The European Society of Gynaecological Oncology, the European Society for Medical Oncology (ESMO) and the European Society of Pathology held a consensus conference (CC) on ovarian cancer on 15-16 June 2022 in Valencia, Spain. The CC panel included 44 experts in the management of ovarian cancer and pathology, an ESMO scientific advisor and a methodologist. The aim was to discuss new or contentious topics and develop recommendations to improve and harmonise the management of patients with ovarian cancer. Eighteen questions were identified for discussion under four main topics: (i) pathology and molecular biology, (ii) early-stage disease and pelvic mass in pregnancy, (iii) advanced stage (including older/frail patients) and (iv) recurrent disease. The panel was divided into four working groups (WGs) to each address questions relating to one of the four topics outlined above, based on their expertise. Relevant scientific literature was reviewed in advance. Recommendations were developed by the WGs and then presented to the entire panel for further discussion and amendment before voting. This manuscript focuses on the recommendation statements that reached a consensus, their voting results and a summary of evidence supporting each recommendation.

Arbeitsgemeinschaft Gynäkologische Onkologie Study Group Germany; Department of Obstetrics and Gynecology University Hospital LMU Munich Munich

Arbeitsgemeinschaft Gynäkologische Onkologie Study Group Germany; Department of Obstetrics and Gynecology University Hospital Mannheim Mannheim; Medical Faculty Mannheim Heidelberg University Mannheim Germany

Cancer Research UK Scotland Centre Institute of Genetics and Cancer University of Edinburgh Edinburgh UK

CIBERONC Madrid; Department of Pathology Hospital Universitari Arnau de Vilanova IRBLLEIDA University of Lleida Lleida; Department of Pathology Hospital Universitari de Bellvitge IDIBELL University of Barcelona Barcelona Spain

Department of Biopathology Bergonié Institut Bordeaux France

Department of Gynaecologic Oncology Leuven Cancer Institute University Hospitals Leuven Leuven Belgium

Department of Gynaecologic Oncology Leuven Cancer Institute University Hospitals Leuven Leuven Belgium; Department of Gynecology Center for Gynecological Oncology Amsterdam Netherlands Cancer Institute Amsterdam The Netherlands

Department of Gynaecology and Gynaecologic Oncology Evang Kliniken Essen Mitte Essen Germany; Arbeitsgemeinschaft Gynäkologische Onkologie Study Group Germany

Department of Gynaecology and Obstetrics Cancer Center Clínica Universidad de Navarra Navarra Spain

Department of Gynecologic Oncology Istituto Europeo di Oncologia IRCCS Milan; Department of Medicine and Surgery University of Milano Bicocca Milan Italy

Department of Gynecologic Oncology School of Medicine Koç University Istanbul Turkey

Department of Gynecologic Surgery Gustave Roussy Cancer Campus Villejuif France

Department of Gynecology Center for Gynecological Oncology Amsterdam Netherlands Cancer Institute Amsterdam The Netherlands

Department of Gynecology Obstetrics and Neonatology 1st Faculty of Medicine Charles University and General University Hospital Prague Prague Czech Republic

Department of Medical Oncology and Program in Solid Tumours Cima Cancer Center Clínica Universidad de Navarra Madrid Spain

Department of Medical Oncology Centre Léon Bérard University Claude Bernard Lyon France

Department of Medical Oncology Hospital Clínico Universitario INCLIVA CIBERONC Valencia Spain

Department of Medical Oncology Instituto Valenciano Oncologia Valencia Spain

Department of Medicine Institut Gustave Roussy Villejuif France

Department of Medicine Yong Loo Lin School of Medicine National University of Singapore Singapore; National University of Singapore Centre for Cancer Research Yong Loo Lin School of Medicine National University of Singapore Singapore; Cancer Science Institute National University of Singapore Singapore; Department of Haematology Oncology National University Cancer Institute Singapore National University Hospital Singapore Singapore

Department of Obstetrics and Gynaecology Medical University of Innsbruck Innsbruck Austria

Department of Obstetrics and Gynaecology Medical University of Innsbruck Innsbruck Austria; Department of Gynaecology and Gynaecologic Oncology Evang Kliniken Essen Mitte Essen Germany

Department of Obstetrics and Gynecology Houston Methodist Hospital Houston USA

Department of Oncology UCL Cancer Institute University College London London UK

Department of Pathology Belfast Health and Social Care Trust Belfast UK

Department of Pathology Norwegian Radium Hospital Oslo University Hospital Oslo; Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway

Department of Surgery and Cancer Faculty of Medicine Imperial College London London UK

Department of Urology and Gynecology Istituto Nazionale Tumori di Napoli IRCCS Fondazione Pascale Napoli Italy

Division of Gynecologic Oncology Fondazione Policlinico Universitario A Gemelli IRCCS Rome; Department of Woman Child and Public Health Catholic University of Sacred Heart Rome Italy

GINECO Group Department of Medical Oncology Centre François Baclesse University of Caen Normandy Caen France

Gynaecologic Cancer Programme Vall d'Hebron Institute of Oncology Hospital Universitari Vall d'Hebron Vall d'Hebron Barcelona Hospital Campus Barcelona

Hereditary Cancer Program Catalan Institute of Oncology L'Hospitalet de Llobregat Barcelona Spain

Institut Bergonié Bordeaux France

Institute of Aging Hospices Civils de Lyon Lyon; CarMeN Laboratory INSERM U1060 Université Lyon 1 INRAE U1397 Hospices Civils Lyon Pierre Bénite France

Institute of Cancer and Genomic Sciences University of Birmingham Birmingham; Pan Birmingham Gynaecological Cancer Centre City Hospital Birmingham UK

Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway; Department of Gynecologic Oncology Division of Cancer Medicine The Norwegian Radium Hospital Oslo University Hospital Oslo Norway

North Eastern German Society of Gynecological Oncology Berlin; Department of Gynecology with Center for Oncological Surgery Charité Berlin University of Medicine Berlin Germany

Oncology Institute of Southern Switzerland Bellinzona Switzerland

Sheba Medical Center Ramat Gan Israel

The Royal Marsden NHS Foundation Trust and Institute of Cancer Research London UK

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