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Clinical practice guidelines: Standards, Options and Recommendations for first line medical treatment of patients with ovarian neoplasms (summary report) Volume 91, issue 7, Juillet - Août 2004

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Oncologue médical, Institut Gustave‐Roussy, Villejuif (coordonnateur) Oncologue médical, Centre Léon‐Bérard, Lyon Médecin généraliste, FNCLCC, Paris (méthodologiste) Oncologue radiothérapeute, Institut Bergonié, Bordeaux Chirurgien, Hôpital de la Conception, Marseille Chirurgien, Hôpital Édouard‐Herriot, Lyon Oncologue radiothérapeute, Polyclinique Bordeaux Nord Aquitaine, Bordeaux Oncologue radiothérapeute, Centre Jean Bernard, Le Mans Chirurgien, Hôpital de la Pitié‐Salpêtrière, Paris Oncologue médical, Hôpital Saint‐Louis, Paris Oncologue médical, Hôpital de la Pitié‐Salpêtrière, Paris Oncologue médical, Centre hospitalier intercommunal, Toulon Oncologue médical, Hôpital Saint‐Antoine, Paris Chirurgien, Hôpital des Diaconesses, Paris Oncologue médical, Centre Léon‐Bérard, Lyon Oncologue médical, Centre Eugène Marquis, Rennes Oncologue médical, FNCLCC, Paris Biologiste, Centre Henri Becquerel, Rouen Radiologue, Centre René Huguenin, Saint‐Cloud Chirurgien, Institut Gustave‐Roussy, Villejuif 21 Pathologiste, Institut Gustave Roussy, Villejuif Oncologue médical, Clinique Victor‐Hugo, Le Mans

Context . The “Standards, Options and Recommendations” (SOR) project, which started in 1993, is a collaboration between the French Federation of Cancer Centers (FNCLCC), the 20 French Regional Cancer Centers, and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. Objective . To update clinical practice guidelines for first line medical treatment of patients with ovarian neoplasms in collaboration with the French Society for Gynaecologica Oncology. Methods . The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts. The CPGs are defined following the definitions of the Standards, Options and Recommendations project. Once the guideline has been developed, the document is submitted for review by independent reviewers. Results . This article is a summary version of the full document presenting the clinical practice guidelines with algorithms. After surgery, most patients with ovarian neoplasms need adjuvant medical treatment. These guidelines concern the initial medical treatment (chemotherapy, hormone treatment and immunotherapy) and potential consolidation treatment. To complete the indications, two alternative treatment strategies are taken into account: no treatment and radiotherapy. This updated version concerns the indications and the modalities of chemotherapy. The main modifications are: 1) first‐line chemotherapy for ovarian neoplasm can be taxane‐platinum or carboplatine alone; 2) polychemotherapy is no longer a standard; 3) for early stages, except for stage IA grade I non‐clear‐cell tumours, adjuvant chemotherapy should be preferred to no treatment; 4) chemotherapy is standard for all stage III tumours, irrespective of the surgical result; 5) for stage IA G2‐3 to IIA tumours, complete surgical staging and determination of the histological grade are standards.