medical guideline

作者： FRANCOGYN (Groupe Français De Recherche En Chirurgie Oncologique Et Gynécologique) Au CNGOF (Collège National Des Gynécologues Obstétriciens Français) À La SFOG (Société Française D’oncologie Gynécologique Et Au Groupe GINECO-ARCAGY (Groupe D’investigateurs Nationaux Pour L’étude Des Cancers Ovariens Et Du Sein – Association De Recherche Sur Les Cancers Dont Gynécologiques) Et Sont Labellisées Par L’INCa (Institut National Du Cancer).

归属分类： 所属人体系统： 其他 | 分类： 腹膜肿瘤

关键词： Transvaginal Ultrasound Is the First-line Examination Allowing Characterizing 80 to 90% of Adnexal Masses (LP1). If Performed by an Expert a Subjective Analysis Is Optimal. If Performed by a Non-expert Combining the Use of Simple Rules with Subjective Analysis Can Achieve the Diagnostic Performance of an Expert (LP1). Whichever the Chosen Model (subjective Analysis by an Expert Or Combination of the Simple Rules with a Subjective Analysis by a Non-expert) a Second-line Examination Will Have to Be Proposed in the Complex Or Indeterminate Cases (about 20% of the Masses) (grade A). the Best-performing Second-line Test for Characterization Is Pelvic MRI (LP1). If Read by an Expert a Pathological Hypothesis Can Or Should Be Suggested (grade D). in Case of Non-expert Reading the Use of the ADNEXMR Score Allows a Reliable Assessment of the Positive Predictive Value of Malignancy to Guide the Patient Towards the Best Management (gradeC). for Preoperative Assessment and Evaluation of Resectability of Ovarian Fallopian Tube Or Primary Peritoneal Cancer It Is Recommended to Perform a Chest Abdomen and Pelvis CT with Contrast Agent Injection (LP2 Grade B). in the Event of a Contraindication to the Injection of Iodinated Contrast Agent (severe Renal Insufficiency GFR <30mL/min) an Abdomen and Pelvis MRI Completed with a Non-injected Chest CT May Be Proposed (LP3 Grade C). by Analogy the Same Examinations Are Recommended to Evaluate the Disease after Neo-adjuvant Chemotherapy (LP3 Recommendation Grade C). Further Studies Will Be Required to Determine Whether PET-CT Provides Better Lymph Node Assessment Before Retroperitoneal and Pelvic Lymphadenectomy. PET-CT May Be Used to Eliminate Lymph Node Involvement in the Absence of Suspicious Lymph Nodes on Morphological Examination (LP3 Grade C). the Report Should Specify the Localizations Leading to a Risk of Incomplete Cytoreductive Surgery and Lesions Outside the Field Explored During Surgery.