For a non-gynecological primary tumor, patients need to be referred to an appropriate specialist, while patients with benign lesions may be followed up and treated conservatively or may be suitable for less radical surgical treatment, depending on the clinical context. Patients with masses that are suspicious for malignancy should be referred to a gynecological oncology center, in order to receive specialist care, as per the definitions of the European Society of Gynaecological Oncology (ESGO) 1 and national and international recommendations and guidelines. The accurate characterization of newly diagnosed adnexal lesions is of paramount importance to define appropriate treatment pathways. This Consensus Statement presents these ESGO/ISUOG/IOTA/ESGE statements on the pre-operative diagnosis of ovarian tumors and the assessment of carcinomatosis, together with a summary of the evidence supporting each statement. The group achieved consensus on 18 statements. Another round of voting was carried out according to the same rules to allow the whole group to evaluate the revised version of the statements. The statements were then revised accordingly. The voters had the opportunity to provide comments/suggestions with their votes. Statements were removed when a consensus among group members was not obtained. During a conference call, the whole group discussed each preliminary statement and a first round of voting was carried out. Preliminary statements were drafted based on the review of the relevant literature. To ensure that the statements were evidence-based, the current literature was reviewed and critically appraised. A patient representative was also included in the group. ESGO/ISUOG/IOTA/ESGE nominated a multidisciplinary international group, including expert practising clinicians and researchers who have demonstrated leadership and expertise in the pre-operative diagnosis of ovarian tumors and management of patients with ovarian cancer (19 experts across Europe). The European Society of Gynaecological Oncology (ESGO), the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), the International Ovarian Tumour Analysis (IOTA) group, and the European Society for Gynaecological Endoscopy (ESGE) jointly developed clinically relevant and evidence-based statements on the pre-operative diagnosis of ovarian tumors, including imaging techniques, biomarkers, and prediction models. Professor Dirk Timmerman, Gynecology and Obstetrics, University Hospitals KU Leuven, Leuven, Belgium 22 Gynaecologic Oncology, Hammersmith Hospital, Imperial College, London, UK. 21 Division of Translational MRI, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.20 Radiology, University Hospitals Leuven, Leuven, Belgium.19 Obstetrics and Gynaecology and Gynaecologic Oncology, University Hospital Leuven, Leuven Cancer Institute, Leuven, Belgium.18 Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy.17 Obstetrics and Gynecologic Oncology, University Hospital, Strasbourg, France.16 Gynecologic Oncology, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.15 Gynaecological Surgery, Institut Gustave Roussy, Villejuif, France.14 Gynecology and Obstetrics, Gynecologic Oncology Unit, Santa Chiara Hospital, Trento, Italy.13 Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.12 KIU - Patient Organisation for Women with Gynaecological Cancer, Copenhagen, Denmark.11 European Network of Gynaecological Cancers Advocacy Groups (ENGAGe) Executive Group, Prague, Czech Republic.10 Radiology, University Clinic of Navarra, Madrid, Spain.9 Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.8 Obstetrics and Gynaecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.7 Gynaecology and Obstetrics, University Clinic of Navarra, Madrid, Spain.6 Gynaecology and Gynaecological Oncology, Evangelische Kliniken Essen-Mitte, Essen, Germany.5 Woman, Child and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.4 Metabolism Digestion and Reproduction, Queen Charlotte’s & Chelsea Hospital, Imperial College, London, UK.3 Clinical Research Unit, Institut Bergonie, Bordeaux, France.2 Development and Regeneration, KU Leuven, Leuven, Belgium.
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