This Article  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (278)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Screening, Treatment, and Follow-up

NIH Consensus Development Panel on Ovarian Cancer; Vicki Seltzer, MD; Bruce H. Drukker, MD; Brenda W. Gillespie, PhD; Lynn M. Gossfeld, RNC, MSN; Perry W. Grigsby, MD, MBA; Harold A. Harvey, MD; Carolyn B. Hendricks, MD; Sherilynn Hummel, MD; Robert W. Makuch, PhD; Grace Powers Monaco, JD; Groesbeck P. Parham, MD; Charles L. Sawyers, MD; Randal J. West, MD; David S. Alberts, MD; Barrie Anderson, MD; Hervy E. Averette, MD; Robert C. Bast, Jr, MD; Michaele C. Christian, MD; Nicoletta Colombo, MD; William T. Creasman, MD; John P. Curtin, MD; David M. Gershenson, MD; William J. Hoskins, MD; Beth Y. Karlan, MD; Barnett S. Kramer, MD, MPH; Maurie Markman, MD; William P. McGuire, MD; Robert F. Ozols, MD, PhD; Sergio Pecorelli, MD, PhD; Karl C. Podratz, MD, PhD; J. Tate Thigpen, MD; Gillian M. Thomas, MD; Cornelia Liu Trimble, MD; Carolyn Westhoff, MD; Alice S. Whittemore, PhD; Robert C. Young, MD; Edward L. Trimble, MD, MPH; Elaine Blume, MS; Elsa Bray; Michaele C. Christian, MD; John Ferguson, MD; David M. Gershenson, MD; Ruthann Giusti, MD; William Hall; Charles Harrison, MD; William J. Hoskins, MD; Barnett S. Kramer, MD, MPH; Maurie Markman, MD; Mary McCabe, RN; Timothy Moore, MD; Susan G. Nayfield, MD; Cherie Nichols, MBA; Robert Park, MD; Eddie Reed, MD; Vicki Seltzer, MD; Charles Sherman, PhD; Samuel Broder, MD; John H. Ferguson, MD

JAMA. 1995;273(6):491-497.

Abstract
Objective.
—To provide physicians with a current consensus on screening, prevention, diagnosis, and treatment of ovarian cancer.

Participants.
—A nonfederal, nonadvocate, 14-member consensus panel representing the fields of gynecologic, medical, and radiation oncology, obstetrics/ gynecology, and biostatistics; 25 experts in obstetrics/gynecology and gynecologic, medical, and radiation oncology who presented data to the consensus panel; and a conference audience of approximately 500.

Evidence.
—The literature was searched through MEDLINE, and an extensive bibliography of references was produced for the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given priority over clinical anecdotal experience.

Consensus.
—The panel, answering predefined consensus questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature.

Consensus Statement.
—The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. The panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference.

Conclusions.
—There is no evidence available yet that the current screening modalities of CA-125 and transvaginal ultrasonography can be effectively used for widespread screening to reduce mortality from ovarian cancer nor that their use will result in decreased rather than increased morbidity and mortality. Women with stage IA grade 1 and stage IB grade 1 ovarian cancer do not require postoperative adjuvant therapy. Many remaining stage I patients do require chemotherapy. Subsets of stage I must be fully defined and ideal treatment determined. Women with stages II, III, and IV epithelial ovarian cancer (other than low malignant potential tumors) should receive postoperative chemotherapy.

(JAMA. 1995;273:491-497)

Author Affiliations
Panel and Conference Chairperson, Chairman, Department of Obstetrics and Gynecology, Long Island Jewish Medical Center, Professor, Obstetrics and Gynecology, Albert Einstein College of Medicine, New Hyde Park, NY Jennie L. Batson, MD, Obstetrician and Gynecologist, Everett, Wash; Professor and Chair, Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, East Lansing; Assistant Professor, Department of Biostatistics, University of Michigan, Ann Arbor; Gynecologic Oncology Clinical Nurse Specialist, Division of Nursing, Memorial Sloan-Kettering Cancer Center, New York, NY; Professor of Radiology, Radiation Oncology Center, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo; Professor of Medicine, Division of Medical Oncology, Milton S. Hershey Medical Center, Hershey, Pa; Medical Oncologist, Associates in Oncology and Hematology, Rockville, Md; Gynecologic Oncologist, Bethesda, Md; Associate Professor, Division of Biostatistics, Department of Epidemiology and Public Health, Yale University, New Haven, Conn; Director (Volunteer), Professional and Legal Affairs, Candlelighters Childhood Cancer Foundation, Bethesda, Md; Associate Professor, Chief, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock; Assistant Professor of Medicine, Division of Hematology and Oncology, Department of Medicine, UCLA School of Medicine, Los Angeles, Calif; Associate Professor, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Medical College of Virginia, Richmond; "Studies of the Pathogenesis and Prognosis of Previously Untreated, Epithelial Type Ovarian Cancer"; "Quality of Life in the Patient With Progressive Ovarian Cancer"; "The Role of Prophylactic Oophorectomy in Cancer Prevention"; "Clinical and Laboratory Directions" Sandra E. Brooks, MD, "Preoperative Evaluation of Patients With Suspected Ovarian Cancer"; "Management of the Symptomatic Patient: Chemotherapy"; "Controversial Issues in the Management of Early Epithelial Ovarian Cancer: Conservative Surgery and Role of Adjuvant Therapy" and "Options for Primary Chemotherapy: In Europe"; "Second-Look Laparotomy in Ovarian Cancer"; "Management of the Adnexal Mass"; "Management of Early Ovarian Cancer: Germ Cell and Sex Cord-Stromal Tumors"; "Principles of Primary Surgery" Ian Jacobs, MD, MRCOG, "Screening Modalities: CA-125/Genetic Markers"; "Screening Modalities: The Current Status of Ultrasound and Color Doppler Imaging in Screening for Ovarian Cancer"; "Screening"; "Follow-up of the Asymptomatic Patient"; "Options for Primary Chemotherapy: Taxanes"; "Research Directions in Epithelial Ovarian Cancer"; "Management of the Symptomatic Patient: Surgery"; "Second-Look Surgery in the Management of Advanced Epithelial Ovarian Cancer"; "Primary Chemotherapy for Advanced Ovarian Carcinoma"; "The Role of Radiation Therapy in Early Ovarian Cancer"; "Management of Epithelial Ovarian Tumors of Low Malignant Potential"; "Current Status of Screening for Ovarian Cancer"; "Epidemiology of Ovarian Cancer"; "Management of Early Ovarian Epithelial Cancer"; Head, Surgery Section, Clinical Investigations Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment, National Cancer Institute, National Institutes of Health, Rockville, Md; Senior Science Writer, Office of Cancer Communications, National Cancer Institute, National Institutes of Health, Bethesda, Md; Program Analyst, Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md; Head, Developmental Chemotherapy Section, Investigational Drug Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment, National Cancer Institute, National Institutes of Health, Rockville, Md; Director, Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md; Professor and Deputy Chairman, Department of Gynecologic Oncology, University of Texas, M.D. Anderson Cancer Center, Houston, Tex; Special Assistant to the Director, Office of the Director, Division of Cancer Treatment, National Cancer Institute, National Institutes of Health, Bethesda, Md; Director of Communications, Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md; Director, Gynecologic Oncology, Department of Obstetrics and Gynecology, National Naval Medical Center, Bethesda, Md; Chief, Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY; Associate Director, Early Detection and Community Oncology Program, Division of Cancer Prevention and Control, National Cancer Institute, National Institutes of Health, Rockville, Md; Director, Cleveland Clinic Cancer Center, Chairman, Department of Hematology and Medical Oncology, Cleveland (Ohio) Clinic Foundation; Investigational Drug Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment, National Cancer Institute, National Institutes of Health, Rockville, Md; Senior Investigator, Developmental Chemotherapy Section, Investigational Drug Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment, National Cancer Institute, National Institutes of Health, Rockville, Md; Program Director, Division of Cancer Prevention and Control, National Cancer Institute, National Institutes of Health, Rockville, Md; Chief, Planning, Evaluation, and Analysis Branch, National Cancer Institute, National Institutes of Health, Bethesda, Md; Chairman, The Gynecologic Oncology Group, Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, Washington, DC; Senior Investigator, Head, Genitourinary Cancer Section, Medicine Branch, Clinical Oncology Program, Division of Cancer Treatment, National Cancer Institute, National Institutes of Health, Bethesda, Md; Chairman, Department of Obstetrics and Gynecology, Long Island Jewish Medical Center, Professor, Obstetrics and Gynecology, Albert Einstein College of Medicine, New Hyde Park, NY; Deputy Director, Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md

Footnotes
NIH Consensus Development Conferences are convened to evaluate available scientific information and to resolve safety and efficacy issues related to a biomedical technology. The resultant NIH Consensus Statements are intended to advance understanding of the technology or issue in question and to be useful to health professionals and the public.

NIH Consensus Statements are prepared by a nonadvocate, nonfederal panel of experts based on (1) presentations by investigators working in areas relevant to the consensus questions during a 2-day public session; (2) questions and statements from conference attendees during open discussion periods that are part of the public session; and (3) closed deliberations by the panel during the remainder of the second day and morning of the third day. This statement is an independent report of the panel and is not a policy statement of the NIH or the federal government.

Preparation and distribution of this statement is the responsibility of the Office of Medical Applications of Research of the National Institutes of Health. Free copies of this statement and bibliographies prepared by the National Library of Medicine are available from the Office of Medical Applications of Research, Federal Bldg, Room 618, National Institutes of Health, 7550 Wisconsin Ave MSC 9120, Bethesda, MD 20892 (William H. Hall), or the NIH Consensus Program Information Service by 24-hour voice mail at (800) NIH-OMAR (644-6627).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for Use of Tumor Markers in Testicular, Prostate, Colorectal, Breast, and Ovarian Cancers
Sturgeon et al.
Clin. Chem. 2008;54:e11-e79.
ABSTRACT | FULL TEXT  

Current Management Strategies for Ovarian Cancer
Aletti et al.
Mayo Clin Proc. 2007;82:751-770.
ABSTRACT | FULL TEXT  

Failing to Plan Is Planning to Fail: Improving the Quality of Care With Survivorship Care Plans
Earle
JCO 2006;24:5112-5116.
ABSTRACT | FULL TEXT  

Effect of Surgeon Specialty on Processes of Care and Outcomes for Ovarian Cancer Patients
Earle et al.
JNCI J Natl Cancer Inst 2006;98:172-180.
ABSTRACT | FULL TEXT  

Src Tyrosine Kinase and Multidrug Resistance Protein-1 Inhibitions Act Independently but Cooperatively to Restore Paclitaxel Sensitivity to Paclitaxel-Resistant Ovarian Cancer Cells
George et al.
Cancer Res. 2005;65:10381-10388.
ABSTRACT | FULL TEXT  

Enhanced Counseling for Women Undergoing BRCA1/2 Testing: Impact on Subsequent Decision Making About Risk Reduction Behaviors
Miller et al.
Health Educ Behav 2005;32:654-667.
ABSTRACT  

Genetic Risk Assessment and BRCA Mutation Testing for Breast and Ovarian Cancer Susceptibility: Systematic Evidence Review for the U.S. Preventive Services Task Force
Nelson et al.
ANN INTERN MED 2005;143:362-379.
ABSTRACT | FULL TEXT  

Treated Ovarian Cancer: MR Imaging, Laparotomy Reassessment, and Serum CA-125 Values Compared with Clinical Outcome at 1 Year
Low et al.
Radiology 2005;235:918-926.
ABSTRACT | FULL TEXT  

Src inhibition enhances paclitaxel cytotoxicity in ovarian cancer cells by caspase-9-independent activation of caspase-3
Chen et al.
Molecular Cancer Therapeutics 2005;4:217-224.
ABSTRACT | FULL TEXT  

Cancer Screening in Theory and in Practice
Brawley and Kramer
JCO 2005;23:293-300.
ABSTRACT | FULL TEXT  

Surgical Prevention of Cancer
Bertagnolli
JCO 2005;23:324-332.
ABSTRACT | FULL TEXT  

Risk-Reducing Salpingo-Oophorectomy in BRCA Mutation Carriers: Role of Serial Sectioning in the Detection of Occult Malignancy
Powell et al.
JCO 2005;23:127-132.
ABSTRACT | FULL TEXT  

Cancer of the Ovary
Cannistra
NEJM 2004;351:2519-2529.
FULL TEXT  

The Economic Impact of False-Positive Cancer Screens
Lafata et al.
Cancer Epidemiol. Biomarkers Prev. 2004;13:2126-2132.
ABSTRACT | FULL TEXT  

Integrated FDG PET/CT in Patients with Persistent Ovarian Cancer: Correlation with Histologic Findings
Sironi et al.
Radiology 2004;233:433-440.
ABSTRACT | FULL TEXT  

Preoperative Sensitivity and Specificity for Early-Stage Ovarian Cancer When Combining Cancer Antigen CA-125II, CA 15-3, CA 72-4, and Macrophage Colony-Stimulating Factor Using Mixtures of Multivariate Normal Distributions
Skates et al.
JCO 2004;22:4059-4066.
ABSTRACT | FULL TEXT  

STK15 Polymorphisms and Association with Risk of Invasive Ovarian Cancer
DiCioccio et al.
Cancer Epidemiol. Biomarkers Prev. 2004;13:1589-1594.
ABSTRACT | FULL TEXT  

An oncologist-based model of cancer genetic counselling for hereditary breast and ovarian cancer
Contegiacomo et al.
Ann Oncol 2004;15:726-732.
ABSTRACT | FULL TEXT  

Hormone Replacement Therapy and Life Expectancy After Prophylactic Oophorectomy in Women With BRCA1/2 Mutations: A Decision Analysis
Armstrong et al.
JCO 2004;22:1045-1054.
ABSTRACT | FULL TEXT  

Elevated Serum Insulin-Like Growth Factor Binding Protein-2 as a Prognostic Marker in Patients with Ovarian Cancer
Baron-Hay et al.
Clin. Cancer Res. 2004;10:1796-1806.
ABSTRACT | FULL TEXT  

Incremental Benefits of FDG Positron Emission Tomography over CT Alone for the Preoperative Staging of Ovarian Cancer
Yoshida et al.
Am. J. Roentgenol. 2004;182:227-233.
ABSTRACT | FULL TEXT  

From the Archives of the AFIP: Radiologic Staging of Ovarian Carcinoma with Pathologic Correlation
Woodward et al.
RadioGraphics 2004;24:225-246.
ABSTRACT | FULL TEXT  

Bilateral Prophylactic Oophorectomy and Ovarian Cancer Screening Following BRCA1/BRCA2 Mutation Testing
Schwartz et al.
JCO 2003;21:4034-4041.
ABSTRACT | FULL TEXT  

Ongoing Care of Patients After Primary Treatment for Their Cancer
Kattlove and Winn
CA Cancer J Clin 2003;53:172-196.
ABSTRACT | FULL TEXT  

Multidetector CT of Peritoneal Carcinomatosis from Ovarian Cancer
Pannu et al.
RadioGraphics 2003;23:687-701.
ABSTRACT | FULL TEXT  

Cyclooxygenase-1 is Overexpressed and Promotes Angiogenic Growth Factor Production in Ovarian Cancer
Gupta et al.
Cancer Res. 2003;63:906-911.
ABSTRACT | FULL TEXT  

International Collaborative Ovarian Neoplasm Trial 1 and Adjuvant ChemoTherapy In Ovarian Neoplasm Trial: Two Parallel Randomized Phase III Trials of Adjuvant Chemotherapy in Patients With Early-Stage Ovarian Carcinoma
ICON1 and EORTC-ACTION
JNCI J Natl Cancer Inst 2003;95:105-112.
ABSTRACT | FULL TEXT  

Evidence-based management options for women at increased breast/ovarian cancer risk
Pichert et al.
Ann Oncol 2003;14:9-19.
ABSTRACT | FULL TEXT  

Methylation Profiles of Sporadic Ovarian Tumors and nonmalignant Ovaries from High-Risk Women
Rathi et al.
Clin. Cancer Res. 2002;8:3324-3331.
ABSTRACT | FULL TEXT  

Intraperitoneal Therapy of Ovarian Cancer Using an Engineered Measles Virus
Peng et al.
Cancer Res. 2002;62:4656-4662.
ABSTRACT | FULL TEXT  

Practice Guidelines for Tumor Marker Use in the Clinic
Sturgeon
Clin. Chem. 2002;48:1151-1159.
ABSTRACT | FULL TEXT  

Paradigms for Primary Prevention of Ovarian Carcinoma
Barnes et al.
CA Cancer J Clin 2002;52:216-225.
ABSTRACT | FULL TEXT  

p53 Mutations in Leukemia and Myelodysplastic Syndrome after Ovarian Cancer
Leonard et al.
Clin. Cancer Res. 2002;8:973-985.
ABSTRACT | FULL TEXT  

Variations in the Use of Chemotherapy for Elderly Patients With Advanced Ovarian Cancer: A Population-Based Study
Sundararajan et al.
JCO 2002;20:173-178.
ABSTRACT | FULL TEXT  

Mechanisms Underlying Chemoprevention of Ovarian Cancer
Mills
Clin. Cancer Res. 2002;8:7-10.
ABSTRACT | FULL TEXT  

Effects of Nonsteroidal Anti-Inflammatory Agents (NSAIDs) on Ovarian Carcinoma Cell Lines: Preclinical Evaluation of NSAIDs as Chemopreventive Agents
Rodriguez-Burford et al.
Clin. Cancer Res. 2002;8:202-209.
ABSTRACT | FULL TEXT  

BRCA1/2 Testing: Complex Themes in Result Interpretation
Peshkin et al.
JCO 2001;19:2555-2565.
ABSTRACT | FULL TEXT  

A secondary interpretation is needed on serum CA 125 levels in case of serosal involvement
The Journal of the Royal Society for the Promotion of Health 2000;120:268-270.
 

Autologous Stem-Cell Transplantation in Ovarian Cancer: Is More Better?
Sarosy and Reed
ANN INTERN MED 2000;133:555-556.
FULL TEXT  

Imaging Evaluation of Ovarian Masses
Jeong et al.
RadioGraphics 2000;20:1445-1470.
ABSTRACT | FULL TEXT  

Adnexal Masses in Women with Breast Cancer: US Findings with Clinical and Histopathologic Correlation
Hann et al.
Radiology 2000;216:242-247.
ABSTRACT | FULL TEXT  

What Would You Do? Specialists' Perspectives on Cancer Genetic Testing, Prophylactic Surgery, and Insurance Discrimination
Matloff et al.
JCO 2000;18:2484-2492.
ABSTRACT | FULL TEXT  

Staging of Advanced Ovarian Cancer: Comparison of Imaging Modalities-Report from the Radiological Diagnostic Oncology Group
Tempany et al.
Radiology 2000;215:761-767.
ABSTRACT | FULL TEXT  

Prophylactic Surgery in Women With a Hereditary Predisposition to Breast and Ovarian Cancer
Eisen et al.
JCO 2000;18:1980-1995.
ABSTRACT | FULL TEXT  

Communicating Genetic Risk: Pros, Cons, and Counsel
Penson et al.
The Oncologist 2000;5:152-161.
ABSTRACT | FULL TEXT  

Lessons to be learned: a case study approach: Ascites and elevated serum CA 125 due to a pancreatic carcinoma. A diagnostic dilemma
Ahmed et al.
The Journal of the Royal Society for the Promotion of Health 2000;120:47-51.
ABSTRACT  

Complex Adnexal Masses: Detection and Characterization with MR Imaging-Multivariate Analysis1
Hricak et al.
Radiology 2000;214:39-46.
ABSTRACT | FULL TEXT  

Testing for Hereditary Cancer Risk: Pandora or Prometheus?
Frank and Skolnick
J. Clin. Endocrinol. Metab. 1999;84:1882-1885.
FULL TEXT  

Treated Ovarian Cancer: Comparison of MR Imaging with Serum CA-125 Level and Physical Examination—A Longitudinal Study
Low et al.
Radiology 1999;211:519-528.
ABSTRACT | FULL TEXT  

Extending the Platinum-Free Interval in Recurrent Ovarian Cancer: The Role of Topotecan in Second-Line Chemotherapy
Bookman
The Oncologist 1999;4:87-94.
ABSTRACT | FULL TEXT  

Fortnightly review: Hereditary ovarian carcinoma
Kasprzak et al.
BMJ 1999;318:786-789.
FULL TEXT  

Risk of Leukemia after Platinum-Based Chemotherapy for Ovarian Cancer
Travis et al.
NEJM 1999;340:351-357.
ABSTRACT | FULL TEXT  

Giant Syncytia and Virus-Like Particles in Ovarian Carcinoma Cells Isolated from Ascites Fluid
Rakowicz-Szulczynska et al.
CVI 1999;6:115-126.
ABSTRACT | FULL TEXT  

Hereditary Risk of Breast and Ovarian Carcinoma: The Role of the Oncologist
Frank
The Oncologist 1998;3:403-412.
ABSTRACT | FULL TEXT  

New Perspectives on an Old Friend: Optimizing Carboplatin for the Treatment of Solid Tumors
Alberts and Dorr
The Oncologist 1998;3:15-34.
ABSTRACT | FULL TEXT  

Quality of Life in Women with Ovarian Cancer
Ersek et al.
West J Nurs Res 1997;19:334-350.
ABSTRACT  

Recommendations for Follow-up Care of Individuals With an Inherited Predisposition to Cancer: II. BRCA1 and BRCA2
Burke et al.
JAMA 1997;277:997-1003.
ABSTRACT  

New Therapy for Ovarian Cancer
Neijt
NEJM 1996;334:50-51.
FULL TEXT  

Family History and Risk of Ovarian Cancer
Foulkes et al.
JAMA 1995;274:383-383.
ABSTRACT