ESGO/ISUOG/IOTA/ESGE Consensus Statement on preoperative diagnosis of ovarian tumours

Abstract

The European Society of Gynaecological Oncology (ESGO), the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), the International Ovarian Tumour Analysis (IOTA) group and the European Society for Gynaecological Endoscopy (ESGE) jointly developed clinically relevant and evidence-based statements on the preoperative diagnosis of ovarian tumours, including imaging techniques, biomarkers and prediction models. ESGO/ISUOG/IOTA/ESGE nominated a multidisciplinary international group, including expert practising clinicians and researchers who have demonstrated leadership and expertise in the preoperative diagnosis of ovarian tumours and management of patients with ovarian cancer (19 experts across Europe). A patient representative was also included in the group. To ensure that the statements were evidence-based, the current literature was reviewed and critically appraised. Preliminary statements were drafted based on the review of the relevant literature. During a conference call, the whole group discussed each preliminary statement and a first round of voting was carried out. Statements were removed when a consensus among group members was not obtained. The voters had the opportunity to provide comments/suggestions with their votes. The statements were then revised accordingly. Another round of voting was carried out according to the same rules to allow the whole group to evaluate the revised version of the statements. The group achieved consensus on 18 statements. This Consensus Statement presents these ESGO/ISUOG/IOTA/ESGE statements on the preoperative diagnosis of ovarian tumours and the assessment of carcinomatosis, together with a summary of the evidence supporting each statement.

Defining Models to Classify between Benign and Malignant Adnexal Masses Using Routine Laboratory Parameters

“…The current ESGO/ISUOG/IOTA/ESGE Consensus Statement on the preoperative diagnosis of ovarian tumors highlights that decision making should never be based only on one modality [3], and that besides adequate ultrasound expertise, accurate biomarkers are valuable in the treatment planning of patients with adnexal masses. Using laboratory parameters derived from a routine clinical setting, this study compared albumin to calculated models in 1552 patients undergoing surgery because of an adnexal mass.…”

“…Even though specific ultrasound criteria help to improve the predictive accuracy [2], the precise preoperative classification remains challenging, particularly if expertise in ultrasonography is lacking. Thus, treatment and particularly surgery planning should always be based on a combination of factors, including clinical and radiological findings as well as laboratory markers [3].…”

Basic Gynecologic Ultrasound Examination (Level I): DEGUM, ÖGUM, and SGUM Recommendations

“…3) [17], ist eine weiterführende gynäkologische Ultraschalldiagnostik zur differenzialdiagnostischen Abklärung, Risikoeinschätzung und ggf. Operationsplanung erforderlich [14,[24][25][26].…”

“…In the case of findings with malignancy criteria (▶ Fig. 15) or findings that cannot be classified as benign with probability (▶ Table 3) [17], a detailed gynecological ultrasound examination for differential diagnosis, risk assessment, and surgical planning, if applicable, is needed [14,[24][25][26].…”

Ultrasound-Guided Tru-Cut Biopsy in Gynecological and Non-Gynecological Pelvic Masses: A Single-Center Experience

“…However, the tru-cut diagnostic path in ovarian cancer patients is dedicated exclusively to those who result unsuitable for surgery due to advanced inoperable disease, poor health conditions, to whom a surgical procedure may be at too high risk, or to those who have already been treated for cancer and clinical or instrumental reasons appear to have a recurrence. It was recently reported in an ESGO/ISUOG/IOTA/ESGE consensus statement that preoperative imaging should not influence the choice of treatment of the patient with ovarian cancer concerning predicting peritoneal tumor resectability [39] and care must be taken not to perform TCNB in patients who could benefit from cytoreductive surgery or in those in whom there is a risk of disseminating the neoplastic pathology.…”