TY - JOUR
T1 - Diagnosis and management of isolated serous tubal intraepithelial carcinoma
T2 - A qualitative focus group study
AU - Consortium STIC focusgroup
AU - Negri, Serena
AU - Fisch, Charlotte
AU - de Hullu, Joanne A.
AU - van Bommel, Majke
AU - Simons, Michiel
AU - Bogaerts, Joep
AU - Apperloo, Mirjam J.A.
AU - Baiocchi, Glauco
AU - Bakker, Janine L.
AU - Bart, Joost
AU - van Beekhuizen, Heleen J.
AU - Bernardini, Marcus Q.
AU - Boere, Ingrid
AU - Bulten, Johan
AU - Chen, Lee may
AU - Chrzan, Alicja
AU - Dørum, Anne
AU - Ewing-Graham, Patricia C.
AU - Ferrero, Annamaria
AU - Flöter Rådestad, Angelique
AU - Fruscio, Robert
AU - Gaarenstroom, Katja N.
AU - Garcia, Christine
AU - Harter, Philipp
AU - Hoogstad-van Evert, Janneke S.
AU - de Iaco, Pierandrea
AU - Klooster, Astrid
AU - Kooreman, Loes F.S.
AU - Jacobsen, Michelle
AU - Kruse, Arnold Jan
AU - Kwon, Janice S.
AU - Lawson, Barrett C.
AU - Lax, Sigurd F.
AU - van Lonkhuijzen, Luc R.C.W.
AU - Lu, Karen H.
AU - Manchanda, Ranjit
AU - Marchetti, Claudia
AU - McCluggage, W. Glenn
AU - McNally, Orla M.
AU - Mourits, Marian J.E.
AU - Nicum, Shibani
AU - Norquist, Barbara M.
AU - Perrone, Anna Myriam
AU - Piek, Jurgen M.J.
AU - Polastro, Laura
AU - Polee, Marco B.
AU - Rabban, Joseph T.
AU - Reesink, Nathalie
AU - Shih, Ie Ming
AU - Stone, Rebecca L.
N1 - Publisher Copyright:
© 2024 The Author(s). BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
PY - 2024/12
Y1 - 2024/12
N2 - 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.
AB - 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.
KW - fallopian tube
KW - ovarian carcinoma
KW - risk reducing salpingo-oophorectomy
KW - serous tubal intraepithelial carcinoma
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U2 - 10.1111/1471-0528.17919
DO - 10.1111/1471-0528.17919
M3 - Article
C2 - 39054407
AN - SCOPUS:85199781527
SN - 1470-0328
VL - 131
SP - 1851
EP - 1861
JO - BJOG: An International Journal of Obstetrics and Gynaecology
JF - BJOG: An International Journal of Obstetrics and Gynaecology
IS - 13
ER -