title: [Third National Ovarian Consensus. 2011. Grupo de Investigación en Cáncer de Ovario y Tumores Ginecológicos de México "GICOM"].
abstract: BACKGROUND
  Ovarian cancer (OC) is the third most common gynecologic malignancy worldwide. Most of cases it is of epithelial origin. At the present time there is not a standardized screening method, which makes difficult the early diagnosis. The 5-year survival is 90% for early stages, however most cases present at advanced stages, which have a 5-year survival of only 5-20%. GICOM collaborative group, under the auspice of different institutions, have made the following consensus in order to make recommendations for the diagnosis and management regarding to this neoplasia.
  
  
  METHODS
  The following recommendations were made by independent professionals in the field of Gynecologic Oncology, questions and statements were based on a comprehensive and systematic review of literature. It took place in the context of a meeting of two days in which a debate was held. These statements are the conclusions reached by agreement of the participant members.
  
  
  RESULTS
  No screening method is recommended at the time for the detection of early lesions of ovarian cancer in general population. Staging is surgical, according to FIGO. In regards to the pre-surgery evaluation of the patient, it is recommended to perform chest radiography and CT scan of abdomen and pelvis with IV contrast. According to the histopathology of the tumor, in order to consider it as borderline, the minimum percentage of proliferative component must be 10% of tumor's surface. The recommended standardized treatment includes primary surgery for diagnosis, staging and cytoreduction, followed by adjuvant chemotherapy Surgery must be performed by an Oncologist Gynecologist or an Oncologist Surgeon because inadequate surgery performed by another specialist has been reported in 75% of cases. In regards to surgery it is recommended to perform total omentectomy since subclinic metastasis have been documented in 10-30% of all cases, and systematic limphadenectomy, necessary to be able to obtain an adequate surgical staging. Fertility-sparing surgery will be performed in certain cases, the procedure should include a detailed inspection of the contralateral ovary and also negative for malignancy omentum and ovary biopsy. Until now, laparoscopy for diagnostic-staging surgery is not well known as a recommended method. The recommended chemotherapy is based on platin and taxanes for 6 cycles, except in Stage IA, IB and grade 1, which have a good prognosis. In advanced stages, primary cytoreduction is recommended as initial treatment. Minimal invasion surgery is not a recommended procedure for the treatment of advanced ovarian cancer. Radiotherapy can be used to palliate symptoms. Follow up of the patients every 2-4 months for 2 years, every 3-6 months for 3 years and anually after the 5th year is recommended. Evaluation of quality of life of the patient must be done periodically.
  
  
  CONCLUSIONS
  In the present, there is not a standardized screening method. Diagnosis in early stages means a better survival. Standardized treatment includes primary surgery with the objective to perform an optimal cytoreduction followed by chemotherapy Treatment must be individualized according to each patient. Radiotherapy can be indicated to palliate symptoms.
authors: Instituto Nacional de Cancerología, Tlalpan, Mexico.
authors: Dolores
authors: D
authors: Gallardo-Rincón
authors: David
authors: D
authors: Cantú-de-León
authors: Patricia
authors: P
authors: Alanís-López
authors: Miguel Angel
authors: MA
authors: Alvarez-Avitia
authors: Joel
authors: J
authors: Bañuelos-Flores
authors: Guillermo Sidney
authors: GS
authors: Herbert-Núñez
authors: Luis Fernando
authors: LF
authors: Oñate-Ocaña
authors: María Delia
authors: MD
authors: Pérez-Montiel
authors: Amelia
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authors: Rodríguez-Trejo
authors: Eva
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authors: Ruvalcaba-Limón
authors: Alberto
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authors: Serrano-Olvera
authors: Andrea
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authors: Ortega-Rojo
authors: Patricia
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authors: Cortés-Esteban
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authors: Erazo-Valle
authors: Raquel
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authors: Gerson-Cwilich
authors: Jaime
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authors: De-la-Garza-Salazar
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authors: Green-Renner
authors: Eucario
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authors: León-Rodríguez
authors: Flavia
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authors: Morales-Vásquez
authors: Andrés
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authors: Poveda-Velasco
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authors: Aguilar-Ponce
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authors: Alva-López
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authors: Alvarado-Aguilar
authors: Isabel
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authors: Alvarado-Cabrero
authors: Cinthia Alejandra
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authors: Castorena-Roji
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authors: Cervantes-Sánchez
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authors: Garibay-Cerdenares
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authors: Gómez-García
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authors: Herrera-Montalvo
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authors: Isla-Ortiz
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authors: Lavín-Lozano
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authors: Antonio
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authors: Maffuz-Aziz
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authors: Martínez-Cedillo
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authors: Martínez-López
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authors: Melo-Martínez
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authors: Gonzalo
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authors: Miguel Angel
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authors: Andrés
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authors: Morán-Mendoza
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authors: Morgan-Villela
authors: Aída
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authors: Mota-García
authors: David Eduardo
authors: DE
authors: Muñoz-González
authors: Francisco J
authors: FJ
authors: Ochoa-Carrillo
authors: Maricruz
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authors: Pérez-Amador
authors: Edgar
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authors: Recinos-Money
authors: Samuel
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authors: Rivera-Rivera
authors: Juan U
authors: JU
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authors: Edith
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authors: Rojas-Castillo
authors: Carlos
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authors: Rojas-Marín
authors: Efraín
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authors: Salas-Gonzáles
authors: Liliana
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authors: Sámano-Nateras
authors: Miguel
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authors: Santibañez-Andrade
authors: Antonio
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authors: Santillán-Gómez
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authors: Silva-García
authors: Juan Alejandro
authors: JA
authors: Silva
authors: Gilberto
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authors: Solorza-Luna
authors: Adán Raúl
authors: AR
authors: Tabarez-Ortiz
authors: Patricia
authors: P
authors: Talamás-Rohana
authors: Laura Leticia
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authors: Tirado-Gómez
authors: Alfonso
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authors: Torres-Lobatón
authors: Félix
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authors: Quijano-Castro
mesh_terms: D000359:Aftercare; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D019008:Drug Resistance, Neoplasm; D042241:Early Diagnosis; D005260:Female; D052138:Genes, Neoplasm; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging / Q000592:standards; D009386:Neoplastic Syndromes, Hereditary / Q000235:genetics; D009852:Omentum / Q000601:surgery; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000473:pathology / Q000628:therapy; D010052:Ovariectomy / Q000379:methods; D010166:Palliative Care; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D016879:Salvage Therapy; D043823:Taxoids / Q000008:administration & dosage
chemical_list: D009944:Organoplatinum Compounds; D043823:Taxoids