Management of epithelial cancer of the ovary, fallopian tube, primary peritoneum. Long text of the joint French clinical practice guidelines issued by FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY, endorsed by INCa. (Part 2: systemic, intraperitoneal treatment, elderly patients, fertility preservation, follow-up).

Adjuvant chemotherapy by carboplatin and paclitaxel is recommended for all high-grade ovarian and tubal cancers (FIGO stages I-IIA) (grade A). After primary surgery is complete, 6 cycles of intravenous chemotherapy (grade A) are recommended, or a discussion with the patient about intraperitoneal chemotherapy, according to her risk-benefit ratio. After complete interval surgery for FIGO stage III, hyperthermic intraperitoneal chemotherapy (HIPEC) can be proposed, in accordance with the modalities of the OV-HIPEC trial (grade B). In cases of postoperative tumor residue or in FIGO stage IV tumors, chemotherapy associated with bevacizumab is recommended (grade A).

[Part II drafted from the short text of the French guidelines entitled "Initial management of patients with epithelial ovarian cancer" developed by FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY and endorsed by INCa. (Systemic and intraperitoneal treatment, elderly, fertility preservation, follow-up)]. / Partie 2 rédigée à partir de la synthèse de la recommandation nationale de bonnes pratiques cliniques intitulée « Conduites à tenir initiales devant des patientes atteintes d'un cancer épithélial de l'ovaire ¼ élaborée par FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY et labélisée par l'INCa. (Traitement systémique et intrapéritonéal, personnes âgées, préservation de la fertilité et suivi).

Adjuvant chemotherapy with carboplatin and paclitaxel is recommended for all high-grade ovarian or Fallopian tube cancers, stage FIGO I-IIA (grade A). After a complete first surgery, it is recommended to deliver 6 cycles of intravenous (grade A) or to propose intraperitoneal (grade B) chemotherapy, to be discussed with patient, according to the benefit/risk ratio. After a complete interval surgery for a FIGO III stage, the hyperthermic intra peritoneal chemotherapy (HIPEC) can be proposed in the same conditions of the OV-HIPEC trial (grade B). In case of tumor residue after surgery or FIGO stage IV, chemotherapy associated with bevacizumab is recommended (grade A). For BRCA mutated patient, Olaparib is recommended (grade B).

[Should we better inform young women about fertility? A state-of-knowledge study in a student population]. / Faut-il mieux informer les femmes jeunes sur leur fertilité ? Étude des connaissances sur une population d'étudiantes.

OBJECTIVES: To assess midwifery students' knowledge in the field of female fertility and to study their decision if they had diagnosis of diminished ovarian reserve (DOR). SUBJECTS AND METHODS: A prospective observational study by self-administered questionnaire was conducted among female midwifery students of seven French schools from June to December 2013. The questionnaire had three parts: (1) questions designed to gather information on the study population; (2) a questionnaire consisting of 10 items to test knowledge about female fertility and ovarian reserve; (3) a self-administered questionnaire simulating a DOR diagnosis and quantifying the decision that students would make using a Likert scale of 5 points. RESULTS: The participation rate was 72.5% (n=285/393). The average age was 22, 6 years±1.9. Among the 285 participants, the ovarian reserve concept was known by 93% of them (n=265) thanks to the midwifery studies (77%, n=204), the media (9%, n=24) and other sources of information. In total, 83.5% of midwifery students (n=238) were interested in assessing their ovarian reserve, and 48.3% of them were interested in evaluating it immediately (n=115). Among midwifery students, 22.5% of them (n=64) reported that female fertility began to decline from the age of 35 years old; 85.6% (n=244) thought that in vitro fertilization allowed women to conceive if fertility is related to a diminished ovarian reserve; 43.9% (n=125) answered that physical activity and a healthy diet had a beneficial effect on the ovarian reserve. If a DOR was diagnosed to them, 76.8% of students (n=219) would be likely to conceive their first child earlier than expected. Among them, 57.9% (n=165) would agree to have oocyte freezing in this context. CONCLUSION: This study is the first in France that assessed students' knowledge on fertility. We observed: (1) gaps and misconceptions about female fertility despite a medical training in midwifery students; (2) a belief that in vitro fertilization is effective to overcome infertility related to age; (3) that some of these young students would be favorable to oocyte social freezing (technique not allowed in France); (4) that an adequate information on the decrease of fertility with age could lead some students to anticipate their first pregnancy. Specific information regarding the decrease of fertility with age should be offered to all reproductive-aged young women.