Table 1.
Summary of guideline recommendations for surgery and systemic therapies
| Country | Guideline | Modality | Additional information | ||||||
| Lymph node staging | Primary debulking surgery | Interval debulking surgery* | IP chemo-therapy | Bevacizumab | Radiotherapy | PARP inhibitors | |||
| Norway | NDH | R | R | R | N | R | N | R | |
| Australia | CA | R | R | R | R† | R | N | R | Can be considered in stage III women optimally debulked; should be provided in a center with appropriate expertize, and potential toxicities should be fully explained† |
| Denmark | DGCG | R† | R | R | N | R | N | R | Systematic lymphadenectomy also recommended† |
| Canada | AHS | R | R | R | R | N† | T‡ | R | More trials needed before this regimen can be adopted† Consider in select cases to improve local control, at the discretion of the radiation oncologist‡ |
| BCC | R | R | R | R | R | T† | R | Post-operative radiation therapy only recommended for clear cell, endometrioid, and mucinous tumors.† | |
| CCO | R | R | R | R | R | N | R | ||
| UK | NICE | R | R | R | N† | N‡ | N | R | Do not offer, except in clinical trial† Not recommended for first-line treatment in combination with carboplatin and paclitaxel‡ |
| BGCS | R | R | R | N† | N | N | R | Can be offered in clinical trial where appropriate expertize and resources exist† | |
| Scotland | SIGN | R | R | R | R† | R | N | R | Can be considered provided a regimen of proven benefit in a clinical trial compared with intravenous therapy is used and delivered in a center with appropriate expertize and where the potential toxicities are fully explained† |
| Wales | SWCN | R | R | R | N† | N | N | N | Concerns regarding associated morbidity and technical difficulties; not considered standard practice in the UK† |
| NWCN | R | R | R | N | N | N | N | ||
| Northern Ireland | NICaN | – | – | – | N† | N | N | R | Not currently recommended outside of clinical trial† |
| New Zealand | NZMH | R | R | R | N | N | N | N | |
| Ireland | NCCP | – | – | – | – | – | – | – | |
| Inter-national | NCCN | R | R | R | R | R | N | R | |
| ESMO | R | R | R | N† | R | N | R | Not adopted as standard of care due to a lack of trials with IV control arm; only recommended in clinical trials† | |
| ESGO | R | R | R | – | – | – | – | ||
Northern Ireland guidelines only contain recommendations for systemic anti-cancer therapy; ESGO only contain recommendations for surgery.
In Ireland, a clinical practice guideline for the management of ovarian cancer did not exist at the time of collection (as of August 2019); a guideline for diagnosis and staging has since been published by Ireland’s National Cancer Control Program (NCCP), with others in development.
*Neoadjuvant chemotherapy followed by interval debulking surgery.
†Signifies additional information relating to the value shown earlier in the same row.
N, not recommended/mentioned; R, recommended; T, textual information.