurrent platinum-sensitive diseases remains poorly defined. Secondary (SCS), tertiary (TCS) or quaternary (QCS) cytoreduction surgery...

Introduction/Background Approximately 75% of patients diagnosed with ovarian cancer present with advanced stage disease. This may include upper abdominal sites such as the liver, spleen, diaphragm, and upper abdominal lymph nodes. Complete macroscopic cytoreduction should be the goal in ovarian surgery, therefore upper abdominal resections may be a...

Introduction/Background Complete cytoreduction in recurrent epithelial ovarian cancer has been shown to improve progression-free survival and overall survival in recurrent ovarian cancer patients, with minimal impact on quality of life. Discussions revolving around bowel resection and stoma formation are most distressing for patients during pre-ope...

Objective To evaluate patient preference for short (gist) or detailed/extensive decision aids (DA) for genetic testing at ovarian cancer (OC) diagnosis. Design Cohort study set within recruitment to the Systematic Genetic Testing for Personalised Ovarian Cancer Therapy (SIGNPOST) study (ISRCTN: 16988857). Setting North‐East London Cancer Network...

Uterine tumour resembling ovarian sex-cord tumour (UTROSCT): a Case Report

Background The Global Gynecological Oncology Surgical Outcomes Collaborative (GO SOAR) has developed a network of gynecological oncology surgeons, surgical departments, and other interested parties that have the long-term ability to collaborate on outcome studies. Presented is the protocol for the GO SOAR2 study. Primary Objectives To compare surv...

Introduction/Background Genetic-testing at ovarian cancer (OC) diagnosis is recommended in all clinical guidelines. The level of detailed information patients should be provided for informed decision making regarding genetic-testing is unknown. We evaluate patient preference for short or detailed/extensive Decision-Aids (DA) or written information-...

Introduction/Background In advanced ovarian cancer (AOC) optimal cytoreductive surgery, <1 cm visible disease (VD), is associated with improved survival. Survival rates in patients with a suboptimal cytoreduction are equivocal. Surgery can be extensive and associated with significant morbidity and mortality. Tumour resectability and patient co-morb...

Introduction/Background Parallel panel-germline and somatic-testing in all women with ovarian-cancer (OC) identifies more pathogenic-variants (PV) benefitting from poly-ADP-ribose (PARP) inhibitor (PARP-i) therapy, and unaffected PV-relatives for precision prevention. This study aims to estimate cost-effectiveness and population impact of parallel...

We present findings of a cancer multidisciplinary-team (MDT) coordinated mainstreaming pathway of unselected 5-panel germline BRCA1/BRCA2/RAD51C/RAD51D/BRIP1 and parallel somatic BRCA1/BRCA2 testing in all women with epithelial-OC and highlight the discordance between germline and somatic testing strategies across two cancer centres. Patients were...

Background Standard of care in patients with advanced ovarian cancer (AOC) is upfront surgery followed by chemotherapy. Neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS) is an alternative in selected patients. Most data exist with IDS following 3–4 cycles chemotherapy, however, some patients experience a delay of IDS. So far, th...

Pre-eclampsia is a disorder that occurs only during pregnancy and the postpartum period and affects both the mother and the unborn child. Affecting at least 5-8% of all pregnancies, it can be a rapidly progressive condition characterised by hypertension and proteinuria. Oedema, sudden weight gain, headaches and changes in vision are important sympt...

To study the distribution of collagen in the regenerated cervical tissue after excisional treatment for cervical intraepithelial neoplasia (CIN). Cohort study. A large tertiary teaching hospital in London. Women who underwent repeat excisional treatment for treatment failure or persistent CIN. Eligible women who underwent a repeat excisional treatm...

A small proportion of women require repeat treatments for cervical intraepithelial neoplasia (CIN). This study aimed to compare the effectiveness of two cervical excisional techniques offered within a London teaching hospital (large loop excision of the transformation zone (LLETZ) and laser cone biopsy) when carried out as secondary procedures. A s...

To compare two excisional treatments, laser cone biopsy and large loop excision of the transformation zone (LLETZ), in terms of the volume of tissue removed, and to determine the relation between the height and the total volume of the cone specimen. Retrospective cross-sectional study. Large teaching hospital in London. A total of 1136 eligible exc...

Non-menstrual bleeding, either intermenstrual or postcoital, is a common symptom among women. It is often the result of minor alterations of physiological events caused by the influence of endogenous or exogenous hormones. It is frequently also associated with a high degree of anxiety. In this review, the authors outline the causes of non-menstrual...

The mainstay of management of ectopic pregnancies is laparoscopic surgery. Other treatment options include open laparotomy, methotrexate or expectant approach. Recently the Royal College of Obstetricians and Gynaecologists (RCOG) revised its guidelines regarding management of suspected ectopic pregnancies. We undertook a retrospective study looking...

Cervical endometriosis is usually a retrospective finding on histology. We describe the diverse symptomatology of the disease, wherein a suspicion of diagnosis may be raised. A series of five patients with cervical endometriosis confirmed on histology was identified. One patient was asymptomatic but examination revealed a mass arising from the cerv...