No widely agreed consensus protocols exist for the management of benign ovarian tumors (BOT) in children. This presents a substantial risk for suboptimal management. We aimed to generate multispecialty consensus guidance to standardize surgical management and provide a clear follow-up protocol for children with BOTs.
Prospective two-round confidential e-Delphi consensus survey distributed among multispecialty expert panel; concluded by two semistructured videoconferences.
Consensus was generated on these core outcome sets: preoperative/intraoperative management; follow-up; adolescent gynecology referral. (1) Children with BOTs should receive the same management as other patients with potentially neoplastic lesions: Preoperative discussion at a pediatric oncology multidisciplinary meeting to risk stratify tumors, and management by health professionals with expertise in ovarian-sparing surgery and laparoscopy. (2) Ovarian-sparing surgery for BOTs should be performed wherever possible to maximize fertility preservation. (3) Ovarian masses detected during emergency laparoscopy/laparotomy should be left in situ wherever feasible and investigated appropriately (imaging/tumor markers) before resection. (4) Follow-up should be undertaken for all patients after BOT resection. Patients should be offered referral to adolescent gynecology to discuss fertility implications.
This best practice Delphi consensus statement emphasizes the importance of managing children with BOTs through a well-defined oncological MDT strategy, in order to optimize risk stratification and allow fertility preservation by ovarian-sparing surgery wherever possible.

OBJECTIVE: The objective of the study was to propose clinical guidelines for the use of minimally invasive surgery (MIS) in pediatric oncology.
METHODS: Two groups of experts, including pediatric surgeons and pediatric oncologists were created in order to establish strategies of diagnostic and therapeutic surgical management in pediatric oncology.
RESULTS: On the basis of the analysis of the existing literature, we elaborated guidelines that were graded according to the simple practical clinical system: yes/no. This project was dedicated to the following topics: adrenal tumors including neuroblastoma, renal tumors including Wilms tumor (nephroblastoma), ovarian tumors and pulmonary nodules and metastases (osteosarcoma).
CONCLUSIONS: Although existing data do not allow the recommendation of the use of MIS for all indications, this technique should currently be regarded as a standard of care in several areas of pediatric oncology.