Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: Society of Gynecologic Oncology and American Society of Clinical Oncology Clinical Practice Guideline
Top Cited Papers
- 1 October 2016
- journal article
- practice guideline
- Published by American Society of Clinical Oncology (ASCO) in Journal of Clinical Oncology
- Vol. 34 (28), 3460-3473
- https://doi.org/10.1200/jco.2016.68.6907
Abstract
Purpose To provide guidance to clinicians regarding the use of neoadjuvant chemotherapy and interval cytoreduction among women with stage IIIC or IV epithelial ovarian cancer. Methods The Society of Gynecologic Oncology and the American Society of Clinical Oncology convened an Expert Panel and conducted a systematic review of the literature. Results Four phase III clinical trials form the primary evidence base for the recommendations. The published studies suggest that for selected women with stage IIIC or IV epithelial ovarian cancer, neoadjuvant chemotherapy and interval cytoreduction are noninferior to primary cytoreduction and adjuvant chemotherapy with respect to overall and progression-free survival and are associated with less perioperative morbidity and mortality. 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 .Keywords
This publication has 52 references indexed in Scilit:
- Long-term results of dose-dense paclitaxel and carboplatin versus conventional paclitaxel and carboplatin for treatment of advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer (JGOG 3016): a randomised, controlled, open-label trialThe Lancet Oncology, 2013
- Neoadjuvant chemotherapy in the Medicare cohort with advanced ovarian cancerGynecologic Oncology, 2011
- Defining the limits of radical cytoreductive surgery for ovarian cancerGynecologic Oncology, 2011
- Thirty-Day Mortality After Primary Cytoreductive Surgery for Advanced Ovarian Cancer in the ElderlyObstetrics & Gynecology, 2011
- Neoadjuvant Chemotherapy or Primary Surgery in Stage IIIC or IV Ovarian CancerThe New England Journal of Medicine, 2010
- Preoperative serum CA‐125 levels and risk of suboptimal cytoreduction in ovarian cancer: A meta‐analysisJournal of Surgical Oncology, 2009
- Specialized and high-volume care leads to better outcomes of ovarian cancer treatment in the NetherlandsGynecologic Oncology, 2009
- Phase II evaluation of neoadjuvant chemotherapy and debulking followed by intraperitoneal chemotherapy in women with stage III and IV epithelial ovarian, fallopian tube or primary peritoneal cancer: Southwest Oncology Group Study S0009Gynecologic Oncology, 2009
- A new frontier for quality of care in gynecologic oncology surgery: Multi-institutional assessment of short-term outcomes for ovarian cancer using a risk-adjusted modelGynecologic Oncology, 2007
- Cyclophosphamide and Cisplatin Compared with Paclitaxel and Cisplatin in Patients with Stage III and Stage IV Ovarian CancerThe New England Journal of Medicine, 1996