Management of epithelial cancer of the ovary, fallopian tube, and primary peritoneum. Long text of the Joint French Clinical Practice Guidelines issued by FRANCOGYN, CNGOF, SFOG, and GINECO-ARCAGY, and endorsed by INCa. Part 1: Diagnostic exploration and staging, surgery, perioperative care, and pathology

Lavoué, Vincent; Huchon, Cyrille; Akladios, Chérif; Alfonsi, Pascal; Bakrin, Naoual; Ballester, Marcos; Bendifallah, Sofiane; Bolze, Pierre Adrien; Bonnet, Fabrice; Bourgin, Charlotte; Chabbert-Buffet, Nathalie; Collinet, Pierre; Courbière, Blandine; Rouge, Thibault De La Motte; Devouassoux‐Shisheboran, Mojgan; Falandry, Claire; Ferron, G; Fournier, Laure; Gladieff, Laurence; Golfier, François; Gouy, Sébastien; Guyon, Frédéric; Lambaudie, Éric; Leary, Alexandra; Lécuru, Fabrice; Lefrère-Belda, Marie-Aude; Leblanc, Éric; Lemoine, Adrien; Narducci, Fabrice; Ouldamer, Lobna; Pautier, Patricia; Planchamp, François; Pouget, Nicolas; Ray-Coquard, I.; Rousset‐Jablonski, Christine; Senechal-Davin, C; Touboul, Cyril; Thomassin‐Naggara, Isabelle; Uzan, Catherine; You, Benoît; Daraı̈, Émile

doi:10.1016/j.jogoh.2019.03.017

Cited by 30 publications

(31 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Macroscopic complete CRS included at least peritoneal cytology, total hysterectomy, bilateral salpingo-oophorectomy, infragastric omentectomy, appendectomy, and other surgical procedures allowing the removal of all visible suspicious peritoneal lesions. Pelvic and para-aortic lymphadenectomy were performed according to the recommendations [ 17 ] and the results of the LION study [ 18 ]. When there was no suspicion of radiological lymph node involvement during initial management or at palpation during surgery, we did not perform routine lymphadenectomy.…”

Section: Methodsmentioning

confidence: 99%

Microscopic Peritoneal Residual Disease after Complete Macroscopic Cytoreductive Surgery for Advanced High Grade Serous Ovarian Cancer

Azaïs

Vignion-Dewalle

Carrier

et al. 2020

JCM

View full text Add to dashboard Cite

Background: Epithelial ovarian cancers (EOC) are usually diagnosed at an advanced stage and managed by complete macroscopic cytoreductive surgery (CRS) and systemic chemotherapy. Peritoneal recurrence occurs in 60% of patients and may be due to microscopic peritoneal metastases (mPM) which are neither eradicated by surgery nor controlled by systemic chemotherapy. The aim of this study was to assess and quantify the prevalence of residual mPM after complete macroscopic CRS in patients with advanced high-grade serous ovarian cancer (HGSOC). Methods: A prospective study conducted between 1 June 2018 and 10 July 2019 in a single referent center accredited by the European Society of Gynecological Oncology for advanced EOC management. Consecutive patients presenting with advanced HGSOC and eligible for complete macroscopic CRS were included. Up to 13 peritoneal biopsies were taken from macroscopically healthy peritoneum at the end of CRS and examined for the presence of mPM. A mathematical model was designed to determine the probability of presenting at least one mPM after CRS. Results: 26 patients were included and 26.9% presented mPM. There were no differences in characteristics between patients with or without identified mPM. After mathematical analysis, the probability that mPM remained after complete macroscopic CRS in patients with EOC was 98.14%. Conclusion: Microscopic PM is systematically present after complete macroscopic CRS for EOC and could be a relevant therapeutic target. Adjuvant locoregional strategies to conventional surgery may improve survival by achieving microscopic CRS.

show abstract

Section: Methodsmentioning

confidence: 99%

Microscopic Peritoneal Residual Disease after Complete Macroscopic Cytoreductive Surgery for Advanced High Grade Serous Ovarian Cancer

Azaïs

Vignion-Dewalle

Carrier

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…To our knowledge, there are no specific tumor markers for the diagnosis of PFTC 6,22 . In this study, the preoperative CA125 levels were normal in half of the patients with Stage I/II PFTC.…”

Section: Discussionmentioning

confidence: 50%

Clinical characteristics of primary Fallopian tube carcinoma: A single‐institution retrospective study of 57 cases

Gao

et al. 2020

Intl J Gynecology & Obste

View full text Add to dashboard Cite

Objective To analyze the clinical profile and prognosis of primary Fallopian tube cancer (PFTC) in order to improve earlier diagnosis. Methods In this retrospective study, 57 women with PFTC were assessed from 2006 to 2016. Pathology, clinical index, recurrence, and survival were analyzed. Results Mean age was 57.35 ± 9.01 years, and 73% (19/26) of the patients with early‐stage PFTC (I/II) were aged less than 60 years. Of patients who presented with abnormal vaginal bleeding, 75% (9/12) were at an early stage and their condition was often misdiagnosed as endometrial carcinoma preoperatively. In patients with Stages I/II and Stages III/IV PFTC, 59.09% (13/22) and 96.43% (27/28), respectively, had adnexal masses on color Doppler ultrasonography. The 5‐year overall survival (OS) and disease‐free survival rates were 69.23% and 44.23%, respectively, and univariate analysis showed that tumor stage and residual tumor size significantly affected the two survival rates. Conclusion Primary Fallopian tube cancer is more likely to be misdiagnosed in patients aged less than 60 years or those presenting with vaginal bleeding at the premenopausal stage. Magnetic resonance imaging, cervical smear, and endometrial brush may be helpful for early PFTC diagnosis. Satisfactory cytoreductive surgery is critical because tumor stage and residual tumor size are significantly associated with the OS rate.

show abstract

“…Most of the adnexal masses found by transvaginal ultrasound (TVU) or other imaging techniques such as computer tomography (CT) are not cancer. To be certain, surgical resection of the ovaries or the ovarian tumor is advised, often together with a complete staging that includes hysterectomy, omentectomy, lymph node sampling, and random peritoneal biopsies [1]. The established biomarker serum cancer antigen 125 (CA125) and the algorithms such as risk of malignancy index (RMI) and risk of ovarian malignancy algorithm (ROMA), which also include serum human epididymis 4 (HE4), have increased our ability to triage women to the correct level of care.…”

Section: Introductionmentioning

confidence: 99%

“…After the discovery of HE4, a TVU-independent triage by ROMA was described combining CA125, HE4, and menopausal status [16]. In larger studies, RMI and ROMA are equally good but have individual differences [1].Serum CA125, a parameter in RMI and ROMA, is currently one of the best biomarkers to detect the most common subtype of EOC, high grade serous ovarian cancer (HGSC), in women above 50 years of age [17]. CA125 has several disadvantages when used as a biomarker in younger women since it is elevated due to inflammation, pregnancy, and endometriosis [18].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Increased Diagnostic Accuracy of Adnexal Tumors with A Combination of Established Algorithms and Biomarkers

Lycke

Ulfenborg

Kristjánsdóttir

et al. 2020

JCM

View full text Add to dashboard Cite

Ovarian cancer is the most lethal gynecologic cancer. Pre-diagnostic testing lacks sensitivity and specificity, and surgery is often the only way to secure the diagnosis. Exploring new biomarkers is of great importance, but the rationale of combining validated well-established biomarkers and algorithms could be a more effective way forward. We hypothesized that we can improve differential diagnostics and reduce false positives by combining (a) risk of malignancy index (RMI) with serum HE4, (b) risk of ovarian malignancy algorithm (ROMA) with a transvaginal ultrasound score or (c) adding HE4 to CA125 in a simple algorithm. With logistic regression modeling, new algorithms were explored and validated using leave-one-out cross validation. The analyses were performed in an existing cohort prospectively collected prior to surgery, 2013–2016. A total of 445 benign tumors and 135 ovarian cancers were included. All presented models improved specificity at cut-off compared to the original algorithm, and goodness of fit was significant (p < 0.001). Our findings confirm that HE4 is a marker that improves specificity without hampering sensitivity or diagnostic accuracy in adnexal tumors. We provide in this study “easy-to-use” algorithms that could aid in the triage of women to the most appropriate level of care when presenting with an unknown ovarian cyst or suspicious ovarian cancer.

show abstract

Cited by 30 publications

References 0 publications

Microscopic Peritoneal Residual Disease after Complete Macroscopic Cytoreductive Surgery for Advanced High Grade Serous Ovarian Cancer

Microscopic Peritoneal Residual Disease after Complete Macroscopic Cytoreductive Surgery for Advanced High Grade Serous Ovarian Cancer

Clinical characteristics of primary Fallopian tube carcinoma: A single‐institution retrospective study of 57 cases

Increased Diagnostic Accuracy of Adnexal Tumors with A Combination of Established Algorithms and Biomarkers

Contact Info

Product

Resources

About