Role of Neoadjuvant Chemotherapy in the Management of Stage IIIC-IV Ovarian Cancer Survey Results from the Members of the European Society of Gynecological Oncology
Role of Neoadjuvant Chemotherapy in the Management of Stage IIIC-IV Ovarian Cancer Survey Results from the Members of the European Society of Gynecological Oncology
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DOI：
10.1097/igc.0b013e31823ea1d8
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发表时间：
2012-03-01
影响因子：
4.8
通讯作者：
Vergote, Ignace
中科院分区：
文献类型：
--
作者：
Cornelis, Sarah;Van Calster, Ben;Vergote, Ignace
目的：本研究的目的是评估欧洲妇科肿瘤学会（ESGO）成员目前对IIIC和IV期卵巢癌新辅助化疗（NACT）的看法。方法：向ESGO成员发送3次21项问卷的链接，其中包括有关IIIC和IV期卵巢癌患者管理的问题结果：在469名（40%）回应成员中，70.2%认为有足够的证据使用NACT，然后间隔减积治疗IIIC和IV期卵巢癌。多变量logistic回归分析的基础上，没有观察到NACT和实践类型（P = 0.15）或经验水平（P = 0.41）的证据之间的关系的信念。只有5.3%的受访者从不使用NACT，30%的受访者在不到10%的患者中使用NACT。最佳减积，定义为“无肉眼可见的残留肿瘤”，超过60%的患者在初次减积时报告了20%的受访者，34.6%的受访者在进行间隔减积时报告。根据51.1%的受访者，术前无法确定患者是否可以进行最佳的初次减容。计算机断层扫描（79.4%）和临床检查（72.5%）被认为是预测可手术性的最重要方法。46.3%的受访者使用诊断性腹腔镜检查。选择NACT的最重要原因是上腹部肿块（64.7%）和IV期疾病（58.7%）。结论：在ESGO成员中，70%的人认为有足够的证据证明NACT治疗IIIC-IV期卵巢癌患者，30%的人在不到10%的患者中使用NACT。
Objective: The aim of this study is to evaluate the current opinion of the members of the European Society of Gynecological Oncology (ESGO) on the use of neoadjuvant chemotherapy (NACT) in stage IIIC and IV ovarian cancer.Methods: A link to a 21-item questionnaire, with questions about the management of patients with stage IIIC and IV ovarian cancer, was sent 3 times to the ESGO members (N = 1177).Results: Of the 469 (40%) responding members, 70.2% believe there is sufficient evidence to use NACT followed by interval debulking for the treatment of stage IIIC and IV ovarian cancer. On the basis of a multivariable logistic regression analysis, no relationships between the belief in evidence for NACT and practice type (P = 0.15) or level of experience (P = 0.41) were observed. Only 5.3% of respondents never use NACT, and 30% uses NACT in less than 10% of their patients. Optimal debulking, defined as "no macroscopic residual tumor,'' is reported in more than 60% of the patients by 20% of the respondents at primary debulking, and by 34.6% of the respondents when interval debulking is performed. Whether a patient can be optimally primarily debulked is impossible to determine preoperatively according to 51.1% of the respondents. Computed tomographic scan (79.4%) and clinical examination (72.5%) are regarded as the most important modalities to predict operability. Diagnostic laparoscopy is used by 46.3% of the respondents. The most important reasons for choosing NACT are bulky disease in the upper abdomen (64.7%) and stage IV disease (58.7%).Conclusions: Of the responding ESGO members, 70% believe there is sufficient evidence to treat patients with stage IIIC-IV ovarian cancer with NACT, and 30% uses NACT in less than 10% of their patients.