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Variability of treatment of locally advanced cervical cancer: How French multidisciplinary teams follow European guidelines?
Sabah, Jonathan; Menoux, Ines; Eberst, Lauriane; Lodi, Massimo; Gantzer, Justine; Azais, Henri; El Hajj, Houssein; Balaya, Vincent; Babin, Guillaume; Espenel, Sophie; Dabi, Yohann; Kissel, Manon; Phuong Lien, Tran; Angeles, Martina Aida; Margueritte, Francois; Deluche, Elise; Marouk, Alexis; Le Borgne, Pierrick; Apithy, Mah-Soune; Laas-Faron, Enora; Akladios, Chérif; Lecointre, Lise.
Afiliación
  • Sabah J; Department of Breast Surgery, European Institute of Cancerology - ICANS, Strasbourg, 2. CHU de Strasbourg, Grand Est, FR, France. Electronic address: jonathan_sabah@yahoo.com.
  • Menoux I; Department of Radiotherapy, European Institute of Cancerology ICANS, Strasbourg, France. Electronic address: i.menoux@icans.eu.
  • Eberst L; ICANS, Strasbourg, France. Electronic address: l.eberst@icans.eu.
  • Lodi M; Department of Breast Surgery, European Institute of Cancerology - Strasbourg, ICANS, France. Electronic address: m.lodi@icans.eu.
  • Gantzer J; ICANS, Strasbourg, France. Electronic address: j.gantzer@icans.eu.
  • Azais H; Hopital Europeen Georges Pompidou, Gynecologic and Breast Oncologic Surgery, 20 rue Leblanc, Paris, Île-de-France, FR, 75015, France. Electronic address: henri.azais@aphp.fr.
  • El Hajj H; Curie Institute Hospital Group, Oncologic Surgery Paris, Île-de-France, FR, France. Electronic address: houssein-elhajj@outlook.com.
  • Balaya V; Hopital Europeen Georges Pompidou, Service de Chirurgie Gynecologique, Cancerologique et du Sein, 25 Rue de Coulmiers, Paris, FR, 75014, France. Electronic address: vbalaya@hotmail.com.
  • Babin G; Institut Bergonié, Department of Surgery, Bordeaux, FR, 33076, France. Electronic address: g.babin@bordeaux.unicancer.fr.
  • Espenel S; Département de Radiothérapie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805, Villejuif, France. Electronic address: sophie.espenel@gustaveroussy.fr.
  • Dabi Y; Assistance Publique - Hopitaux de Paris, Gynecologic Oncology, 4 rue de la Chine, Paris, FR, 75184, France. Electronic address: yohann.dabi@gmail.com.
  • Kissel M; Institut Curie Radiation Oncology Department, Paris, Curie Institute Hospital Group, Radiotherapy, Paris, Île-de-France, FR, France. Electronic address: manonkissel@hotmail.com.
  • Phuong Lien T; University Hospital Reunion South Sites Saint-Pierre, Gynecology Obstetrics Avenue François Mitterrand, Saint-Pierre, RE, 97448, France. Electronic address: phuong.tran@chu-reunion.fr.
  • Angeles MA; Institut Universitaire du Cancer Toulouse Oncopole, Department of Surgical Oncology 1, Avenue Irène Joliot-Curie, Toulouse, FR, 31100, France. Electronic address: martinangeles22@hotmail.com.
  • Margueritte F; Centre Hospitalier Universitaire de Limoges, Gynecology and Obstetrics, 8 Avenue Dominique Larrey, Limoges, FR, 87000, France. Electronic address: fmargueritte@gmail.com.
  • Deluche E; Centre Hospitalier Universitaire de Limoges, Oncologie Médicale, Limoges, FR, France. Electronic address: elise.DELUCHE@chu-limoges.fr.
  • Marouk A; Emergency Department, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Paris, France. Electronic address: alexis.marouk@aphp.fr.
  • Le Borgne P; Structure des Urgences, Hôpitaux Universitaires de Strasbourg, 67000, Strasbourg, France. Electronic address: pierrick.leborgne@chru-strasbourg.fr.
  • Apithy MS; Chirurgie Oncologique, Cotonou, Littoral, Benin. Electronic address: msapithy@gmail.com.
  • Laas-Faron E; Curie Institute Hospital Group, Chirurgie Senologique, Gynécologique et Reconstructrice Paris, Île-de-France, FR, France. Electronic address: enora.laas@curie.fr.
  • Akladios C; Hôpitaux Universitaires de Strasbourg, Department of Gynecology Strasbourg, FR, 67091, France. Electronic address: cherif.akladios@chru-strasbourg.fr.
  • Lecointre L; CHRU de Strasbourg | CHRU Strasbourg Chirurgie Gynécologique, Pôle Gynécologie-Obstétrique, Institute of Image Guided Surgery, IHU-Strasbourg, France; ICube, Laboratoire des Sciences de l'Ingérnieur de l'Informatique et de l'Imagerie, France. Electronic address: lise.lecointre@chru-strasbourg.fr.
Eur J Surg Oncol ; 50(6): 108281, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38642512
ABSTRACT

INTRODUCTION:

Cervical cancer is a global public health concern. Despite ESGO recommendations and FIGO classification changes, management of locally advanced cervical cancer (LACC) remains debated in France. Our study aimed to review LACC treatment practices and assess adherence to ESGO recommendations among different practitioners.

METHODS:

From February 2021 to August 2022, we conducted a survey among gynecologic oncology surgeons, radiation oncologists, and medical oncologists practicing in France and managing LACC (FIGO stages IB3-IVA) according to the 2018 FIGO classification. We analyzed responses against the 2018 ESGO recommendations as a "gold standard."

RESULTS:

Among 115 respondents (56% radiation oncologists, 30% surgeons, 13% medical oncologists), 48.6% of gynecologic surgeons didn't perform para-aortic lymphadenectomy (PAL) with significant radiologic pelvic involvement. PAL, when indicated by PET-CT, was more common in university hospitals (66.7% of surgeons). Surgeons in university hospitals also followed ESGO recommendations more closely. Overall, compliance with all ESGO recommendations was low 5.7% of surgeons, 21.5% of radiation oncologists, and 60% of medical oncologists. Prophylactic para-aortic irradiation, per ESGO, was more frequent in comprehensive cancer centers (52% of radiation oncologists).

CONCLUSION:

Adherence to ESGO recommendations for LACC treatment appears low in France, particularly in surgery, with limited PAL in cases of lymph node negativity on PET-CT. However, these recommendations are more often followed by surgeons in university hospitals and radiation oncologists in cancer centers. Adherence to these recommendations may impact patient survival and warrants evaluation of care quality, justifying the organization of LACC management in expert centers.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pautas de la Práctica en Medicina / Neoplasias del Cuello Uterino / Adhesión a Directriz / Escisión del Ganglio Linfático Límite: Female / Humans País/Región como asunto: Europa Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pautas de la Práctica en Medicina / Neoplasias del Cuello Uterino / Adhesión a Directriz / Escisión del Ganglio Linfático Límite: Female / Humans País/Región como asunto: Europa Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido