Virginie Bund

Preliminary observational study of the implementation of hyperthermic intraperitoneal chemotherapy in ovarian cancer in the gynecological surgery department at the University Hospital of Strasbourg

According to French guidelines, hyperthermic intraperitoneal chemotherapy (HIPEC) can be performed for Federation of Gynecology and Obstetrics stage III primary epithelial ovarian, tubal, and peritoneal cancers that are initially unresectable after 3 or 4 cycles of intravenous chemotherapy. The main objective of this preliminary study was to analyze the components necessary for the establishment of HIPEC in an expert gynecological oncological surgery center. The secondary objective was to compare HIPEC using conventional laparotomy and laparoscopic approaches. We conducted a single-center retrospective study of patients who received HIPEC. All patients who met the criteria of the French HIPEC guidelines were included from 2019 to 2021. Prior to HIPEC, there were a mean of 3.7 courses of neoadjuvant chemotherapy with carboplatin and paclitaxel. Of the 16 patients who received HIPEC, 9 (56.2%) underwent HIPEC laparoscopically, while 7 (43.8%) underwent laparotomy. There were no differences between the rates of intra- and postoperative complications between the two groups. (p > 0.05). The duration of hospitalization was significantly shorter in patients who were operated laparoscopically than in those treated using laparotomy (55.6% <10 days vs. 0 by laparotomy, p = 0.01). There was also a tendency, although not significant, for a more rapid resumption of adjuvant chemotherapy in the laparoscopy group, with 57.1% resuming chemotherapy in <6 weeks compared to 42.9% in the laparotomy group (p = 0.52). This study demonstrates the feasibility of HIPEC in a center with expertise in gynecological surgery when there is a suitable technical platform and close collaboration between the different teams involved. We also showed the first cases of HIPEC using laparoscopy, which seems to be a promising approach.

Status of Surgical Management of Borderline Ovarian Tumors in France: are Recommendations Being Followed? Multicentric French Study by the FRANCOGYN Group

Abstract Background Borderline ovarian tumors (BOTs) are tumors with a favorable prognosis but whose management by consensus is essential to limit the risk of invasive recurrence. This study aimed to conduct an inventory of surgical practices for BOT in France and to evaluate the conformity of the treatment according to the current French guidelines. Methods This retrospective, multicenter cohort study included nine referral centers of France between January 2001 and December 2018. It analyzed all patients with serous and mucinous BOT who had undergone surgery. A peritoneal staging in accordance with the recommendations was defined by performance of a peritoneal cytology, an omentectomy, and at least one peritoneal biopsy. Results The study included 332 patients. A laparoscopy was performed in 79.5% of the cases. Treatment was conservative in 31.9% of the cases. The recurrence rate was significantly increased after conservative treatment (17.3% vs 3.1%; p &lt; 0.001). Peritoneal cytology was performed for 95.5%, omentectomy for 83.1%, and at least one biopsy for 82.2% of the patients. The overall recurrence rate was 7.8%, and the recurrence was invasive in 1.2% of the cases. No link was found between the recurrence rate and the conformity of peritoneal staging. The overall rate of staging noncompliance was 22.9%. Conclusion The current standards for BOT management seem to be well applied.

Presentation of the ENDO-SFOG CAMPUS app: An easy therapeutic decision support app in endometrial cancer created by the French Society of Young Gynecological Oncologists (SFOG Campus)

This study evaluates a new decision support tool-a computer/mobile application designed to align with the latest ESGO guidelines, French practices, and molecular biology data-to aid in decision-making for endometrial cancer management. An observational, multicenter, retrospective study was conducted. It compared management decisions from multidisciplinary tumor boards (MTBs) with those suggested by the application for patients with histologically confirmed endometrial cancer, irrespective of their FIGO stage. Each center included the last 20 cases discussed in multidisciplinary tumor boards between May to December 2022. Thirteen centers participated: eight university hospitals (61.5 %), four cancer centers (30.8 %), and one private center (7.7 %). A total of 259 patients were included, with a mean age of 69 years (range 30-96 years). Most patients had endometrioid tumors (77.2 %), low-grade (62.6 %), FIGO stage IA (41.3 %), no lymphovascular invasion (77.9 %), and a non-specific molecular profile (50.6 %). The application's recommendations matched the MTB decisions 76.6 % of the time. Discrepancies arose mainly from the non-administration of brachytherapy (22.8 %), rare presentations or pathological discordance (22.8 %), and patients' deteriorated conditions precluding standard treatments (19.3 %). The SFOG campus application demonstrates a high concordance with multidisciplinary tumor board decisions, indicating its potential as an efficient, and valuable tool for managing endometrial cancer.