A questionnaire-based survey on the diagnostic and therapeutic approaches for patients with STIC in Germany

Josche van der Ven; Valerie Catherine Linz; Katharina Anic; Mona Wanda Schmidt; Amelie Loewe; Slavomir Krajnak; Marcus Schmidt; Stefan Kommoss; Barbara Schmalfeldt; Jalid Sehouli; Annette Hasenburg; Marco Johannes Battista

doi:10.1007/s00404-023-06919-8

A questionnaire-based survey on the diagnostic and therapeutic approaches for patients with STIC in Germany

Arch Gynecol Obstet. 2023 Aug;308(2):527-534. doi: 10.1007/s00404-023-06919-8. Epub 2023 Jan 27.

Affiliations

¹ Department of Gynaecology and Obstetrics, University Medical Centre of the Johannes Gutenberg-University Mainz, Langenbeckstreet 1, 55131, Mainz, Rhineland-Palatinate, Germany.
² Department of Gynaecology and Obstetrics, University Medical Centre of the Johannes Gutenberg-University Mainz, Langenbeckstreet 1, 55131, Mainz, Rhineland-Palatinate, Germany. valerie.linz@unimedizin-mainz.de.
³ Department of Women's Health, Tübingen University Hospital, Calwerstreet 7, 72076, Tübingen, Baden-Württemberg, Germany.
⁴ Department of Gynaecology, University Medical Centre Hamburg-Eppendorf, Martinistreet 52, 20251, Hamburg, Germany.
⁵ Department of Gynaecology and Centre of Oncological Surgery, Charité Universitaetsmedizin Berlin Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.

^# Contributed equally.

Abstract

Purpose: Despite the growing understanding of the carcinogenesis of pelvic high-grade serous carcinoma (HGSC) of the ovary and peritoneum and its precursor lesion serous tubal intraepithelial carcinoma (STIC), evidence-based proven recommendations on the clinical management of patients with STIC are lacking so far.

Methods: A questionnaire containing 21 questions was developed to explore the clinical experience with patients with the diagnosis of STICs and the diagnostic, surgical and histopathological approaches in Germany. Overall, 540 clinical heads of department in all German gynaecological centres were asked to participate.

Results: 131 questionnaires (response rate 24.3%) were included in this survey. 45.8% of the respondents had treated one to three STIC patients during their career. 75.6% of the respondents performed opportunistic bilateral salpingectomies during other gynaecological surgeries. Most of the participants (31.3%) started with the SEE-FIM (Sectioning and Extensively Examining the FIMbria) protocol in 2014. It was requested by 39.7% centres for prophylactic salpingectomies, by 13.7% for both prophylactic and opportunistic salpingectomies and by 22.1% for neither of both. 38.2%, 1.5% and 24.4% of the participants would use the laparoscopic, transverse and midline laparotomic approach for a surgical staging procedure, respectively. 25.6% (54.7%) of the respondents recommended a hysterectomy in premenopausal (versus postmenopausal) patients with a STIC, 24.4% (88.4%) a bilateral oophorectomy and 50.0% (4.7%) an affected side oophorectomy (all p values < 0.001). Omentectomy, pelvic and para-aortic lymphadenectomy would be performed by 60.5% (64.0%), 9.3% (11.6%) and 9.3% (11.6%) of respondents in premenopausal (versus postmenopausal) patients (all p values > 0.05).

Conclusion: Our survey highlights significant inconsistency in the management of patients with STIC. Prospective data are urgently needed to elucidate the clinical impact of a STIC lesion and its clinical management.

Keywords: BRCA; Ovarian cancer; SEE-FIM; STIC; Salpingectomy; Serous tubal intraepithelial carcinoma; Survey.

MeSH terms

Carcinoma in Situ* / pathology
Cystadenocarcinoma, Serous* / pathology
Fallopian Tube Neoplasms* / pathology
Female
Humans
Ovarian Neoplasms* / diagnosis
Ovarian Neoplasms* / pathology
Ovarian Neoplasms* / surgery
Prospective Studies
Surveys and Questionnaires