REPORT ON SASGO MEETING OF 28 NOVEMBER 2008 HELD IN STELLENBOSCH

SASGO ended 2008 on a high note with a very successful meeting that was made possible with generous sponsorship organised by one of our members Dr George du Toit. The meeting was attended by delegates from all over South Africa active in the field of gynaecological oncology and the afternoon session was attended by many pathologists with an interest in cytology.

The day started with a session on the effect of the HIV pandemic on cervical cancer and HPV related disease and a number of excellent talks were delivered by experts in the field of cervical cancer. The first session was chaired by the emeritus professor Ernie Sonnendecker who added significant depth to the discussion because of his years of experience and study in the field.


Prof E Sonnendecker adds experience

The first talk given by Dr Mani Moodley from the University of Kwa-Zulu Natal on invasive cervical cancer in the HIV infected population, focussed on the strong like between these two very prevalent diseases in South Africa. His talk was followed by a discussion about low-grade squamous intra-epithelial lesions (LSIL) which is a common occurrence in HIV positive patients. Dr Liz Hugo, from Stellenbosch University, argued that HIV may alter the well described course of pre-malignant disease and HIV positive individuals progress quicker to invasive disease and may need closer surveillance.

Dr Arrie Mouton presented interesting data about surgery in HIV positive patients and gave clear guidelines about planning of major surgery in these patients.


From left to right: Prof I Loftus, I le Roux, Dr T Erasmus, Prof G Dreyer, Dr A Mouton

Dr Msibi from the University of Limpopo gave a good summary of the basic science behind the interaction between HIV and HPV infection and concluded that further surveillance and research of the current epidemic of both HPV and HIV is essential.

Prof Franco Guiddozzi from Wits University ended the first morning session with a discussion about the potential benefits of HPV vaccination in the background of the HIV burden in South Africa.

The second session of the morning was chaired by Prof Hennie Cronjè from the University of the Free State who published widely in the field of cervical cancer prevention. The first talk in this session was by Dr Hanna Simonds from Stellenbosch University about treatment of advanced cervical cancer in HIV positive patients. After careful study of the available literature she concluded with recommendations that all patients diagnosed with advanced cervical cancer should be started on HAART therapy at the time of diagnosis before starting with radiotherapy but warned that there may be increased risks of toxicity in this sub-group of patients.


Prof H Cronje chairs a session

Dr Bruce Howard from the University of Cape Town and Dr Trudy Smith from Wits both gave background and suggestions about the management of HPV related vulva conditions. The severe morbidity associated with extensive vulval Condylomata acuminate was clearly demonstrated and suggestions about management were discussed. The discussion after the two talks was lively and highlighted the paucity of effective treatment options available.


From left to right: Proff L Denny, E Sonnendecker and Dr H Van der Merwe

After lunch the topic for discussion was a mini-symposium on liquid-based cytology (LBC). The topic was introduced by two pathologists Dr Judy Whittiker from Cape Town and Dr Thomas Slavic from Pretoria who interpreted the large body of medical literature on this topic. Miss Irene le Roux added a very important perspective from the public sector scenario.This was followed by a lively discussion on the merits or not of liquid-based cytology. This session was attended by many pathologists both in the private and the public sector.


Dr Whittaker and Prof Lindeque in discussion

The conclusion of the LBC discussion will be prepared in a consensus statement.

The day was concluded with a SASGO Annual General Meeting at which time the future planning for SASGO was discussed.

The next meeting will be at the same time as the O&G update conference in Pretoria on 21-23rd May 2009.