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EP1225 How the conformity of surgical practice with the national guidelines improved the quality of management of ovarian granulosa cell tumors (GCT)? A TMRG and GINECO group study
  1. C Lenck1,
  2. N Chopin1,
  3. S Gouy2,
  4. H Bonsang Kitzis3,
  5. C Martinez Gomez4,
  6. N Radosevic-Robin5,
  7. S Martin6,
  8. C Lefeuvre-Plesse7,
  9. E Lambaudies8,
  10. E Leblanc9,
  11. F Guyon10,
  12. J-M Classe11,
  13. R Ramanah12,
  14. F Beurrier1,
  15. M Angeles-Fite4,
  16. C Pomel13,
  17. F Joly14,
  18. T De La Motte Rouge7,
  19. M Provansal15,
  20. A Lesoin16,
  21. A Floquet17,
  22. D Berton-Rigaud18,
  23. E Kalbacher19,
  24. P Meus1,
  25. F Selle20,
  26. I Treilleux21,
  27. F Lecuru3,
  28. P Pautier22 and
  29. I Ray-Coquard23,24
  1. 1Surgery, Centre Anticancereux Léon Bérard, Lyon
  2. 2Institut Gustave Roussy, Villejuif
  3. 3Surgery, Assistance Publique des Hôpitaux de Paris (AP-HP) Hôpital Georges Pompidou, Paris
  4. 4Surgery, Institut Universitaire du Cancer, Toulouse
  5. 5Pathology, Centre Jean Perrin, Clermont-Ferrand
  6. 6Surgery, Centre Francois Baclesse, Caen
  7. 7Medical Oncology, Centre Eugene Marquis, Rennes
  8. 8Surgery, Institut Paoli Calmettes, Marseille
  9. 9Centre Oscar Lambret, Lille
  10. 10Surgery, Institut Bergonié, Bordeaux
  11. 11Surgery, Institut de Cancérologie de l’Ouest, Nantes
  12. 12Surgery, CHRU de Besancon, Hôpital Jean Minjoz, Besancon
  13. 13Surgery, Centre Jean Perrin, Clermont-Ferrand
  14. 14Medical Oncology, Centre Francois Baclesse, Caen
  15. 15Medical Oncology, Institut Paoli Calmettes, Marseille
  16. 16Medical Oncology, Centre Oscar Lambret, Lille
  17. 17Medical Oncology, Institut Bergonié, Bordeaux
  18. 18Medical Oncology, Institut de Cancérologie de l’Ouest (site René Gauducheau), Nantes
  19. 19Medical Oncology, CHRU de Besancon, Hôpital Jean Minjoz, Besancon
  20. 20Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint Simon, Hôpital de La Croix Saint Simon, Paris
  21. 21Pathology, Centre Anticancereux Léon Bérard, Lyon
  22. 22Medical Oncology, Institut Gustave Roussy, Villejuif
  23. 23Medical Oncology, Centre Anticancereux Léon Bérard
  24. 24University Claude Bernard Lyon 1, Lyon, France


Introduction/Background Surgery is the cornerstone of ovarian Granulosa Cell Tumor (GCT). Complete resection with adequate staging is the gold standard in 1st line setting.

The aim of this study is to assess the impact of an appropriate surgery according to the guidelines.

Methodology This is a nationwide five-year retrospective study, including 463 patients (of the 639 included patients) with a definitive diagnosis of GCT between 2011 and 2016. Medical and surgical practices were analyzed for conformity. Conformity to guidelines was defined by a conservative (unilateral salpingo-oophorectomy) or radical surgery (hysteretomy and bilateral salpingo-oophorectomy) including surgical staging (omentectomy, peritoneal biopsy and peritoneal cytology) according to the FIGO classification.

Results Median age at diagnosis was 49 years old (range 10–89). The median size of tumor was 94 mm (range 5–400). Radical surgery was performed in 240 patients (51,8%), while a fertility-sparing surgery was performed in 98 cases (21,2%). A complete surgical staging was performed in only 76 cases (16,4%). 289 (62.4%) patients received an evaluation of the endometrium (hysterectomy or endometrial curettage).

Surgery was fully compliant with the guidelines in 65 patients (14%), partially compliant in 213 patients (46%), non-compliant in 137 patients (29,6%) and not assessable in 48 cases (10,4%) respectively. A statistically significant improvement in the surgical management was observed among patients treated after 2012 compared to those treated before 2012. This Improvement included: endometrial evaluation (p=0,026), tumour rupture rate during surgery (p=0,010) and the global compliance of the surgery (p<0,001). Survival data will be reported.

Conclusion Staging surgery provides a better assessment and an appropriate treatment of this rare tumors. According to this study, the implementation of a national network and guidelines dedicated to rare gynaecologic tumors seems to significantly improve the surgical management of the patients with GCT.

Disclosure Nothing to disclose.

Abstract EP1225 Figure 1

Progression free survival compared to the surgical conformity

Abstract EP1225 Figure 2

Overall survival compared to the surgical conformity

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