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Management of epithelial ovarian cancer. Short text drafted from the French joint recommendations of FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY and endorsed by INCa
- Source :
- Bulletin du Cancer, Bulletin du Cancer, John Libbey Eurotext, 2019, 106 (4), pp.354-370. ⟨10.1016/j.bulcan.2019.01.014⟩, Bulletin du Cancer, 2019, 106 (4), pp.354-370. ⟨10.1016/j.bulcan.2019.01.014⟩
- Publication Year :
- 2019
- Publisher :
- HAL CCSD, 2019.
-
Abstract
- Faced to an undetermined ovarian mass on ultrasound, an MRI is recommended and the ROMA score (combining CA125 and HE4) can be proposed (grade A). In case of suspected early stage ovarian or fallopian tube cancer, omentectomy (at least infracolonic), appendectomy, multiple peritoneal biopsies, peritoneal cytology (grade C) and pelvic and para-aortic lymphadenectomy are recommended (grade B) for all histological types, except for the expansive mucinous subtype where lymphadenectomy may be omitted (grade C). Minimally invasive surgery is recommended for early stage ovarian cancer, if there is no risk of tumor rupture (grade B). Adjuvant chemotherapy with carboplatin and paclitaxel is recommended for all high-grade ovarian or Fallopian tube cancers, stage FIGO I-IIA (grade A). In case of ovarian, Fallopian tube or primitive peritoneal cancer of FIGO III-IV stages, thoraco-abdomino-pelvic CT scan with injection (grade B) is recommended. Laparoscopic exploration for multiple biopsies (grade A) and to evaluate carcinomatosis score (at least using the Fagotti score) (grade C) are recommended to estimate the possibility of a complete surgery (i.e. no macroscopic residue). Complete medial laparotomy surgery is recommended for advanced cancers (grade B). It is recommended in advanced cancers to perform para-aortic and pelvic lymphadenectomy in case of clinical or radiological suspicion of metastatic lymph node (grade B). In the absence of clinical or radiological lymphadenopathy and in case of complete peritoneal surgery during an initial surgery for advanced cancer, it is possible not to perform a lymphadenectomy because it does not modify the medical treatment and the overall survival (grade B). Primary surgery is recommended when no tumor residue is possible (grade B). After a complete first surgery, it is recommended to deliver 6 cycles of intravenous (grade A) or to propose intraperitoneal (grade B) chemotherapy, to be discussed with patient, according to the benefit/risk ratio. After a complete interval surgery for a FIGO III stage, the hyperthermic intra peritoneal chemotherapy (HIPEC) can be proposed in the same conditions of the OV-HIPEC trial (grade B). In case of tumor residue after surgery or FIGO stage IV, chemotherapy associated with bevacizumab is recommended (grade A).
- Subjects :
- 0301 basic medicine
Cancer Research
medicine.medical_specialty
Bevacizumab
medicine.medical_treatment
Cancer de l’ovaire
Recommandations
[SDV.CAN]Life Sciences [q-bio]/Cancer
Cancer du péritoine primitif
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Laparotomy
medicine
Cancer de la trompe
Radiology, Nuclear Medicine and imaging
Stage (cooking)
Chirurgie
ComputingMilieux_MISCELLANEOUS
Gynecology
business.industry
Hematology
General Medicine
medicine.disease
female genital diseases and pregnancy complications
Carboplatin
3. Good health
030104 developmental biology
medicine.anatomical_structure
Oncology
chemistry
030220 oncology & carcinogenesis
Fallopian tube cancer
Lymphadenectomy
Ovarian cancer
business
Chimiothérapie
medicine.drug
Fallopian tube
Subjects
Details
- Language :
- French
- ISSN :
- 00074551 and 17696917
- Database :
- OpenAIRE
- Journal :
- Bulletin du Cancer, Bulletin du Cancer, John Libbey Eurotext, 2019, 106 (4), pp.354-370. ⟨10.1016/j.bulcan.2019.01.014⟩, Bulletin du Cancer, 2019, 106 (4), pp.354-370. ⟨10.1016/j.bulcan.2019.01.014⟩
- Accession number :
- edsair.doi.dedup.....6ee163a7eefbd668aa01682add29c7b6