Leuven Cancer Institute, Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, University Leuven, the Netherlands.
Int J Gynecol Cancer. 2012 Mar;22(3):407-16. doi: 10.1097/IGC.0b013e31823ea1d8.
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.
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).
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%).
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.
本研究旨在评估欧洲妇科肿瘤学会（ESGO）成员对新辅助化疗（NACT）在 IIIIC 期和 IV 期卵巢癌中的应用的现有观点。
向 ESGO 成员（N=1177）发送了一个包含 21 个问题的问卷链接，这些问题涉及 IIIIC 期和 IV 期卵巢癌患者的管理。
在 469 名（40%）应答成员中，70.2%的人认为有足够的证据使用 NACT 后进行间隔减瘤术治疗 IIIIC 和 IV 期卵巢癌。基于多变量逻辑回归分析，对 NACT 的证据的信念与实践类型（P=0.15）或经验水平（P=0.41）之间没有关系。只有 5.3%的应答者从不使用 NACT，30%的应答者在不到 10%的患者中使用 NACT。在初次减瘤术时，有 20%的应答者报告了超过 60%的患者达到了最佳减瘤术，定义为“无肉眼残留肿瘤”，而在进行间隔减瘤术时，有 34.6%的应答者报告了这一结果。根据 51.1%的应答者的说法，是否可以对患者进行最佳的初次减瘤术是无法在术前确定的。79.4%的应答者认为计算机断层扫描（CT）扫描和 72.5%的应答者认为临床检查是预测可操作性的最重要方式。46.3%的应答者使用诊断性腹腔镜检查。选择 NACT 的最重要原因是上腹部肿块性疾病（64.7%）和 IV 期疾病（58.7%）。
在应答的 ESGO 成员中，有 70%的人认为有足够的证据用 NACT 治疗 IIIIC-IV 期卵巢癌患者，而 30%的人在不到 10%的患者中使用 NACT。
