目的:不伴有浸润性癌的浆液性输卵管上皮内癌(STIC)偶尔被发现,并与随后腹膜癌的高风险相关。管理需要优化。这项研究探讨了专业人士对诊断的意见和临床实践,咨询,孤立的STIC的治疗和随访,以促进临床决策和优化未来研究的方向。次要目标是评估国际临床指南。
方法:焦点小组研究。
方法:四个在线会话。
方法:国际妇科医生小组(n=12个国家),妇科肿瘤学家,病理学家和医学肿瘤学家(n=49)。
方法:使用半结构化访谈指南。两名独立的研究人员通过开放和轴向编码分析了转录本。结果按领域进行组织。筛选了有关(国际)国家指南,以提供有关孤立STIC的建议。
方法:专业人员关于孤立的STIC管理的意见和临床实践。
结果:关于病理学,大多数专业人士将SEE-FIM协议确定为高危患者的护理标准,而一般人群输卵管的组织病理学检查存在差异。建议由专业病理学家确认STIC诊断。关于STIC诊断后的工作和随访,有多样性和不和谐。关于结果的数据有限。至于治疗,大多数人不推荐化疗和PARP抑制剂.11条准则提供了有限的建议。
结论:我们确定了建议,并强调了孤立性STIC的诊断和管理方面的知识差距。此外,临床指南中的建议有限.商定有必要进行国际合作,以进行孤立的STIC的预期注册。
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.
METHODS: Focus group study.
METHODS: Four online sessions.
METHODS: 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.
METHODS: 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.