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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. 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). A patient representative was also included in the group. To ensure that the statements were evidence-based, the current literature was reviewed and critically appraised. Preliminary statements were drafted based on the review of the relevant literature. During a conference call, the whole group discussed each preliminary statement and a first round of voting was carried out. Statements were removed when a consensus among group members was not obtained. The voters had the opportunity to provide comments/suggestions with their votes. The statements were then revised accordingly. 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 group achieved consensus on 18 statements. 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. ispartof: INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER vol:31 issue:7 pages:961-982 ispartof: location:England status: published

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 preoperative diagnosis of ovarian tumors, including imaging techniques, biomarkers and prediction models. ESGO/ISUOG/IOTA/ESGE nominated a multidisciplinary international group, including expert practising clinicians and researchers who have demonstrated leadership and expertise in the preoperative diagnosis of ovarian tumors and management of patients with ovarian cancer (19 experts across Europe). A patient representative was also included in the group. To ensure that the statements were evidence-based, the current literature was reviewed and critically appraised. Preliminary statements were drafted based on the review of the relevant literature. During a conference call, the whole group discussed each preliminary statement and a first round of voting was carried out. Statements were removed when consensus among group members was not obtained. The voters had the opportunity to provide comments/suggestions with their votes. The statements were then revised accordingly. 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 group achieved consensus on 18 statements. This Consensus Statement presents these ESGO/ISUOG/IOTA/ESGE statements on the preoperative diagnosis of ovarian tumors and the assessment of carcinomatosis, together with a summary of the evidence supporting each statement.

We thank Isabelle Thomassin-Nagarra et al for their interest in the ESGO/ISUOG/IOTA/ESGE consensus statement on the pre-operative diagnosis of ovarian tumors. This statement is based on a careful review of the relevant literature and available evidence as well as on structured discussions between

BackgroundPatients’ reported outcomes and their perspectives around their therapeutic management is a field of continuously increasing relevance in gynecological oncology. We report the results of the Berlin dialog on seven patient-reported parameters and outcomes concerning chemotherapy and maintenance treatment in patients with gynecological cancer.MethodsKey opinion leaders in gynecological oncology from different European counties and representatives of leading patients’ advocate groups in Berlin held a consensus meeting in Berlin on April 6, 2019. Seven topics of interest were identified in advance around quality of life, iatrogenic toxicity, treatment decision-making processes, sexuality, participation in clinical trials, second opinion, and long-term survivors with the the following standard operating procedure for processing and discussion: (1) agreement on its relevance; (2) literature review, and (3) discussion and consensus statements.ResultsAll main topics reached a consensus approval. The defined statements emphasized the importance of patients’ role in incorporating and establishing quality of life as an outcome parameter in clinical trials. Furthermore, discussants raised the importance of identifying new tools for reflecting patient-reported iatrogenic toxicity as well as emphasizing patients’ rights in providing personal information, access to second opinion in the decision-making process, and their participation in clinical trials.ConclusionThe results of this round table meeting could help redefine perspectives on the discussed topics and the importance for therapeutic management as well as for trial designs.

Background The impact of the COVID‐19 pandemic on European gynaecological cancer patients under active treatment or follow‐up has not been documented. We sought to capture the patient perceptions of the COVID‐19 implications and the worldwide imposed treatment modifications. Methods A patient survey was conducted in 16 European countries, using a new COVID‐19‐related questionnaire, developed by ENGAGe and the Hospital Anxiety & Depression Scale questionnaire (HADS). The survey was promoted by national patient advocacy groups and charitable organisations. Findings We collected 1388 forms; 592 online and 796 hard‐copy (May, 2020). We excluded 137 due to missing data. Median patients’ age was 55 years (range: 18–89), 54.7% had ovarian cancer and 15.5% were preoperative. Even though 73.2% of patients named cancer as a risk factor for COVID‐19, only 17.5% were more afraid of COVID‐19 than their cancer condition, with advanced age (>70 years) as the only significant risk factor for that. Overall, 71% were concerned about cancer progression if their treatment/follow‐up was cancelled/postponed. Most patients (64%) had their care continued as planned, but 72.3% (n = 892) said that they received no information around overall COVID‐19 infection rates of patients and staff, testing or measures taken in their treating hospital. Mean HADS Anxiety and Depression Scores were 8.8 (range: 5.3–12) and 8.1 (range: 3.8–13.4), respectively. Multivariate analysis identified high HADS‐depression scores, having experienced modifications of care due to the pandemic and concern about not being able to visit their doctor as independent predictors of patients’ anxiety. Interpretation Gynaecological cancer patients expressed significant anxiety about progression of their disease due to modifications of care related to the COVID‐19 pandemic and wished to pursue their treatment as planned despite the associated risks. Healthcare professionals should take this into consideration when making decisions that impact patients care in times of crisis and to develop initiatives to improve patients’ communication and education., Gynaecological cancer patients in Europe appeal for more transparency and continuation of high standard oncologic care even in times of crisis like the COVID‐19 pandemic.

Shared decision making in care for the gynecologic cancer patient Steffensen KD, Fokdal LU, Oer Knudsen A, Vestergaard Madsen C, Jensen PT, Lundvall L, Olling K, Lemley B, Blou D, Büchmann H, Haee M Introduction: Treatment of recurrent ovarian cancer is complex and may involve surgery, chemotherapy or surveillance options that should be discussed with patients to reach a shared decision. This project aims to develop and test a patient decision aid (PDA) to facilitate shared decision making (SDM) in treatment planning of the ovarian cancer patient with relapse and furthermore, to evaluate SDM implementation methods Material & Methods: Development, testing, evaluation, and implementation of a PDA for women with relapsed ovarian cancer will be performed at three hospitals in Denmark. The test phase will include; 1) Alpha test: Patients and clinicians are interviewed based on a structured interview guide based on internationally validated questionnaires used to assess, to what extent the PDA prepare the patient to make a decision. 2) Betatest: Validated outcome measures, such a SDM-Q9, SDM-Q-DOC, OPTION and CollaboRATE will be used to assess patients and doctors experiences of SDM in consultations with patients experiencing a disease relapse at baseline before introduction of the PDA (Betatest 1) and after the use of the PDA (Betatest 2) Results: Based on an existing generic platform we have developed a PDA for platinum-sensitive as well as platinum-resistant relapse. The patient-clinician conversation in which the PDA is used consists of 5 steps: 1) The purpose of the PDA is presented 2) The patient is informed of the available treatment possibilities 3) The patients personal preferences is identified, what is important/concerns the patient 4) Patient's options and harms/benefits of each option are reviewed 5) A shared treatment decision is made with the patient Conclusions: The project results are intended to be disseminated on a national level through the Danish Gynecological Cancer Group for the benefit of other cancer patients. The generic PDA template can also be adjusted and used to develop new tools for other clinical decisions within Danishhealthcare

SHARED DECISION MAKING IN THE CARE FOR THE GYNECOLOGIC CANCER PATIENT Background and Aims:Despite surgery and adjuvant chemotherapy, a large number of patients with ovarian cancer experience relapse. Treatment of recurrent disease is complex and strategies that involve both surgery and chemotherapy or surveillance can be discussed. This project aims to contribute to and evaluate clinical implementation of shared decision making (SDM) in ovarian cancer patients. A patient decision aid (PDA) will be developed to facilitate SDM related to treatment planning of the ovarian cancer patient with relapseMethods:The project includes development, testing, evaluation, and implementation of a PDA for women with relapsed ovarian cancer at three hospitals in Denmark. This wide test environment will enable national dissemination and ensure a uniform treatment of future Danish ovarian cancer patients. The test phase will include;1) Alpha test: Patients and clinicians are interviewed based on a structured interview guide based on internationally validated questionnaires used to assess, to what extent the PDA prepare the patient to make a decision.2) Beta test: Validated outcome measures, such as SDM-Q9, SDM-Q-DOC, OPTION and CollaboRATE will be used to asses patients and doctors experiences of SDM in consultations with patients experiencing a disease relapse at baseline before introduction of the PDA (Beta test 1) and after the use of the PDA (Beta test 2)Results:Based on an existing generic platform we have developed a PDA for relapsed platinum-sensitive as well as platinum-resistant ovarian cancer. The patient-clinician conversation in which the PDA is used consists of 5 steps:Purpose of the PDA is presentedPatient is informed of the available treatment possibilitiesPatients personal preferences is identified, what is important/concerns the patientPatient's options and harms/benefits of each option are reviewedA shared treatment decision is made with the patientConclusions:The result of the project will be implemented broadly and systematically for the benefit of other cancer patients. The generic model can also be used to develop new tools for other clinical decisions within the health service