The INDEPSO-ISPSM Consensus on Peritoneal Malignancies-Management of Advanced Epithelial Ovarian Cancer

This consensus on advanced epithelial ovarian cancer was focused on issues not covered by existing international guidelines, some country-specific issues, and general and technical aspects of cytoreductive surgery (CRS). The modified Delphi technique was employed with two rounds of voting. There were 47 close-ended questions on 7 key topics that were disseminated through the SurveyMonkey (www.surveymonkey.com) platform. Out of 54 invited surgical and gynecologic oncologists, 48 agreed to vote. A consensus was reached if any one option received > 70% votes (strong consensus-> 90%votes). The response rate was 100% in round 1 and 95.8% in round 2. A consensus was reached on 32/47(68.0%) questions, with strong consensus on 10/47 (21.2%). The panel recommended neoadjuvant chemotherapy (NACT) for patients with positive pleural cytology, and resection of regions involved prior to NACT for stage III-C and only resection of sites of residual disease for stage IV patients. For both primary and secondary CRS, using a combination of clinical and radiological features and validated predictive scores was recommended for patient selection. There was a strong consensus that hyperthermic intraperitoneal chemotherapy (HIPEC) should be added to interval CRS for high-grade serous and mucinous carcinomas, but no consensus on its use in stage IV-A disease. Visceral resections and lymphadenectomy were not recommended in absence of overt disease or suspicion of disease. The panel reached a consensus on many technical aspects of CRS and issues related to HIPEC. These recommendations should be a useful clinical guide for surgeons treating ovarian cancer. Some recommendations could change as new evidence comes in.

The online version contains supplementary material available at 10.1007/s13193-025-02300-0.