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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
  1. Sarah Cornelis, MD*,
  2. Ben Van Calster, PhD,,
  3. Frederic Amant, MD, PhD*,
  4. Karin Leunen, MD*,
  5. Ate Gerard Jan van der Zee, MD, PhD§ and
  6. Ignace Vergote, MD, PhD*
  1. * Leuven Cancer Institute, Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, University Leuven;
  2. Department of Electrical Engineering (ESAT-SCD), University Leuven;
  3. Department of Biostatistics, Leuven Cancer Institute, Leuven, Belgium; and
  4. § Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, the Netherlands.
  1. Address correspondence and reprint requests to Ignace Vergote, MD, PhD, Leuven Cancer Institute, Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, University Hospitals Gasthuisberg, University Leuven, Herestraat 49, B-3000 Leuven, Belgium. E-mail: Ignace.Vergote{at}uzleuven.be.

Abstract

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.

  • Advanced ovarian cancer
  • Management
  • Survey
  • European Society of Gynecological Oncology

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Footnotes

  • The authors declare that there are no conflicts of interest.

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