Pioneering Progress in Gynecologic Oncology: A Career of Many Advancements

As a gynecologic oncology surgeon, Mario M. Leitao, MD, FACOG, FACS, highlights how his career has evolved through using robotic surgery, new fertility preservation techniques, and his contributions to the research field.

Sitting down to speak with Mario M. Leitao Jr, MD, FACOG, FACS, you can feel the passion for his career exude out of him. Having trained extensively to become a gynecologic oncology surgeon, an early adopter of robotic surgery, and innovating new techniques for fertility preservation, Leitao truly followed the right path to this calling.

Leitao, a fellowship director of the Gynecology Service, and director of Minimal Access and Robotic Surgery Program in the Department of Surgery at Memorial Sloan Kettering Cancer Center, and gynecologic malignances editorial advisory board member of ONCOLOGY®, discussed highlights from his career with CancerNetwork® that included working on trials that impacted NCCN guidelines, a co-author of the Diagnosis and Treatment of Rare Gynecologic Cancer, and pioneering uterine transposition surgery. These accomplishments have led to great advances in the gynecologic oncology field, as well as improved quality of life for patients.

“It’s been a fruitful and meaningful experience for me. I wouldn’t change what I did, and I would encourage lots of people to go into this field of [gynecologic cancer]. The future is to minimize the morbidity of surgery while achieving the same, if not better, oncologic outcomes, and we’ve done this,” Leitao said.

An Early Career That Led to Big Advances

A graduate from the University of Medicine and Dentistry of New Jersey/Robert Wood Johnson Medical School, with a residency in obstetrics and gynecology at Beth Israel Medical Center, and a fellowship in gynecologic oncology at MSK, Leitao settled on this specialty because of his interest with surgery and the need for having something more involved or challenging.

When he was on his OBGYN rotation, he felt that this would be a place where he could experience surgery as well as other areas outside of that field. As this idea began to grow, he realized that surgery in the gynecologic oncology space would allow him the opportunity to have a tremendous impact on patients while also focusing on therapeutics and research.

As this space is unique, Leitao was able to mold and shape his career in a way that he wanted. Along the way, he became part of some big changes, and while he notes there is a lot of training involved, he would do it all over again.

In 2006, Leitao conducted his first robotic surgery. Just 1 year earlier, the FDA approved the use of the Da Vinci surgical system for gynecologic surgery.¹ Because of his technique and familiarity with this platform, he was invited back to MSK as faculty to establish the robotic surgery program in 2007.

When he arrived at MSK, there were 8 surgeons who conducted 140 surgeries over the course of a year. In 2024, with 60 surgeons, they were able to complete 4000 surgeries. Currently, they have 11 platforms in use and available to them.

“I’ve pushed the envelope and advanced robotic procedures, and doing very complex things with the robotic platform,” Leitao said.

New Research and the Importance of a Fellowship

At MSK, Leitao also serves as fellowship director, which is something he finds joy in. He wants to expand the knowledge he has gained throughout his years of experience and pass it on to subsequent generations of surgeons.

MSK currently had the only US training program that has received certification from the European Society of Gynecologic Oncology. This is for a 2-year training period where they take an international candidate to learn different procedures in a US setting.

His career has also led him to being a principal investigator on large trials. He spoke about one that is underway (NCT04831580), which is assessing women who are randomly assigned to receive either robotic surgery or open surgery for cervical cancer. Preliminary results from the trials were presented at the 2024 International Gynecologic Cancer Society. Currently, there are only 156 patients of the 840 enrolled.²

Additionally, he and his junior partner are looking at the use of indocyanine green plus sentinel lymph node mapping for patients with vulvar cancer. To date, it is almost enrolled. Furthermore, he has an open prospective trial to look at the use of fluorescein for patients with Paget’s disease of the vulva, which is a rare cancer.

Leitao also wanted to highlight how proud of the work he is with the textbook he cultivated with his colleagues. One such, Michael Frumovitz, MD, who was co-editor and someone Leitao admired. He noted they are going to try and continue with updating the textbook, as it currently is the only one published and specific to rare tumors of the gynecological tract.

A Unique Approach to Fertility Preservation

Finding new and alternative ways to help patients is one of Leitao’s missions. He recently accomplished this by performing a uterine transposition surgery. Uterine transposition surgery is when the ovaries and uterus are temporarily moved into the abdominal wall. This is so it’s moved out of the way from the pelvis and the direct field of radiation. When a patient completes their radiation, a second surgery occurs to move the organs back into place.

This procedure also still allows the woman to conceive after treatment is done, which makes it unique from other fertility sparring techniques like egg freezing.

In December 2020, Leitao completed the first uterine transposition surgery in the US. The surgery is optimal for patients with colorectal cancer who are under the age of 40, have no had previous cancer to the uterus, cervix or ovaries, and no large fibroids or extensive endometriosis.

The baby from this surgery was born in March 2024. Leitao mentioned that he received a Christmas card from the family, and this particular accomplishment in his career is something he is very proud of.

This surgery is also something Leitao doesn’t feel like he should gate keep. He has shared his experience and trained others from around the US and the world about these techniques.

“I think it’s very important to also disseminate what you do and to create techniques that are reproducible, so that lots of [clinicians] can offer to [patients] around the world,” Leitao said.

Finding Ways to Avoid Burnout

While Leitao has a fruitful and fulfilling career, it’s always important to take a step back “in order to keep your sanity”. One highlight of working at MSK is that it is a large group, and while Monday through Friday can be very busy with long days, he has most weekends to himself, aside from occasionally being on call.

He has committed to not working on the weekends. He reserves that time for friends, family, and his kids. You can often find him playing various sports like pickleball, softball, or volleyball. When his kids are home in the summer, he enjoys traveling, or just spending as much time as possible with them.

Overall, the career Leitao has created for himself is intensely meaningful and one he speaks about with pure joy and excitement.

To finish off the conversation, Leitao said it simply but with much enthusiasm, “I really love what I do.”

References

1. Bankar GR, Keoliya A. Robot-assisted surgery in gynecology. Cureus. 2022;14(9):e29190. Published 2022 Sep 15. doi:10.7759/cureus.29190
2. Bixel K, Baiocchi G, Black D, et al. TP001/#1584 GOG-3043 (nct04831580): a randomized non-inferiority trial of robotic versus open surgery for early stage cervical cancer (ROCC). International Journal of Gynecological Cancer. 2024;34(3):A347.
3. Baby Hudson Makes History. Memorial Sloan Kettering Cancer Center. September 3, 2024. Accessed February 11, 2025. https://tinyurl.com/5n8jt4ex