Pathology and staging
- Ovarian biopsy is strongly discouraged at diagnosis [Level III,
grade E].
- Pathological assessment should include evaluation for capsule rupture,
capsular invasion, subtyping of OSCSTs, grading (grade of immaturity
in SLCTs), and description of prognostic histologic factors such as
heterologous elements in SLCTs, mitotic rate in GrCTs [Level II,
Grade A]. Pathologic samples should be evaluated by an experienced
gyneco-/pediatric pathologist, a central reference pathologist review
is recommended [Level IV, Grade A].21
- FOXL2 genetic assessment could be performed in GrCTs to
distinguish juvenile and adult types.
- SCSTs should be staged according to the updated staging system of the
International Federation of Gyneco-oncology (FIGO) for epithelial
ovarian cancer [Level IV, Grade B] (Table II).18,
24, 24, 25
Therapy