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301 Management of patients with advanced stage epithelial ovarian cancer: results of a national french survey on current practices in 2021
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  1. L Drouin1,
  2. B Guani2,3,
  3. V Balaya2,
  4. H Azais4,
  5. S Betrian5,
  6. PA Bolze6,
  7. Y Dabi7,
  8. Y Kerbage8,
  9. C Sanson9,
  10. F Zaccarini9,
  11. P Mathevet2,3,
  12. F Lécuru10,
  13. F Guyon11,
  14. C Akladios12,
  15. S Bendifallah13 and
  16. E Deluche14
  1. 1CHU de Limoges, Department of Gynecology, Limoges, France
  2. 2CHUV, Gynecology , Lausanne, Switzerland
  3. 3UNIL, Faculty of Biology and Medicine, Lausanne, Switzerland
  4. 4Georges Pompidou European Hospital, Gynecologic and Breast Oncologic Surgery Department, Paris, France
  5. 5IUCT Oncopole, Department of Médical Oncology , Toulouse, France
  6. 6CHU Lyon Sud, Department of Gynecology, Lyon, France
  7. 7Tenon Hospital, AP-HP, Département of Gynecology, Paris, France
  8. 8Jean de Flandre Hospital, Département of Gynecology, Lille, France
  9. 9Gustave Roussy Institute, Surgical Oncology Department, Villejuif, France
  10. 10Curie Institute, Breast. Gynecology and reconstructive surgery unit, Paris, France
  11. 11Bergonié Institute, Surgical oncology Department, Bordeaux, France
  12. 12University Hospital of Strasbourg, Department of Obstetrics and Gynecology, Strasbourg, France
  13. 13Tenon Hospital AP-HP, Department of Gynecology, Paris, France
  14. 14CHU de Limoges, Department of Medical Oncology, Limoges, France

Abstract

Introduction/Background*The management of ovarian cancer has rapidly become more complex in recent years due to surgical and medical advances. The aim of this study was to assess French current practice in management of patients with advanced epithelial ovarian cancer.

Methodology An anonymous survey was sent to the SFOG, GINECO-ARCAGY and FRANCOGYN members. The survey consisted of 58 items divided in five sections dealing with diagnostic staging, pathological and genetic data, surgical practice patterns, adjuvant/neoadjuvant treatment, and follow-up strategies.

Result(s)*Overall, 107 answers were available. Most of participants were obstetrician-gynecologists (37.4%), surgical oncologists (34.6%), and medical oncologists (17.8%). Most of participants came from University Hospitals (40.2%) and Comprehensive Cancer Center (37.4%).

For 76.8% of respondents, less than 50% of patients are eligible for primary debulking surgery. In case of neoadjuvant chemotherapy, surgical resecability is assessed after 3 cycles for 92.7% of respondents. LION study’s criteria were always applied during primary surgery for 69,5% of respondents. Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is used as a first-line treatment for 41.4% of respondents (26.8% within clinical trial and 14.6% outside) and during interval surgery for 37.8% of respondents.

According to the completeness of cytoreduction surgery and the BRCA mutation status, association of Paclitaxel-Carboplatin (every 3 weeks) is the most used combination as adjuvant chemotherapy for 69.7 to 84.8% of respondents and bevacizumab 15mg/kg is used in case of no residual disease for 52.9 to 61.7 of respondents.

In case of BRCA1-2 mutations, Olaparib is given by 75.8% to 84.8% of respondents. The delay to obtain BRCA germline mutation results is less than 1 month for 26.5% of respondents and less than 3 months for 76.5% of respondents. An Homologous Recombination Repair Deficiency is searched for 73.5% of respondents and mainly by Myriad test (91.3%).

Conclusion*In our study, the rate of HIPEC was high because 2 clinical trials are currently ongoing in France on HIPEC as 1st line treatment.

Our results provide an interesting picture of current management in France in relation to International Guidelines. They provide a basis for further research and raise the question of updating guidelines for ovarian cancer management.

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