Low grade serous carcinomas (LGSC), accounting for approximately 10% of the ovarian tumors, are associated with a better prognosis compared to high-grade serous carcinomas (HGSC). Nevertheless, we are confronted with a challenging treatment, since the median age at diagnosis is younger (55.5 years versus 62.6 years), standard platinum-based chemotherapy is less effective and most importantly, it has still not been as well studied as HGSC. The aim of this survey was to identify the current treatment strategies in Germany.
An anonymous, digital multiple-choice questionnaire, including 38 questions, was developed and provided to gynaecologists, gynaecologic oncologists and oncologists via Internet.
From December 2017 to January 2018, a total of 180 participants took part in the survey (28% head physicians; 46% senior physicians). The median age was 49 years. 53% stated to have more than 15 years of experience in the treatment of cancer patients. No significant difference was seen in the extent of surgery between HGSC and LGSC (answered by 45%). While 88% stated to perform lymphonodectomy (LNE) for diagnostic and prognostic reasons, 69% used LNE as a decision-making tool for adjuvant therapy (answered by 47%). The most important factors for the indication of chemotherapy (answered by 47%) were comorbidities (92%), residual tumor (79%) and tumor histology (77%). While 43% did not consider antihormonal therapy as a treatment option, 39% stated to indicate a therapy with PARP-inhibitors (answered by 47%).
The results of this study underline the uncertainty in the treatment of LGSC. The implementation of own treatment standards and a prospective register for patients with LGSC is necessary and planed.
Clinical trial identification
Legal entity responsible for the study
North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany.
Has not received any funding.
B. Schmalfeldt: Advisor: Roche, Astra Zeneca, Novartis, Tesoro Clovis; Travel support: Roche, AstraZeneca; Research support: MSD, Roche, AstraZeneca. A. du Bois: Advisory board: AstraZeneca, Roche, Pharmamar, Tesaro. All other authors have declared no conflicts of interest.