JCO open access: Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer

open access:
August 8, 2016
Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: Society of Gynecologic Oncology and American Society of Clinical Oncology Clinical Practice Guideline

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1. Top
2. Abstract
3. INTRODUCTION
4. GUIDELINE QUESTIONS
5. METHODS
6. RESULTS
7. RECOMMENDATIONS
8. PATIENT AND CLINICIAN COMMUNICATION
9. HEALTH DISPARITIES
10. MULTIPLE CHRONIC CONDITIONS
11. COST IMPLICATIONS
12. EXTERNAL REVIEW
13. GUIDELINE IMPLEMENTATION
14. FUTURE DIRECTIONS
15. AUTHOR CONTRIBUTIONS
16. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST
17. Acknowledgment
18. Appendix
19. Footnotes
20. REFERENCES

 Recommendations All women with suspected stage IIIC or IV invasive epithelial ovarian cancer should be evaluated by a gynecologic oncologist prior to initiation of therapy. The primary clinical evaluation should include a CT of the abdomen and pelvis, and chest imaging (CT preferred). Women with a high perioperative risk profile or a low likelihood of achieving cytoreduction to < 1 cm of residual disease (ideally to no visible disease) should receive neoadjuvant chemotherapy. Women who are fit for primary cytoreductive surgery, and with potentially resectable disease, may receive either neoadjuvant chemotherapy or primary cytoreductive surgery. However, primary cytoreductive surgery is preferred if there is a high likelihood of achieving cytoreduction to < 1 cm (ideally to no visible disease) with acceptable morbidity. Before neoadjuvant chemotherapy is delivered, all patients should have confirmation of an invasive ovarian, fallopian tube, or peritoneal cancer. Additional information is available at www.asco.org/NACT-ovarian-guideline and www.asco.org/guidelineswiki.