Article Text
Abstract
Introduction/Background Low-grade serous carcinoma (LGSOC) of the ovary is a rare entity. There are significant regional and individual differences in management. This study is unique and possibly the first survey to focus on global variations in management.
Methodology A survey was prepared using the ‘SurveyMonkey’ application and distributed across gynecological oncology groups using social media platforms from 2nd October to 8th November 2022. There were 21 survey questions;6 on demography and 15 on diagnosis and management. Descriptive statistics including frequencies and percentages were used to report data and analyses were performed using SPSS version 25.
Results There were a total of 203 responses from 50 countries across 6 continents. The majority responding to the survey were gynecological oncologists (73.10%). Only 29.56% of institutions used immunohistochemistry along with tissue morphology for diagnosis.55.78%practitioners offered platinum-based Neoadjuvant Chemotherapy for newly diagnosed apparent Stage III C disease seemingly inoperable.44.83% of practitioners offered adjuvant Chemotherapy(±Bevacizumab) followed by hormonal maintenance (HM) for advanced stage after optimal cytoreduction. Letrozole was the preferred drug (63.37%). In recurrent settings not feasible for secondary cytoreduction, there was a lack of consensus on further management. Regarding targeted therapy,83% of practitioners had never used MEK inhibitors in practice. In patients desirous for fertility preservation in sub-optimally staged apparent Stage IA LGSOC, most clinicians (71%) offered completion staging with preservation of the uterus and other ovary followed by observation if histologically confirmed Stage IA. Regarding adjuvant treatment for optimally staged IC disease, there were varied opinions ranging from observation, chemotherapy alone, chemotherapy followed by HM or HM alone. The use of HIPEC in any setting was not favored by the majority (81.26%). A majority (45.32%) of practitioners didn’t offer routine genetic testing in all cases.
Conclusion There are global similarities and disparities regarding the management of LGSOC. These factors may be considered while formulating international guidelines.