TY - JOUR
T1 - Part I drafted from the short text of the French Guidelines entitled “Initial management of patients with epithelial ovarian cancer” developed by FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY and endorsed by INCa. (Diagnosis management, surgery, perioperative care, and pathological analysis)
AU - Lavoué, V.
AU - Huchon, C.
AU - Akladios, C.
AU - Alfonsi, P.
AU - Bakrin, N.
AU - Ballester, M.
AU - Bendifallah, S.
AU - Bolze, P. A.
AU - Bonnet, F.
AU - Bourgin, C.
AU - Chabbert-Buffet, N.
AU - Collinet, P.
AU - Courbiere, B.
AU - De la Motte Rouge, T.
AU - Devouassoux-Shisheboran, M.
AU - Falandry, C.
AU - Ferron, G.
AU - Fournier, L.
AU - Gladieff, L.
AU - Golfier, F.
AU - Gouy, S.
AU - Guyon, F.
AU - Lambaudie, E.
AU - Leary, A.
AU - Lécuru, F.
AU - Lefrère-Belda, M. A.
AU - Leblanc, E.
AU - Lemoine, A.
AU - Narducci, F.
AU - Ouldamer, L.
AU - Pautier, P.
AU - Planchamp, F.
AU - Pouget, N.
AU - Ray-Coquard, I.
AU - Rousset-Jablonski, C.
AU - Sénéchal-Davin, C.
AU - Touboul, C.
AU - Thomassin-Naggara, I.
AU - Uzan, C.
AU - You, B.
AU - Daraï, E.
N1 - Publisher Copyright:
© 2019 Elsevier Masson SAS
PY - 2019/2/1
Y1 - 2019/2/1
N2 - 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). 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).
AB - 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). 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).
KW - Chemotherapy
KW - Fallopian tube cancer
KW - Guidelines
KW - Ovarian cancer
KW - Peritoneal cancer
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=85060330365&partnerID=8YFLogxK
U2 - 10.1016/j.gofs.2018.12.010
DO - 10.1016/j.gofs.2018.12.010
M3 - Article
C2 - 30686724
AN - SCOPUS:85060330365
SN - 2468-7197
VL - 47
SP - 100
EP - 110
JO - Gynecologie Obstetrique Fertilite et Senologie
JF - Gynecologie Obstetrique Fertilite et Senologie
IS - 2
ER -