ASCO and SGO issue new guidelines for the treatment of ovarian cancer

By Liz Meszaros, MDLinx
Published August 16, 2016

Key Takeaways

The American Society of Clinical Oncology (ASCO) and the Society of Gynecologic Oncology (SGO) have issued a joint clinical practice guideline on the treatment of ovarian cancer, with evidence-based recommendations on the choice between neoadjuvant chemotherapy (NACT) or surgery as initial treatment in women with stage IIIC and IV epithelial ovarian cancers. The guidelines are published in the August 8, 2016 issue of Gynecologic Oncology and the Journal of Clinical Oncology.

Experts in gynecologic oncology and medical oncology formed the multidisciplinary panel charged with developing these guideline recommendations. To provide a balanced patient perspective, the panel also included a patient advocacy representative. In developing these guidelines, panel members performed a systematic review of all literature published from March 20, 2005, through March 20, 2015.

“This guideline is a big step forward in one of the most contentious areas within gynecologic oncology,” said Alexi A. Wright, MD, MPH, co-chair and ASCO’s representative on the expert panel that developed the guideline. “It provides clear recommendations to help patients and physicians make more evidence-based and informed decisions when women are first diagnosed with ovarian cancer.”

The following are some of the key guideline recommendations:

  • A gynecologic oncologist should evaluate all women with suspected stage IIIC or IV invasive epithelial ovarian cancer before treatment initiation to determine whether they are candidates for primary cytoreductive surgery (PCS).
  • Women with a high perioperative risk profile or a low likelihood of achieving cytoreduction to less than 1 cm (ideally to no visible disease) should receive NACT.
  • Women who are fit for PCS, with potentially resectable disease, may receive either NACT or PCS.
  • For women with a high likelihood of achieving cytoreduction to less than 1 cm (ideally to no visible disease), PCS is recommended over NACT.
  • For women who are fit for PCS but are deemed by a gynecologic oncologist as unlikely to have cytoreduction to less than 1 cm (ideally to no visible disease), NACT is recommended over PCS.

“This guideline represents an important collaboration between the SGO and ASCO,” said Mitchell I. Edelson, MD, co-chair and SGO’s representative on the Expert Panel that developed the guideline. “These evidence-based recommendations will improve the quality of care provided to women with ovarian cancer.”

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