In regards to surgery it is recommended to perform total omentectomy since subclinic metastasis have been documented in 10 - 30 % of all cases , and systematic limphadenectomy , necessary to be able to obtain an adequate surgical staging .
Minimal invasion surgery is not a recommended procedure for the treatment of advanced ovarian cancer .
Radiotherapy can be used to palliate symptoms .
In the present , there is not a st and ardized screening method .
Diagnosis in early stages means a better survival .
Radiotherapy can be indicated to palliate symptoms
INTRODUCTION Ovarian cancer ( OC ) is the third most common gynecologic malignancy worldwide .
Most of cases it is of epithelial origin .
At the present time there is not a st and ardized screening method , which makes difficult the early diagnosis .
The 5-year survival is 90 % for early stages , however most cases present at advanced stages , which have a 5-year survival of only 5 - 20 % .
GICOM collaborative group , under the auspice of different institutions , have made the following consensus in order to make recommendations for the diagnosis and management regarding to this neoplasia .
Until now , laparoscopy for diagnostic-staging surgery is not well known as a recommended method .
In advanced stages , primary cytoreduction is recommended as initial treatment .
Outcome and staging evaluation in malignant germ cell tumors of the ovary in children and adolescents: an intergroup study.
PURPOSE The aim of this study was to perform an evaluation of outcome and the role of surgical staging components in malignant germ cell tumors ( GCT ) of the ovary in children and adolescents . METHODS From 1990 to 1996 , 2 intergroup trials for malignant GCT were undertaken by Pediatric Oncology Group ( POG ) and Children 's Cancer Study Group ( CCG ) . Stage I-II patients were treated with surgical resection and 4 cycles of st and ard dose cisplatin ( 100 mg/m2/cycle ) , etoposide , and bleomycin ( PEB ) chemotherapy . Stage III-IV patients were treated with surgical resection and r and omly assigned to chemotherapy with PEB or high-dose cisplatin ( 200 mg/m2/cycle ) with etoposide and bleomycin ( HDPEB ) . Patients unresectable at diagnosis had second-look operation after 4 cycles of chemotherapy if residual tumor was seen on imaging studies . IRB approval of the protocol s was obtained at each participating institution . An analysis of outcome data , operative notes , and pathology reports in girls with ovarian primary site was done for this report . RESULTS There were 131 patients with ovarian primary tumors of 515 entered on these studies . Mean age was 11.9 years ( range , 1.4 to 20 years ) .  Six-year survival rate was stage , I 95.1 % ; stage II , 93.8 % ; stage III , 98.3 % ; stage IV , 93.3 % . In only 3 of 131 patients were surgical guidelines followed completely . Surgical omissions result ing in protocol noncompliance result ed from failure to biopsy bilateral nodes ( 97 % ) , no omentectomy ( 36 % ) , no peritoneal cytology ( 21 % ) , no contralateral ovary biopsy ( 59 % ) . More aggressive procedure than recommended by guidelines included total hysterectomy and bilateral salpingo-oophorectomy in 6 patients and retroperitoneal node dissection in 10 patients . Correlation of gross operative findings with pathology results was carried out for ascites , lymph nodes , implants , omentum , and contralateral ovary . CONCLUSIONS Pediatric ovarian malignant GCT ( stages I-IV ) have excellent survival with conservative surgical resection and platinum-based chemotherapy . Survival appears to have been unaffected by deviations from surgical guidelines . New surgical guidelines are proposed based on correlation of gross findings , histology , and outcome in these intergroup trials
In regards to surgery it is recommended to perform total omentectomy since subclinic metastasis have been documented in 10 - 30 % of all cases , and systematic limphadenectomy , necessary to be able to obtain an adequate surgical staging .
Minimal invasion surgery is not a recommended procedure for the treatment of advanced ovarian cancer .
Radiotherapy can be used to palliate symptoms .
In the present , there is not a st and ardized screening method .
Diagnosis in early stages means a better survival .
Radiotherapy can be indicated to palliate symptoms
INTRODUCTION Ovarian cancer ( OC ) is the third most common gynecologic malignancy worldwide .
Most of cases it is of epithelial origin .
At the present time there is not a st and ardized screening method , which makes difficult the early diagnosis .
The 5-year survival is 90 % for early stages , however most cases present at advanced stages , which have a 5-year survival of only 5 - 20 % .
GICOM collaborative group , under the auspice of different institutions , have made the following consensus in order to make recommendations for the diagnosis and management regarding to this neoplasia .
Until now , laparoscopy for diagnostic-staging surgery is not well known as a recommended method .
In advanced stages , primary cytoreduction is recommended as initial treatment .