System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

English Abstract Journal Article Practice Guideline Ppublish

PubMed: 41620325 DOI: 10.1016/j.bulcan.2025.12.004

[French recommendations for clinical practice, Nice/Saint-Paul-de-Vence 2024-2025: Management of high-grade ovarian epithelial cancer].

Bull Cancer 113(2):191-207

Authors: Frédéric Selle, Manuel Rodrigues, Benoît You, Laurence Gladieff, Anne-Claire Hardy-Bessard, Thibault de la Motte Rouge, Jean-David Fumet, Olivia Le Saux, Pierre-Emmanuel Colombo, Gabriel Ferron, Isabelle Treilleux, Etienne Rouleau, Claire Falandry, Florence Joly, Jean-Sébastien Frénel, Stanislas Quesada, Jean-Marc Classe

Affiliations

  • Département d'oncologie médicale, groupe hospitalier Diaconesses Croix Saint Simon, 125, rue d'Avron, 75020 Paris, France; Intergroupe GINECO, Paris, France.
  • Intergroupe GINECO, Paris, France; Département d'oncologie médicale, institut Curie, Paris, France.
  • Intergroupe GINECO, Paris, France; IC-HCL, CICLY, EPSILYON, CITOHL, Lyon University Hospital, Lyon University, Lyon, France.
  • Intergroupe GINECO, Paris, France; Département d'oncologie médicale, Oncopole Claudius-Regaud, IUCT-Oncopole, Toulouse, France.
  • Oncologie médicale, hôpital privé des Côtes d'Armor, Plérin, France.
  • Intergroupe GINECO, Paris, France; Département d'oncologie médicale, centre Eugène-Marquis, Rennes, France.
  • Intergroupe GINECO, Paris, France; Département d'oncologie médicale, centre Georges-François-Leclerc, Dijon, France.
  • Intergroupe GINECO, Paris, France; Département d'oncologie médicale, centre Léon-Bérard, Lyon, France.
  • Intergroupe GINECO, Paris, France; Département de chirurgie oncologique, institut du cancer de Montpellier (ICM), institut de recherche en cancérologie de Montpellier (IRCM), Montpellier, France.
  • Intergroupe GINECO, Paris, France; Département de chirurgie oncologique, Oncopole Claudius-Regaud - IUCT Toulouse, Toulouse, France.
  • Laboratoire d'anatomie et cytologie pathologiques, CLCC Léon-Bérard, 69008 Lyon, France.
  • Service de génétique des tumeurs, département de biologie médicale et de pathologie, Gustave-Roussy, Inserm U981, Villejuif, France.
  • Intergroupe GINECO, Paris, France; Service de gériatrie du CH Croix-Rousse-Dugoujon, institut du vieillissement, hospices civils de Lyon, Lyon, France; Laboratoire CarMeN de l'Université de Lyon, Inserm U.1060, INRAE U.1397, Université Lyon 1, hospices civils Lyon, Pierre-Bénite, France.
  • Intergroupe GINECO, Paris, France; Département d'oncologie médicale, centre François-Baclesse, 14000 Caen, France.
  • ICO Saint-Herblain, boulevard Jacques-Monod, 44805 Saint-Herblain, France.
  • Département d'oncologie médicale, institut du cancer de Montpellier (ICM), institut de recherche en cancérologie de Montpellier (IRCM), Montpellier, France.
  • Département de chirurgie oncologique, institut de cancérologie de l'Ouest, Nantes, France.

Abstract

The evolution of serous high grade ovarian cancer management is characterized by a more regulated patients' journey on the one hand and the development of new therapeutic options on the other hand, the selection of which is guided by tumor molecular characteristics. Surgery remains the cornerstone of treatment. It can be performed only in authorized expert sites that can demonstrate sufficient experience from highly skilled surgical teams, and quality criteria including prehabilitation and rehabilitation programs. The diagnostic step is crucial; it comprises multiple biopsies that allow reliable pathological and molecular analyses, and a comprehensive surgical staging. Determination of BRCA1/2 mutation and homologous recombination deficiency statuses by validated methods guide maintenance therapy at advanced stages and referring to oncogenetic consultation if appropriate. For these advanced diseases, the two main questions for surgical strategy are the feasibility of complete resection (without residual disease, CC-0), assessed during surgical exploration of pelvis and abdomen, and the optimal timing of this surgery (upfront or after neoadjuvant chemotherapy). In recurrent diseases, surgery remains a main piece of treatment in case of late relapse and medical treatment depends on drugs used in the first line; in early platinum resistant relapse, a new therapeutic option is available with mirvétuximab soravtansine.

MeSH

Ovary, Neoplasms, Rehabilitation, Therapeutics, Carcinoma, Ovarian Epithelial