Page 2 - Ovarian cancer surgery - Guidelines (early stages)

Specialized multidisciplinary decision making

Treatment must be planned preoperatively at a multidisciplinary team meeting, after workup aiming at ruling
out 1 unresectable metastases, 2 secondary ovarian and peritoneal metastasis from other primary
malignancies.

Surgery must be carried out by experienced and trained operators. Surgery in low-volume and low-quality
centers is discouraged. The existence of an intermediate care facility, and access to an intensive care unit
management, are required. Participation to clinical trials is a quality indicator.

Surgical management

Complete resection of all visible disease is the goal of surgical management.

Primary surgery is recommended in patients who can be debulked upfront to no residual tumor with a
reasonable complication rate.

Minimum required elements in operative reports

Adequate information must be available in the operative report.

The operative report must be structured. Location and size of the disease at the beginning of the operation must
be described.

All the areas of the abdominal and pelvic cavity must be evaluated and described.

All the completed surgical procedures must be mentioned.

If any, the size and location of residual disease at the end of the operation must be described. Reasons for not
achieving complete cytoreduction must be reported.

Minimal information contained in the ESGO operative report1 must be present.

Minimum required elements in pathology reports

Adequate information must be available in the pathology report.

Reporting of postoperative complications

Complications must be recorded, and selected cases must be discussed at morbidity and mortality conferences.

Selection rules for primary debulking

Risk-benefit ratio in favor of primary surgery when:

 There is no unresectable tumor extent

 Complete debulking to no residual tumour seems feasible with reasonable morbidity, taking into account the
patient’s status. Decisions are individualized and based on multiple parameters performance status,
comorbidities, imaging and/or exploratory laparoscopy or laparotomy, pathologic type and grade.

 Patient accepts potential supportive measures as blood transfusions or stoma.

1 The ESGO operative report is available in Appendix 1.

guidelines.esgo.org | esgo-guidelines@esgomail.org
Published October 2016 by European Society of Gynaecological Oncology
Copyrights: © European Society of Gynaecological Oncology
ESGO Ovarian Cancer Surgery Guidelines (advanced stage)_v1

 OVARIAN CANCER SURGERY - GUIDELINES 
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