Texte court rédigé à partir de la recommandation nationale de bonnes pratiques cliniques « Conduites à tenir initiales devant des patientes atteintes d’un cancer épithélial de l’ovaire » élaborée par FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY et labélisée par l’INCa »

Vincent Lavoue 1 Cyrille Huchon Cherif Akladios 2 Pascal Alfonsi 3 Naoual Bakrin 4 Marcos Ballester Sofiane Bendifallah 5 Pierre-Adrien Bolze Fabrice Bonnet Charlotte Bourgin Nathalie Chabbert-Buffet 5 Pierre Collinet Blandine Courbiere 6 Thibault de la Motte Rouge 7 Mojgan Devouassoux-Shisheboran 4 Claire Falandry 4 Gwenal Ferron 8 Laure Fournier 9, 10 Laurence Gladieff 11 Francois Golfier Sébastien Gouy 12 Frédérique Guyon 13 Eric Lambaudie 14 Alexandra Leary 15 Fabrice Lecuru 9 Marie-Aude Lefrere-Belda 9, 16 Eric Leblanc 17 Adrien Lemoine Fabrice Narducci 17 Lobna Ouldamer Patricia Pautier 15 François Planchamp 13 Nicolas Pouget Isabelle Ray-Coquard 18 Christine Rousset-Jablonski 18 Claire Senechal-Davin 13 Cyril Touboul Isabelle Thomassin-Naggara Catherine Uzan 5 Benoit You Emile Daraï 5
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).
Document type :
Journal articles
Complete list of metadatas

Cited literature [11 references]  Display  Hide  Download

https://hal-univ-rennes1.archives-ouvertes.fr/hal-02088075
Contributor : Laurent Jonchère <>
Submitted on : Friday, April 12, 2019 - 11:01:28 AM
Last modification on : Wednesday, June 26, 2019 - 2:53:11 PM

File

 Restricted access
To satisfy the distribution rights of the publisher, the document is embargoed until : 2020-04-12

Please log in to resquest access to the document

Identifiers

Citation

Vincent Lavoue, Cyrille Huchon, Cherif Akladios, Pascal Alfonsi, Naoual Bakrin, et al.. Texte court rédigé à partir de la recommandation nationale de bonnes pratiques cliniques « Conduites à tenir initiales devant des patientes atteintes d’un cancer épithélial de l’ovaire » élaborée par FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY et labélisée par l’INCa ». Bulletin du Cancer, John Libbey Eurotext, 2019, 106 (4), pp.354-370. ⟨10.1016/j.bulcan.2019.01.014⟩. ⟨hal-02088075⟩

Share

Metrics

Record views

83