Innovations in pelvic gynecological oncology

Mathieu Luyckx, Violette Warzée, Jean-François Baurain, Filomena Mazzeo, Jean-Luc Squifflet Published in the journal : February 2020 Category : Onco-Gynécologie Pelvienne

The last two years have been prolific in pelvic gynecologic oncology, particularly for ovarian cancer, considering the results of large prospective randomized studies. The first, published in the NEJM by Van Driel et al. in January 2018, revealed for the first time the benefits of hyperthermic intraperitoneal chemotherapy (HIPEC) in the initial management of advanced ovarian cancers. These benefits involved both disease-free survival and overall survival without significantly increasing the surgery’s morbi-mortality. The second, also published in the NEJM in December 2018, demonstrated the undeniable benefits of PARP inhibitors (Olaparib) in the initial management of patients with advanced ovarian cancer carrying a BRCA 1 or 2 mutation. The third study, published in February 2019 by Harter et al., showed quite surprisingly that routine lymphadenectomy during cytoreductive surgery for advanced ovarian cancer (Stage IIB-IV) did not provide any benefits in terms of disease-free survival and overall survival. Even in the lymphadenectomy group, half of the patients exhibited lymphnode involvement. Finally, in September 2019, for two other PARP inhibitors tested in the initial management of advanced ovarian cancer, their indisputable usefulness was confirmed.

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