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Review
. 2021 Mar;32(2):e49.
doi: 10.3802/jgo.2021.32.e49.

The 2020 Japan Society of Gynecologic Oncology guidelines for the treatment of ovarian cancer, fallopian tube cancer, and primary peritoneal cancer

Hideki Tokunaga  1 , Mikio Mikami  2 , Satoru Nagase  3 , Yoichi Kobayashi  4 , Tsutomu Tabata  5 , Masanori Kaneuchi  6 , Toyomi Satoh  7 , Yasuyuki Hirashima  8 , Noriomi Matsumura  9 , Yoshihito Yokoyama  10 , Kei Kawana  11 , Satoru Kyo  12 , Daisuke Aoki  13 , Hidetaka Katabuchi  14
Affiliations
Review

The 2020 Japan Society of Gynecologic Oncology guidelines for the treatment of ovarian cancer, fallopian tube cancer, and primary peritoneal cancer

Hideki Tokunaga et al. J Gynecol Oncol. 2021 Mar.

Abstract

The fifth edition of the Japan Society of Gynecologic Oncology guidelines for the treatment of ovarian cancer, fallopian tube cancer, and primary peritoneal cancer was published in 2020. The guidelines contain 6 chapters-namely, (1) overview of the guidelines; (2) epithelial ovarian cancer, fallopian tube cancer, and primary peritoneal cancer; (3) recurrent epithelial ovarian cancer, fallopian tube cancer, and primary peritoneal cancer; (4) borderline epithelial tumors of the ovary; (5) malignant germ cell tumors of the ovary; and (6) malignant sex cord-stromal tumors. Furthermore, the guidelines comprise 5 algorithms-namely, (1) initial treatment for ovarian cancer, fallopian tube cancer, and primary peritoneal cancer; (2) treatment for recurrent ovarian cancer, fallopian tube cancer, and primary peritoneal cancer; (3) initial treatment for borderline epithelial ovarian tumor; (4) treatment for malignant germ cell tumor; and (5) treatment for sex cord-stromal tumor. Major changes in the new edition include the following: (1) revision of the title to "guidelines for the treatment of ovarian cancer, fallopian tube cancer, and primary peritoneal cancer"; (2) involvement of patients and general (male/female) participants in addition to physicians, pharmacists, and nurses; (3) clinical questions (CQs) in the PICO format; (4) change in the expression of grades of recommendation and level of evidence in accordance with the GRADE system; (5) introduction of the idea of a body of evidence; (6) categorization of references according to research design; (7) performance of systematic reviews and meta-analysis for three CQs; and (8) voting for each CQ/recommendation and description of the consensus.

Keywords: Clinical Practice Guideline; Fallopian Tube Neoplasms; Ovarian Neoplasms; Peritoneal Neoplasms.

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Conflict of interest statement

Dr. Aoki reports grants from Takeda Pharmaceutical Co., Ltd., personal fees from AstraZeneca K.K., Chugai Pharmaceutical Co., Ltd., Abbvie Inc., Taiho Pharmaceutical Co., Ltd., MSD K.K., and Mochida Pharmaceutical Co., Ltd., outside the submitted work. Dr. Hirashima reports grants from Takeda Pharmaceutical Company Limited, grants and personal fees from AstraZeneca, grants and personal fees from MSD K.K., grants from IQVIA, and personal fees from Chugai Pharmaceutical Co., Ltd. outside the submitted work. Dr. Matsumura reports grants and personal fees from AstraZeneca and personal fees from Takara Bio outside the submitted work. Dr. Nagase reports personal fees from Chugai Pharmaceutical Co. Ltd. and personal fees from AstraZeneca outside the submitted work. Dr. Satoh reports personal fees from Chugai Pharmaceutical Co., Ltd., personal fees from Daiichi Sankyo Co. Ltd., personal fees from Kyowa Kirin Co. Ltd., personal fees from AstraZeneca plc., personal fees from Eisai Co. Ltd., personal fees from Kaken Pharmaceutical Co Ltd,, personal fees from Tsumura, personal fees from Nippon Kayaku Co. Ltd., personal fees from Mochida Pharmaceutical Co. Ltd., Bayer Yakuhin Ltd., personal fees from ASKA Pharmaceutical Co. Ltd., and personal fees from Bristol-Myers Squibb Co. outside the submitted work. Dr. Tabata reports personal fees from Chugai, personal fees from AstraZeneca, and personal fees from Terumo outside the submitted work. The other authors have nothing to disclose.

Figures

Fig. 1
Fig. 1. Initial treatment for ovarian cancer, fallopian tube cancer, and primary peritoneal cancer.
Complete surgery: no residual carcinoma; optimal surgery: residual tumor <1 cm; suboptimal surgery: residual tumor >1 cm. CQ11 and CQ14 for first-line chemotherapy, CQ12 and CQ13 for maintenance therapy, CQ17 for intraperitoneal chemotherapy, or CQ22 for hormone replacement therapy. CCC, clear cell carcinoma; CQ, clinical question.
Fig. 2
Fig. 2. Treatment for recurrent ovarian cancer, fallopian tube cancer, and primary peritoneal cancer.
CQ, clinical question.
Fig. 3
Fig. 3. Initial treatment for borderline epithelial ovarian tumor.
BSO, bilateral salpingo-oophorectomy; CQ, clinical question; OMT, omentectomy; USO, unilateral salpingo-oophorectomy. *Fertility-sparing surgery: USO (affected side) + OMT + peritoneal cytology. **Standard procedures: BSO + hysterectomy + OMT + peritoneal cytology.
Fig. 4
Fig. 4. Treatment for malignant germ cell tumor.
CQ, clinical question; OMT, omentectomy; USO, unilateral salpingo-oophorectomy. *Fertility-sparing surgery: USO (affected side) + OMT + peritoneal cytology + careful examination of the abdominal cavity. **For those aged <15 years with immature teratoma, regardless of grade or whether complete resection was achieved, observation without chemotherapy is recommended (CQ38).
Fig. 5
Fig. 5. Treatment for sex cord-stromal tumor.
OMT, omentectomy; USO, unilateral salpingo-oophorectomy. *Fertility-sparing surgery: USO (affected side) + OMT + peritoneal cytology + careful examination of the abdominal cavity.
See this image and copyright information in PMC

References

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