title: [Initial management of advanced ovarian cancer: What radiological, pathological and surgical information are important for optimal therapeutic strategy?].
abstract: Because the majority of patients present advanced disease at diagnosis, the management of epithelial ovarian cancer needs specialist multidisciplinary teamwork. Expertise in surgery, chemotherapy, imaging and histopathology is essential to achieve optimum outcomes. Computed tomography scans are routinely used to determine the extent of disease and to aid in surgical planning. The histologic classification is crucial to plan the best therapeutic strategy and to define the prognosis of disease. Pathological prognostic factors, such as degree of differentiation, FIGO-stage, and histological type have to be described. This report is fundamental to assessing prognosis and selection of appropriate treatment strategy. An adequate staging procedure is an extensive staging by an experienced gynecological oncologist, exploring the entire upper abdomen, and the pelvic and para-aortic lymph node regions to define the Peritoneal Cancer Index (PCI). The final assessment is the completeness of cytoreduction (CC) score, which is an assessment of residual disease after a maximal surgical effort. Initial management of advanced ovarian cancer is best provided by a specialist multidisciplinary team, including a radiologist, a pathologist, a gynecologic oncologist and a medical oncologist.
authors.affiliation: Centre Léon-Bérard, département d'oncologie médicale, 69008 Lyon, France. Electronic address: pierre-etienne.heudel@lyon.unicancer.fr.
authors.forename: Pierre-Etienne
authors.initials: PE
authors.lastname: Heudel
authors.affiliation: Hôpital Tenon, service d'oncologie médicale, 75020 Paris, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Selle
authors.affiliation: Institut Gustave-Roussy, département de chirurgie, 94800 Villejuif, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Morice
authors.affiliation: Institut Curie, département de chirurgie, 75005 Paris, France.
authors.forename: Roman
authors.initials: R
authors.lastname: Rouzier
authors.affiliation: Centre Oscar-Lambret, département d'imagerie médicale, 59000 Lille, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Taieb
authors.affiliation: Hospices civils de Lyon, service d'anatomo-pathologie, 69004 Lyon, France.
authors.forename: Mojgan
authors.initials: M
authors.lastname: Devouassoux-Shisheboran
authors.affiliation: Institut Gustave-Roussy, service d'anatomo-pathologie, 94800 Villejuif, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Genestie
authors.affiliation: Institut Gustave-Roussy, département d'imagerie médicale, 94800 Villejuif, France.
authors.forename: Corinne
authors.initials: C
authors.lastname: Balleyguier
authors.affiliation: Centre Léon-Bérard, département d'oncologie médicale, 69008 Lyon, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Ray-Coquard
mesh_terms: D001706:Biopsy; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003287:Contrast Media; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000628:therapy*; D010053:Ovary / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D003287:Contrast Media
keywords: Advanced ovarian cancer; Bilan d’extension initial; Cancer de l’ovaire avancé; Initial staging; Multidisciplinary team; Équipe pluridisciplinaire