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Master Thesis

Recherche des métastases péritonéales microscopiques des cancers épithéliaux de l’ovaire après chirurgie de cytoréduction macroscopiquement complète

Abstract : Epithelial ovarian cancer (EOC) has the highest mortality rate in western countries among gynecological cancers. It is often diagnosed at the stage of peritoneal carcinomatosis. Therapeutic management is based on macroscopic complete cytoreductive surgery (MCCS) and on chemotherapy. One hypothesis explaining the high rate of peritoneal recurrence is the existence of microscopic peritoneal involvement not resected during surgery. The objective of this study is to search for microscopic peritoneal metastases (MPm) in macroscopically healthy peritoneum (MHP) after MCCS for EOC. The secondary objective is to find out whether the MPm express the isoform α of the folate receptor (FRα), a therapeutic target for targeted therapies. This is a descriptive, prospective monocentric cohort study. MHP biopsies are taken at the end of CCMC for CEO. A search for the expression of FRα by immunohistochemistry is carried out on MPm, macroscopic peritoneal metastases and biopsies performed before neoadjuvant chemotherapy. Thirty patients were included, between January the 1st, 2018 and June the 1st, 2019. MPM were identified in 7 patients (23%). 75% of MPm overexpress FRα. A mathematical approach allows us to estimate that the probability of residual microscopic metastases after surgery is close to 100%. Patients with EOC have unresected MPm at MCCS. The presence of MPm is an argument for the development of complementary intracavitary treatments. The overexpression of FRα makes it possible to envisage targeted therapies.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03447370
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Submitted on : Wednesday, November 24, 2021 - 5:21:38 PM
Last modification on : Wednesday, January 5, 2022 - 3:09:10 AM

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  • HAL Id : dumas-03447370, version 1

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Marine Carrier. Recherche des métastases péritonéales microscopiques des cancers épithéliaux de l’ovaire après chirurgie de cytoréduction macroscopiquement complète. Médecine humaine et pathologie. 2020. ⟨dumas-03447370⟩

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