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Rare ovarian tumours: Epidemiology, treatment challenges in and outside a network setting

2017; Elsevier BV; Volume: 45; Issue: 1 Linguagem: Inglês

10.1016/j.ejso.2017.09.025

1532-2157

Isabelle Ray‐Coquard, Annalisa Trama, MJ Seckl, Christina Fotopoulou, Patricia Pautier, Sandro Pignata, Gunnar B. Kristensen, Giorgia Mangili, Henrik Falconer, L.F.A.G. Massuger, Jalid Sehouli, Éric Pujade-Lauraine, Domenica Lorusso, Frédéric Amant, Erik Rokkones, Ignace Vergote, Jonathan A. Ledermann, Monika Hackl, E. Van Eycken, Kris Henau, Nadya Dimitrova, Mario Sekerija, Ladislav Dušek, Margit Mägi, Nea Malila, Maarit K. Leinonen, Michel Velten, Xavier Troussard, Véronique Bouvier, Anne‐Valérie Guizard, Anne–Marie Bouvier, P. Arveux, Marc Maynadié, Anne-Sophie Woronoff, M. Robaszkiewicz, Isabelle Baldi, Alain Monnereau, Brigitte Trétarre, Marc Colonna, F. Molinié, Simona Bara, C. Schvartz, B. Lapôtre‐Ledoux, Pascale Grosclaude, Roland Stabenow, Sabine Luttmann, Alice Nennecke, Jutta Engel, G. Schubert-Fritschle, Jan Heidrich, Bernd Holleczek, Jón G. Jónasson, Kerri M. Clough‐Gorr, Harry Comber, Guido Mazzoleni, Adriano Giacomin, Antonella Sutera Sardo, Alessandro Barchielli, Diego Serraino, Roberta De Angelis, Sandra Mallone, Andrea Tavilla, Daniela Pierannunzio, Silvia Rossi, Mariano Santaquilani, Arnold Knijn, Fabio Pannozzo, Valerio Gennaro, Lucia Benfatto, Paolo Ricci, M. Autelitano, Gianbattista Spagnoli, Mario Fusco, Mario Usala, Francesco Vitale, Maria Michiara, ­Rosario ­Tumino, Lucìa Mangone, Fabio Falcini, Stefano Ferretti, Rosangela Filiberti, Enza Marani, Arturo Iannelli, Flavio Sensi, Silvano Piffer, Maria Gentilini, Anselmo Madeddu, Antonio Ziino, S. Maspero, P. Candela, Fabrizio Stracci, Giovanna Tagliabue, Massimo Rugge, Annalisa Trama, Gemma Gatta, Laura Botta, Riccardo Capocaccia, Santa Pildava, Giedrė Smailytė, Neville Calleja, Tom Børge Johannesen, Jadwiga Rachtan, Stanisław Góźdż, Jerzy Błaszczyk, Kamila Kępska, G. Forjaz de Lacerda, María José Bento, Ana Miranda, Chakameh Safaei Diba, E. Almar, Nerea Larrañaga, Arantza López de Munain, A. Torrella-Ramos, J.M. Díaz García, Rafael Marcos‐Gragera, Maria Josè Sanchez, Carmen Navarro, Diego Salmerón, Conchi Moreno‐Iribas, Jaume Galcerán, Marià Carulla, Seyed Mohsen Mousavi, Christine Bouchardy, Silvia M. Ess, Andrea Bordoni, Isabelle Konzelmann, Jem Rashbass, Anna Gavin, David Brewster, Dyfed Wyn Huws, Otto Visser, Magdalena Bielska-Lasota, Maja Primic‐Žakelj, Ian Kunkler, E Benhamou,

Ectopic Pregnancy Diagnosis and Management

More than 50% of all gynaecological cancers can be classified as rare tumours (defined as an annual incidence of <6 per 100,000) and such tumours represent an important challenge for clinicians.Rare cancers account for more than one fifth of all new cancer diagnoses, more than any of the single common cancers alone. Reviewing the RARECAREnet database, some of the tumours occur infrequently, whilst others because of their natural history have a high prevalence, and therefore appear to be more common, although their incidence is also rare. Harmonization of medical practice, guidelines and novel trials are needed to identify rare tumours and facilitate the development of new treatments. Ovarian tumours are the focus of this review, but we comment on other rare gynaecological tumours, as the diagnosis and treatment challenges faced are similar.This requires European collaboration, international partnerships, harmonization of treatment and collaboration to overcome the regulatory barriers to conduct international trials. Whilst randomized trials can be done in many tumour types, there are some for which conducting even single arm studies may be challenging. For these tumours alternative study designs, robust collection of data through national registries and audits could lead to improvements in the treatment of rare tumours. In addition, concentring the care of patients with rare tumours into a limited number of centres will help to build expertise, facilitate trials and improve outcomes.