Follow-up of patients treated for an epithelial ovarian cancer, place of hormone replacement therapy and of contraception: Article drafted from the French Guidelines in oncology entitled 'Initial management of patients with epithelial ovarian cancer' developed by FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY under the aegis of CNGOF and endorsed by INCa

摘要

Objectives. - To define follow-up modalities after an epithelial ovarian, tubal or primitive peritoneal cancer. To define possibilities of hormone replacement therapy (HRT) and contraceptive use after treatment. Methods. - Systematic review of the literature in French and English langage conducted on Pubmed/ Medline and the Cochrane Library. Results. - After the treatment of an epithelial ovarian, tubal or primitive peritoneal cancer, symptoms evaluation for follow-up is recommended at 3 months, 6 months, 12 months, 18 months, 24 months, and then yearly (Grade B). Only patients with an initial complete surgery (CCO, without any macroscopic signs of disease), and with a good general condition (ECOG 0) should be followed with paraclinic tests, with a serum HE4 or CA125 concentration measurement, from 6 months after the end of treatments (Grade C). Systematic follow-up with CT of the chest, abdomen, and pelvis is not recommended (Grade C). Imaging test is recommended in case of an increased serum concentration of HE4 or CA125 (Grade B). An HRT should be proposed to women younger than 45 after a non-conservative treatment for a high grade serous (Grade C) or for a mucinous (Grade C) ovarian, tubal or primitive peritoneal adenocarcinoma. HRT is not contra-indicated in women older than 45 presenting a climacteric syndrome after the treatment of a high grade serous (Grade B) or of a mucinous (Grade C) ovarian, tubal or primitive peritoneal adenocarcinoma.