Diagnosis and management of isolated serous tubal intraepithelial carcinoma: A qualitative focus group study

IF 4.7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Bjog-An International Journal of Obstetrics and Gynaecology Pub Date : 2024-07-25 DOI:10.1111/1471-0528.17919
Serena Negri, Charlotte Fisch, Joanne A. de Hullu, Majke van Bommel, Michiel Simons, Joep Bogaerts, Consortium STIC focusgroup, Rosella P. M. G. Hermens, Miranda P. Steenbeek
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Abstract

Objective

A Serous Tubal Intraepithelial Carcinoma (STIC) without concomitant invasive carcinoma is occasionally identified and associated with a high risk of subsequent peritoneal carcinomatosis. Management needs optimisation. This study explores professionals' opinions and clinical practices regarding the diagnosis, counselling, treatment and follow-up of isolated STIC to facilitate clinical decision making and optimise the direction of future research. A secondary aim is to assess international clinical guidelines.

Design

Focus group study.

Setting

Four online sessions.

Population

International panel (n = 12 countries) of gynaecologists, gynaecologic oncologists, pathologists and medical oncologists (n = 49).

Methods

A semi-structured interview guide was used. Two independent researchers analysed transcripts by open and axial coding. Results were organised in domains. Relevant (inter)national guidelines were screened for recommendations regarding isolated STIC.

Main Outcome Measures

Professionals' opinions and clinical practices regarding isolated STIC management.

Results

Regarding pathology, most professionals identified the SEE-FIM protocol as standard of care for high-risk patients, whereas variation exists in the histopathological examination of fallopian tubes in the general population. Confirmation of STIC diagnosis by a specialised pathologist was recommended. Regarding work-up and follow-up after STIC diagnosis, there was variety and discordance. Data on outcomes is limited. As for treatment, chemotherapy and PARP inhibitors were not recommended by most. Eleven guidelines provided limited recommendations.

Conclusions

We identified recommendations and highlighted knowledge gaps in the diagnosis and management of isolated STIC. Moreover, recommendations in clinical guidelines are limited. There is an agreed need for international collaboration for the prospective registration of isolated STIC.

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孤立性浆液性输卵管上皮内癌的诊断和管理:焦点小组定性研究。
目的:偶尔会发现无并发浸润性癌的浆液性输卵管上皮内癌(STIC),其后续腹膜癌变的风险很高。需要优化管理。本研究探讨了专业人士对孤立性 STIC 的诊断、咨询、治疗和随访的意见和临床实践,以促进临床决策并优化未来的研究方向。次要目的是评估国际临床指南:设计:焦点小组研究:四次在线会议:国际小组(n = 12 个国家):妇科医生、妇科肿瘤学家、病理学家和肿瘤内科医生(n = 49):采用半结构化访谈指南。两名独立研究人员通过开放式和轴向编码对记录誊本进行了分析。结果按领域进行整理。筛选了相关(跨)国家指南中有关孤立 STIC 的建议:结果:在病理学方面,大多数专业人士认为 SEE-FIM 方案是高危患者的标准治疗方案,而普通人群的输卵管组织病理学检查则存在差异。建议由专业病理学家确认 STIC 诊断。在 STIC 诊断后的检查和随访方面,存在着差异和不一致。有关结果的数据有限。在治疗方面,大多数指南不推荐化疗和 PARP 抑制剂。11份指南提供了有限的建议:我们确定了诊断和管理孤立性 STIC 的建议,并强调了知识差距。此外,临床指南中的建议也很有限。我们一致认为有必要开展国际合作,对孤立性 STIC 进行前瞻性登记。
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来源期刊
CiteScore
10.90
自引率
5.20%
发文量
345
审稿时长
3-6 weeks
期刊介绍: BJOG is an editorially independent publication owned by the Royal College of Obstetricians and Gynaecologists (RCOG). The Journal publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. Its aim is to publish the highest quality medical research in women''s health, worldwide.
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