ESMO-ESGO recommendations for early-stage and borderline ovarian cancer

  • Colombo N & al.
  • Ann Oncol
  • 1 May 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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This is part 1 of a 2-part series on the new ESMO-ESGO recommendations for ovarian cancer.

Takeaway

  • European Society for Medical Oncology (ESMO) and European Society of Gynaecologial Oncology (ESGO) issue recommendations for the management of early-stage and borderline ovarian cancer.

Key recommendations

  • Surgical management:
    • Perform laparotomy for early-stage cancer.
    • Minimally invasive surgery can be performed for restaging.
    • Peritoneal restaging surgery is mandatory.
    • Peritoneal restaging should be considered in cases of incidentally detected, apparently isolated serous tubal intraepithelial carcinoma (STIC) lesions.
    • Surgical staging with systematic lymph node dissection of the pelvic and the paraaortic regions is the standard.
  • Fertility-sparing surgery:
    • Can be offered to all stage IA and IC1 low-grade carcinomas, but not for stage >I.
  • Adjuvant chemotherapy:
    • Recommended for patients with stage I-IIA ovarian cancer.
    • Not recommended for incidentally detected isolated STIC lesions.
    • Carboplatin alone or in combination with paclitaxel is acceptable treatment regimen; ≥3 cycles are recommended.
  • Borderline ovarian tumors (BOTs):
    • Offer fertility-sparing surgery to young patients.
    • Unilateral salpingo-oophorectomy is recommended for mucinous BOTs.
    • Cystectomy may be offered for serous BOTs (sBOTs) to preserve fertility.
    • Perform peritoneal staging surgery for sBOTs.
    • Consider restaging for sBOTs with micropapillary pattern or incomplete visual exploration of the peritoneal cavity.
    • Remove peritoneal implants for staging and therapeutic purposes in sBOTs.
    • Consider fertility-sparing surgery for selected patients with stage II-III sBOTs.

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