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

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 tumors, 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 tumors 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 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 tumors and the assessment of carcinomatosis, together with a summary of the evidence supporting each statement.

Endometrioid carcinoma associated with ovarian endometriosis: need for cautions during treatment

“…Transvaginal ultrasonography is a crucial investigational technique for endometriosis. Typical benign endometriomas can be identified as unilocular or multilocular cystic lesions with consistent low-level echoes (ground glass appearance) [11]. The International Ovarian Tumor Analysis (IOTA) classification system is critical for distinguishing suspicious features as it can help differentiate benign from malignant endometriomas [12].…”

Quality Requirements for gynecological ultrasound examinations of DEGUM level II – Recommendations of the Sections/Working Groups Gynecology and Obstetrics of DEGUM, ÖGUM and SGUM

“…The potential of MRI, CT, and PET as second-line diagnostics is undisputed, but unfortunately, gynecological issues are currently still being addressed in an unfocused manner by cost-intensive, partly radiation-intensive, and non-specialized techniques. This lack of confidence in gynecologic diagnostics is not evidence- or guideline-based 6 . Other radiological methods are not superior with respect to most issues; radiological cross-sectional imaging techniques can provide relevant information in only a few selected specific issues 7 8 9 10 11 12 13 14 15 .…”

Building a Personalized Medicine Infrastructure for Gynecological Oncology Patients in a High-Volume Hospital

“…Candidates for surgical treatments undergo a preoperative assessment which includes blood tests, anesthetic, and gynecologic examination. Chest radiography is scheduled for those patients who do not have a CT scan of the chest, while an abdominal and transvaginal ultrasound scan is always performed since it offers a noninvasive evaluation of the risk of malignancy of ovarian masses [62], local infiltration of the cervix and endometrial cancer [63,64], and the morphology of inguinal lymph nodes in vaginal and vulvar cancer [65]. A specific department, Catholic Laparoscopy Advanced Surgery School (CLASS) Ultrasound (Figure 3), is dedicated to this task.…”

“…Imaging is fully integrated in the initial work up, as a completely integrated preoperative work up (dedicated ultrasound and/or CT scan and/or PET/CT scan, and/or MRI DWI, etc.) which allows the estimation of the clinical stage of the disease and enables the identification of patients suitable for minimally invasive surgery or, in the case of advanced disease, for radio/chemotherapy [62].…”