Ovarian cancer: screening, treatment, and followup.
OBJECTIVE
To provide physicians with a current consensus on screening, prevention, diagnosis, and treatment of ovarian cancer.


METHODS
A non-Federal, nonadvocate, 14-member consensus panel representing the fields of gynecologic, medical, and radiation oncology, obstetrics/gynecology, and biostatistics; 25 experts in obstetrics/gynecology and gynecologic, medical, and radiation oncology who presented data to the consensus panel; and a conference audience of approximately 500.


METHODS
The literature was searched through Medline and an extensive bibliography of references was produced for the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given priority over clinical anecdotal experience.


METHODS
The panel, answering predefined consensus questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature.


METHODS
The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. The panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference.


CONCLUSIONS
There is no evidence available yet that the current screening modalities of CA 125 and transvaginal ultrasonography can be effectively used for widespread screening to reduce mortality from ovarian cancer nor that their use will result in decreased rather than increased morbidity and mortality. Women with stage IA grade 1 and IB grade 1 ovarian cancer do not require postoperative adjuvant therapy. Many remaining stage I patients do require chemotherapy. Subsets of stage I must be fully defined and ideal treatment determined. Women with stages II, III, and IV epithelial ovarian cancer (other than low malignant potential tumors) should receive postoperative chemotherapy.
D000328:Adult; D018394:CA-125 Antigen / Q000097:blood; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000517:prevention & control / Q000601:surgery; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000517:prevention & control* / Q000601:surgery*; D012307:Risk Factors; D014463:Ultrasonography
D018394:CA-125 Antigen