This issue of the Obstetrics and Gynecology Clinics provides an update in Gynecologic Oncology.? Vulvar/Vaginal, cervical, uterine, and ovarian cancer are all covered, along with early detection and screening, and genetics and hereditary risk.? There is also an article on trends in cancer care in North America, which discusses cancer care and cost and sustainability as well as practice evloution.

In consultation with Dr. William Rayburn, Dr. Muller has put together an issue designed to educate the reader on the rapid progress in Gynecologic Cancer Care. More than any other field in obstetrics and gynecology, gynecologic oncology has seen an explosion in integrated drug development and technology, including personalized medicine, germline and somatic testing, targeted therapeutics, biologic and immunotherapies, improved robotic technology, and a paradigm shift towards "less is more." Evolving data in quality measures including enhanced surgical recovery, integrative palliative care, and survivorship management has strengthened the need for a seemless team approach to the care of our patients. Despite the complexity and rapid discoveries leading to significant change in practice, the dedication to patients is the driver to stay up to date and participate in the research and clinical trials that lead to the cancer care advances that are substantial in this update. Expert authors have contributed articles on the following topics: Trends in Gynecologic Cancer Care in North America: Safety, Value and Quality; Cancer Screening and Prevention Highlights in Gynecologic Cancer; Germline and Somatic Tumor Testing in Gynecologic Cancer Care; Less is More: Minimally Invasive and Quality Surgical Management of Gynecologic Cancer; Ovarian Cancer: Clinical Trial Breakthroughs and Impact on Management; Endometrial Cancer: Obesity, Genetics and Targeted Trials; Cervical Cancer: A Global and Access to Care Crisis; Vulvar and Vaginal Cancer; Gestational Trophoblastic Neoplasia; Chemotherapy, Biologic and Immunotherapy Breakthroughs in Cancer Care; Palliative Care in Gynecologic Oncology; Personalized Medicine in Gynecologic Cancer: Fact or Fiction; and Survivorship Care in Gynecologic Cancer.