Assessment of Adult Women With Ovarian Masses and Treatment of Epithelial Ovarian Cancer: ASCO Resource-Stratified Guideline
To provide expert guidance to clinicians and policymakers in three resource-constrained settings on diagnosis and staging of adult women with ovarian masses and treatment of patients with epithelial ovarian (including fallopian tube and primary peritoneal) cancer. A multidisciplinary, multinational...
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| Vydané v: | JCO global oncology Ročník 7; číslo 7; s. 1032 - 1066 |
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| Hlavní autori: | , , , , , , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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United States
Wolters Kluwer Health
01.06.2021
American Society of Clinical Oncology |
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| ISSN: | 2687-8941, 2687-8941 |
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| Abstract | To provide expert guidance to clinicians and policymakers in three resource-constrained settings on diagnosis and staging of adult women with ovarian masses and treatment of patients with epithelial ovarian (including fallopian tube and primary peritoneal) cancer.
A multidisciplinary, multinational ASCO Expert Panel reviewed existing guidelines, conducted a modified ADAPTE process, and conducted a formal consensus process with additional experts.
Existing sets of guidelines from eight guideline developers were found and reviewed for resource-constrained settings; adapted recommendations from nine guidelines form the evidence base, informing two rounds of formal consensus; and all recommendations received ≥ 75% agreement.
Evaluation of adult symptomatic women in all settings includes symptom assessment, family history, and ultrasound and cancer antigen 125 serum tumor marker levels where feasible. In limited and enhanced settings, additional imaging may be requested. Diagnosis, staging, and/or treatment involves surgery. Presurgical workup of every suspected ovarian cancer requires a metastatic workup. Only trained clinicians with logistical support should perform surgical staging; treatment requires histologic confirmation; surgical goal is staging disease and performing complete cytoreduction to no gross residual disease. In first-line therapy, platinum-based chemotherapy is recommended; in advanced stages, patients may receive neoadjuvant chemotherapy. After neoadjuvant chemotherapy, all patients should be evaluated for interval debulking surgery. Targeted therapy is not recommended in basic or limited settings. Specialized interventions are resource-dependent, for example, laparoscopy, fertility-sparing surgery, genetic testing, and targeted therapy. Multidisciplinary cancer care and palliative care should be offered.Additional information can be found at www.asco.org/resource-stratified-guidelines. It is ASCO's view that health care providers and health care system decision makers should be guided by the recommendations for the highest stratum of resources available. The guideline is intended to complement but not replace local guidelines. |
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| AbstractList | PURPOSETo provide expert guidance to clinicians and policymakers in three resource-constrained settings on diagnosis and staging of adult women with ovarian masses and treatment of patients with epithelial ovarian (including fallopian tube and primary peritoneal) cancer.METHODSA multidisciplinary, multinational ASCO Expert Panel reviewed existing guidelines, conducted a modified ADAPTE process, and conducted a formal consensus process with additional experts.RESULTSExisting sets of guidelines from eight guideline developers were found and reviewed for resource-constrained settings; adapted recommendations from nine guidelines form the evidence base, informing two rounds of formal consensus; and all recommendations received ≥ 75% agreement.RECOMMENDATIONSEvaluation of adult symptomatic women in all settings includes symptom assessment, family history, and ultrasound and cancer antigen 125 serum tumor marker levels where feasible. In limited and enhanced settings, additional imaging may be requested. Diagnosis, staging, and/or treatment involves surgery. Presurgical workup of every suspected ovarian cancer requires a metastatic workup. Only trained clinicians with logistical support should perform surgical staging; treatment requires histologic confirmation; surgical goal is staging disease and performing complete cytoreduction to no gross residual disease. In first-line therapy, platinum-based chemotherapy is recommended; in advanced stages, patients may receive neoadjuvant chemotherapy. After neoadjuvant chemotherapy, all patients should be evaluated for interval debulking surgery. Targeted therapy is not recommended in basic or limited settings. Specialized interventions are resource-dependent, for example, laparoscopy, fertility-sparing surgery, genetic testing, and targeted therapy. Multidisciplinary cancer care and palliative care should be offered.Additional information can be found at www.asco.org/resource-stratified-guidelines. It is ASCO's view that health care providers and health care system decision makers should be guided by the recommendations for the highest stratum of resources available. The guideline is intended to complement but not replace local guidelines.[Media: see text] To provide expert guidance to clinicians and policymakers in three resource-constrained settings on diagnosis and staging of adult women with ovarian masses and treatment of patients with epithelial ovarian (including fallopian tube and primary peritoneal) cancer. To provide expert guidance to clinicians and policymakers in three resource-constrained settings on diagnosis and staging of adult women with ovarian masses and treatment of patients with epithelial ovarian (including fallopian tube and primary peritoneal) cancer. A multidisciplinary, multinational ASCO Expert Panel reviewed existing guidelines, conducted a modified ADAPTE process, and conducted a formal consensus process with additional experts. Existing sets of guidelines from eight guideline developers were found and reviewed for resource-constrained settings; adapted recommendations from nine guidelines form the evidence base, informing two rounds of formal consensus; and all recommendations received ≥ 75% agreement. Evaluation of adult symptomatic women in all settings includes symptom assessment, family history, and ultrasound and cancer antigen 125 serum tumor marker levels where feasible. In limited and enhanced settings, additional imaging may be requested. Diagnosis, staging, and/or treatment involves surgery. Presurgical workup of every suspected ovarian cancer requires a metastatic workup. Only trained clinicians with logistical support should perform surgical staging; treatment requires histologic confirmation; surgical goal is staging disease and performing complete cytoreduction to no gross residual disease. In first-line therapy, platinum-based chemotherapy is recommended; in advanced stages, patients may receive neoadjuvant chemotherapy. After neoadjuvant chemotherapy, all patients should be evaluated for interval debulking surgery. Targeted therapy is not recommended in basic or limited settings. Specialized interventions are resource-dependent, for example, laparoscopy, fertility-sparing surgery, genetic testing, and targeted therapy. Multidisciplinary cancer care and palliative care should be offered.Additional information can be found at www.asco.org/resource-stratified-guidelines. It is ASCO's view that health care providers and health care system decision makers should be guided by the recommendations for the highest stratum of resources available. The guideline is intended to complement but not replace local guidelines. To provide expert guidance to clinicians and policymakers in three resource-constrained settings on diagnosis and staging of adult women with ovarian masses and treatment of patients with epithelial ovarian (including fallopian tube and primary peritoneal) cancer.PURPOSETo provide expert guidance to clinicians and policymakers in three resource-constrained settings on diagnosis and staging of adult women with ovarian masses and treatment of patients with epithelial ovarian (including fallopian tube and primary peritoneal) cancer.A multidisciplinary, multinational ASCO Expert Panel reviewed existing guidelines, conducted a modified ADAPTE process, and conducted a formal consensus process with additional experts.METHODSA multidisciplinary, multinational ASCO Expert Panel reviewed existing guidelines, conducted a modified ADAPTE process, and conducted a formal consensus process with additional experts.Existing sets of guidelines from eight guideline developers were found and reviewed for resource-constrained settings; adapted recommendations from nine guidelines form the evidence base, informing two rounds of formal consensus; and all recommendations received ≥ 75% agreement.RESULTSExisting sets of guidelines from eight guideline developers were found and reviewed for resource-constrained settings; adapted recommendations from nine guidelines form the evidence base, informing two rounds of formal consensus; and all recommendations received ≥ 75% agreement.Evaluation of adult symptomatic women in all settings includes symptom assessment, family history, and ultrasound and cancer antigen 125 serum tumor marker levels where feasible. In limited and enhanced settings, additional imaging may be requested. Diagnosis, staging, and/or treatment involves surgery. Presurgical workup of every suspected ovarian cancer requires a metastatic workup. Only trained clinicians with logistical support should perform surgical staging; treatment requires histologic confirmation; surgical goal is staging disease and performing complete cytoreduction to no gross residual disease. In first-line therapy, platinum-based chemotherapy is recommended; in advanced stages, patients may receive neoadjuvant chemotherapy. After neoadjuvant chemotherapy, all patients should be evaluated for interval debulking surgery. Targeted therapy is not recommended in basic or limited settings. Specialized interventions are resource-dependent, for example, laparoscopy, fertility-sparing surgery, genetic testing, and targeted therapy. Multidisciplinary cancer care and palliative care should be offered.Additional information can be found at www.asco.org/resource-stratified-guidelines. It is ASCO's view that health care providers and health care system decision makers should be guided by the recommendations for the highest stratum of resources available. The guideline is intended to complement but not replace local guidelines.RECOMMENDATIONSEvaluation of adult symptomatic women in all settings includes symptom assessment, family history, and ultrasound and cancer antigen 125 serum tumor marker levels where feasible. In limited and enhanced settings, additional imaging may be requested. Diagnosis, staging, and/or treatment involves surgery. Presurgical workup of every suspected ovarian cancer requires a metastatic workup. Only trained clinicians with logistical support should perform surgical staging; treatment requires histologic confirmation; surgical goal is staging disease and performing complete cytoreduction to no gross residual disease. In first-line therapy, platinum-based chemotherapy is recommended; in advanced stages, patients may receive neoadjuvant chemotherapy. After neoadjuvant chemotherapy, all patients should be evaluated for interval debulking surgery. Targeted therapy is not recommended in basic or limited settings. Specialized interventions are resource-dependent, for example, laparoscopy, fertility-sparing surgery, genetic testing, and targeted therapy. Multidisciplinary cancer care and palliative care should be offered.Additional information can be found at www.asco.org/resource-stratified-guidelines. It is ASCO's view that health care providers and health care system decision makers should be guided by the recommendations for the highest stratum of resources available. The guideline is intended to complement but not replace local guidelines. |
| Author | Burke, William M. Paudel, Bishnu D. Konney, Thomas Okpoti Gonzáles Nogales, Jose Enrique Colgan, Terence J. Cevallos, Nixon Leonardo Tóth, Icó Fujiwara, Keiichi Aziz, Zeba Mukhopadhyay, Asima del Carmen, Marcela G. Chuang, Linus T. Ghebre, Rahel G. Clemenceau, Jean Rene V. Vanderpuye, Verna D. Kohn, Elise C. Wilailak, Sarikapan Temin, Sarah |
| Author_xml | – sequence: 1 givenname: Verna D. orcidid: 0000-0003-3656-6965 surname: Vanderpuye fullname: Vanderpuye, Verna D. organization: Korlebu Teaching Hospital, Accra, Ghana – sequence: 2 givenname: Jean Rene V. surname: Clemenceau fullname: Clemenceau, Jean Rene V. organization: Hospital Angeles Del Pedregal, Mexico City, Mexico – sequence: 3 givenname: Sarah orcidid: 0000-0002-1834-0551 surname: Temin fullname: Temin, Sarah organization: American Society of Clinical Oncology, Alexandria, VA – sequence: 4 givenname: Zeba orcidid: 0000-0001-5032-4503 surname: Aziz fullname: Aziz, Zeba organization: Hameed Latif Hospital, Lahore, Pakistan – sequence: 5 givenname: William M. surname: Burke fullname: Burke, William M. organization: Stony Brook University Hospital, Stony Brook, NY – sequence: 6 givenname: Nixon Leonardo surname: Cevallos fullname: Cevallos, Nixon Leonardo organization: Sociedad Lucha Contra Cancer Ecuador, Machala, Ecuador – sequence: 7 givenname: Linus T. surname: Chuang fullname: Chuang, Linus T. organization: Nuvance Health System, Danbury, CT – sequence: 8 givenname: Terence J. surname: Colgan fullname: Colgan, Terence J. organization: National Cancer Institute, Bethesda, MD – sequence: 9 givenname: Marcela G. surname: del Carmen fullname: del Carmen, Marcela G. organization: LifeLabs, Ontario, Canada – sequence: 10 givenname: Keiichi orcidid: 0000-0002-7388-0243 surname: Fujiwara fullname: Fujiwara, Keiichi organization: Massachusetts General Hospital, Boston, MA – sequence: 11 givenname: Elise C. surname: Kohn fullname: Kohn, Elise C. organization: Saitama Medical University International Medical Center, Saitama, Japan – sequence: 12 givenname: Jose Enrique surname: Gonzáles Nogales fullname: Gonzáles Nogales, Jose Enrique organization: Instituto Nacional de Cancerología, La Paz, Bolivia – sequence: 13 givenname: Thomas Okpoti surname: Konney fullname: Konney, Thomas Okpoti organization: Komfo Anokye Teaching Hospital, Kumasi, Ghana – sequence: 14 givenname: Asima surname: Mukhopadhyay fullname: Mukhopadhyay, Asima organization: Chittaranjan National Cancer Institute, Kolkata, India, Northern Gynaecological Oncology Centre, Gateshead, Newcastle, United Kingdom – sequence: 15 givenname: Bishnu D. orcidid: 0000-0002-8817-7585 surname: Paudel fullname: Paudel, Bishnu D. organization: NAMS, Bir Hospital, Kathmandu, Nepal – sequence: 16 givenname: Icó surname: Tóth fullname: Tóth, Icó organization: Mallow Flower Foundation, Dunaharaszti, Hungary – sequence: 17 givenname: Sarikapan surname: Wilailak fullname: Wilailak, Sarikapan organization: Ramathibodi Hospital, Mahidol University, Bangkok, Thailand – sequence: 18 givenname: Rahel G. orcidid: 0000-0001-7049-290X surname: Ghebre fullname: Ghebre, Rahel G. organization: University of Minnesota Medical School, Minneapolis, MN, St Paul's Hospital Millennium Medical School, Addis Ababa, Ethiopia |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34185571$$D View this record in MEDLINE/PubMed |
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| SubjectTerms | Adult CA-125 Antigen Carcinoma, Ovarian Epithelial - diagnosis Carcinoma, Ovarian Epithelial - therapy Cytoreduction Surgical Procedures Female Humans Neoadjuvant Therapy Ovarian Neoplasms - diagnosis Ovarian Neoplasms - therapy SPECIAL ARTICLES |
| Title | Assessment of Adult Women With Ovarian Masses and Treatment of Epithelial Ovarian Cancer: ASCO Resource-Stratified Guideline |
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