The natural history and treatment of ovarian cancer

Annual Review of Medicine
D L Longo, R C Young

Abstract

Several advances in the understanding of the biology and treatment of ovarian cancer over the past five years have changed the pessimistic view of this disease that was formerly commonplace. A cornerstone of the management of patients with ovarian cancer is careful pathological staging both prior to and at the cessation of therapy. Patients with all grades of Stage I lesions except the well-differentiated ones should have some form of adjuvant therapy, although the best choice is still unclear. Similarly, Stage II patients, though few in number, have only a 50% change of surviving five years without some adjuvant treatment. Since the best choice is unclear, it would be ideal if such all patients could be treated in a study setting. Every early stage patient treated off study slows the identification of definitive therapy. For the majority of patients with advanced disease, the treatment of choice is aggressive debulking surgery followed by combination chemotherapy. After six cycles of therapy, patients should be restaged sequentially moving all the way to repeat laparotomy, if necessary, to find residual disease before therapy is discontinued. If no disease is found, we randomize patients to either careful follow-up or six cycl...Continue Reading

Citations

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