Clinical Evaluation and Treatment of Women With Suspected
Stage IIIC or IV Epithelial Ovarian Cancer, Fallopian Tube Cancer,
or Primary Peritoneal Cancer
Work-up should include an evaluation by a gynecologic
oncologist and at least a CT of the abdomen and pelvis with oral
and intravenous contrast, and chest imaging (CT preferred).
Recommended treatment is
NACT. Consult with gynecologic
or medical oncologist before
decision made not to pursue
chemotherapy or surgery.
NO YES
Does the patient have a high risk of
perioperative morbidity?
Do characteristics of the tumor
suggest that cytoreduction to
<1 cm is unlikely?
NO YES
Recommended
treatment is NACT.
Patients may receive either
NACT or PCS. For patients
with a high likelihood of
cytoreduction to <1 cm, PCS is
preferred.
Before starting NACT,
confirm the primary
diagnosis and exclude other
primaries (core biopsy
preferred).
Recommended NACT consists
of a platinum/taxane doublet.
If disease progresses before
interval cytoreduction, offer
alternative chemotherapy
regimens, clinical trials, and/or
discontinuation of active cancer
therapy.
If NACT
