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Evaluation of surgical resection in advanced ovarian, fallopian tube, and primary peritoneal cancer: laparoscopic assessment. A European Network of Gynaecological Oncology Trial (ENGOT) group survey
  1. Stefano Greggi1,
  2. Francesca Falcone1,
  3. Cono Scaffa1,
  4. Andreas du Bois2,
  5. Eleftherios Pierre Pierre Samartzis3,
  6. Eric Pujade-Lauraine4,
  7. David Cibula5,
  8. Radoslaw Mądry6,
  9. Jacob Korach7,
  10. Kemal Gungorduk8,
  11. Iain A McNeish9,
  12. Vanna Zanagnolo10,
  13. Christian Marth11,
  14. Anne M van Altena12,
  15. Gerasimos Aravantinos13,
  16. Jalid Sehouli14,
  17. Ignace Vergote15 and
  18. Antonio Gonzalez Martin16
  1. 1 Multicentre Italian Trials in Ovarian cancer and gynecologic malignancies (MITO) Group and Department of Gynecologic Oncology Surgery, Istituto Nazionale Tumori, IRCSS, “Fondazione G. Pascale”, Naples, Italy
  2. 2 Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) Group and Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte gGmbH, Essen, Germany
  3. 3 Swiss Group for Clinical Cancer Research (SAKK) and Department of Gynecology, University Hospital Zurich, Zurich, Switzerland
  4. 4 Groupe des Investigateurs Nationaux pour l'Etude des Cancers de l'Ovaire, gynécologiques et du sein (GINECO) and Department of Medical Oncology, Hôpital Hôtel-Dieu, Université Paris Descartes, Paris, France
  5. 5 Central and Eastern European Gynecologic Oncology Group (CEEGOG) and Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
  6. 6 Polish Gynecologic Oncology Group (PGOG) and Department of Gynecological Oncology, Poznan University of Medical Sciences, Poznan, Poland
  7. 7 Israeli Society of Gynecologic Oncology (ISGO) and Department of Gynecologic Oncology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Tel Aviv, Israel
  8. 8 Turkish Society of Gynecologic Oncology (TRSGO) and Department of Gynecologic Oncology, Mugla Sitki Kocman University, Education and Research Hospital, Mugla, Turkey
  9. 9 National Cancer Research Institute (NCRI) and Department of Surgery and Cancer, Imperial College London, London, United Kingdom
  10. 10 Mario Negri Gynecologic Oncology (MaNGO) Group and Department of Gynecologic Oncology, Istituto Europeo di Oncologia, Milan, Italy
  11. 11 AGO-Austria and Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
  12. 12 Dutch Gynaecological Oncology Group (DGOG) and Department of Obstetrics and Gynecology, Radboud University Medical Centre, Nijmegen, the Netherlands
  13. 13 Ηellenic Cooperative Oncology Group (HeCOG) and Second Department of Medical Oncology, Agii Anargiri Cancer Hospital, Athens, Greece
  14. 14 Nord-Ostdeutsche Gesellschaft für Gynäkologische Onkologie (NOGGO) and Department of Gynecologic Oncology, Charité Comprehensive Cancer Center Berlin, Berlin, Germany
  15. 15 Belgium and Luxembourg Gynaecological Oncology Group (BGOG) and Department of Gynecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
  16. 16 Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Department of Medical Oncology, Clínica Universidad de Navarra, Madrid, Spain
  1. Correspondence to Professor Stefano Greggi, Department of Gynecologic Oncology Surgery, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Naples 80131, Italy; s.greggi{at}istitutotumori.na.it

Abstract

Objective Laparoscopy is one of the diagnostic tools available for the complex clinical decision-making process in advanced ovarian, fallopian tube, and peritoneal carcinoma. This article presents the results of a survey conducted within the European Network of Gynaecological Oncology Trial (ENGOT) group aimed at reviewing the current patterns of practice at gynecologic oncology centers with regard to the evaluation of resection in advanced ovarian, fallopian tube, and peritoneal carcinoma.

Methods A 24-item questionnaire was sent to the chair of the 20 cooperative groups that are currently part of the ENGOT group, and forwarded to the members within each group.

Results A total of 142 questionnaires were returned. Only 39 respondents (27.5%) reported using some form of clinical (not operative) score for the evaluation of resection. The frequency of use of diagnostic laparoscopy to assess disease status and feasibility of resection was as follows: never, 21 centers (15%); only in select cases, 83 centers (58.5%); and routinely, 36 centers (25.4%). When laparoscopy was performed, 64% of users declared they made the decision to proceed with maximal effort cytoreductive surgery based on their personal/staff opinion, and 36% based on a laparoscopic score. To the question of whether laparoscopy should be considered the gold standard in the evaluation of resection, 71 respondents (50%) answered no, 66 respondents (46.5%) answered yes, whereas 5 respondents (3.5%) did not provide an answer.

Conclusions This study found that laparoscopy was routinely performed to assess feasibility of cytoreduction in only 25.4% of centers in Europe. However, it was commonly used to select patients and in a minority of centers it was never used . When laparoscopy was adopted, the treatment strategy was based on laparoscopic scores only in a minority of centers.

  • ovarian neoplasms
  • laparoscopes
  • surgical procedures, operative
  • peritoneal neoplasms
  • fallopian tube neoplasms
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Footnotes

  • Contributors All authors have significantly contributed to paper and they are in agreement with the content of the manuscript; moreover, they declare no financial support or relationships that may pose conflict of interest.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement The authors confirm at all data relevant to the study are included in the article or uploaded as supplementary information.

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