Treatment
receive NACT. (Moderate recommendation; EB-B-I)
Î Decisions that women are not eligible for medical or surgical cancer
treatment should be made after a consultation with a gynecologic oncologist
and/or a medical oncologist with gynecologic expertise.
(Moderate recommendation; IC-B-I)
Î For women who are fit for PCS, with potentially resectable disease, either
NACT or PCS may be offered based on data from phase III
RCTs that demonstrate that NACT is noninferior to PCS with respect
to progression-free and overall survival.
(Moderate recommendation; EB-B-I)
• NACT is associated with less peri- and post-operative morbidity and mortality and
shorter hospitalizations, but PCS may offer superior survival in selected patients.
Î For women with a high likelihood of achieving cytoreduction to <1 cm
(ideally to no visible disease) with acceptable morbidity, PCS is
recommended over NACT. (Moderate recommendation; EB-B-I)
Î For women who are fit for PCS but are deemed unlikely to have
cytoreduction to <1 cm (ideally to no visible disease) by a gynecologic
oncologist, NACT is recommended over PCS.
(Moderate recommendation; EB-B-I)
• NACT is associated with less peri- and post-operative morbidity and mortality and
shorter hospitalizations.
Table 1. Risk Factors for Perioperative Morbidity or Mortality
Advanced age or frailty
Multiple chronic conditions
Poor nutritional status or low albumin
Ascites
Newly diagnosed venous thromboembolism
Body mass index
Stage
Performance status
