Borderline Ovarian Tumor Consensus Workshop August 27-28, 2003 Hyatt Regency Bethesda Jules Berman, Ph.D., M.D. Program Director for Pathology Informatics Cancer Diagnosis Program, NCI

Sponsors: NIH Office of Rare Diseases NCI Office of Women’s Health NCI Cancer Diagnosis Program

Special Thanks to: Rebecca Liddell & Pamela Handon Jeff Seidman, Mark Sherman & Ted Trimble Fred Gorstein Sheila Taube, Anna Levy and Mary Demory

Planning Committee: Steven Silverberg (Co-Chair) Robert Kurman Robert Young Elvia Silva

Purpose of Meeting: To reach consensus on a variety of issues related to Borderline Tumors And To identify issues where there is no consensus And To recommend questions worthy of future study And Publish (probably more than one) consensus paper

Should benefit: Clinicians Pathologists Researchers Patients

Consensus: Does not mean debating Does not typically mean voting Does mean getting a sense of where opinions converge and developing a common understanding of the limitations in our understanding and some sort of idea of what questions we need to answer

Behavior at a consensus meeting is different from behavior at other kinds of meetings Need to avoid: Tendency to lose focus Tendency to polarize the group around tenaciously held opinions.

Needs to have: Respected moderators A way to move past a stalemate For each moment, a purpose

Today’s talks: Not really designed to review our state of knowledge of borderline tumors Not intended to give the lecturers an opportunity to discuss their latest research achievements Intended to focus the group on consensus issues

Tomorrow’s charge: 8:00 Planning Committee plus Drs. Seidman and Ronnett will make final decisions on the minimal set of issues to be discussed in breakout sessions. Choose your session. Best chance to add issues to agenda (see handout). In afternoon, session leaders will make presentations followed by more discussion. Publication issues discussion followed by adjournment at 3:00

What kind of people are here today? 1. The hard-core. People who have made a major professional/personal investment in borderline ovarian tumors and who are highly committed to achieving the goals of the conference, for the benefit of their patients and of themselves.

What kind of people are here today? 2. The hopeful. People who are experts in the field (either as clinicians or as pathologists) and who have a sense that something important is likely to be accomplished during the meeting, and they want to be a part of the process.

What kind of people are here today? 3. The watchful. People who are experts in the field and who are skeptical that anything can be achieved by the workshop, but who think that there’s something to be gained by observing the process (includes those confronting their own existential angst).

What kind of people are here today? 4. The judgmental. Government leadership who either helped fund this meeting or who are in the position to fund similar meetings in the future, and who will judge whether pathologists can work as an effective group to produce a scientifically valid consensus report on an historically difficult problem.

Why I believe I am the perfect person to organize this meeting. 1.Unbiased by knowledge of the field 2. Work in a field (Pathology Informatics) sufficiently remote from Gyn-Path that I don’t have to worry about consequences of anyone in this room getting mad at me. 3. Have experience organizing a published consensus meeting 4. Surround myself with people who know what they’re talking about

BUT 3. Protective bubble will break the moment I actually express an opinion on the subject of the borderlines. So I won’t.

Workshop survival tips: Breaks Dinner Check-out tomorrow Lunch tomorrow Adjournment time tomorrow