Abstract
Management strategies in ovarian cancer are divided between those for early and late presentations of the disease. In early cancer, the emphasis is on ensuring adequate treatment and avoiding the need for chemotherapy where possible by completing full staging. In situations where fertility is required, the relevant information concerning risks must be discussed with the patient. In late-stage cancer, the emphasis is on extended radical debulking surgery to remove all visible disease plus the use of combination chemotherapy. The timing of surgery may be varied. Chemotherapy options include dose-dense paclitaxel, intraperitoneal chemotherapy and maintenance therapy. In recurrent disease, surgery must be considered and combination chemotherapy used depending on the interval from the initial treatment.
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References
Le T, Adolph A, Krepart GV, Lotocki R, Heywood MS. The benefits of comprehensive surgical staging in the management of early-stage epithelial ovarian carcinoma. Gynecol Oncol. 2002;85(2):351–5.
Benjamin I, Morgan MA, Rubin SC. Occult bilateral involvement in stage I epithelial ovarian cancer. Gynecol Oncol. 1999;72(3):288–91.
Kajiyama H, Shibata K, Suzuki S, Ino K, Nawa A, Kawai M, Nagasaka T, Kikkawa F. Fertility-sparing surgery in young women with invasive epithelial ovarian cancer. Eur J Surg Oncol. 2010;36(4):404–8.
Schilder JM, Thompson AM, DePriest PD, Ueland FR, Cibull ML, Kryscio RJ, et al. Outcome of reproductive age women with stage IA or IC invasive epithelial ovarian cancer treated with fertility-sparing therapy. Gynecol Oncol. 2002;87(1):1–7.
Morice P, Denschlag D, Rodolakis A, Reed N, Schneider A, Kesic V, Colombo N, Fertility Task Force of the European Society of Gynecologic Oncology. Recommendations of the Fertility Task Force of the European Society of Gynecologic Oncology about the conservative management of ovarian malignant tumors. Int J Gynecol Cancer. 2011;21(5):951–63.
Vitobello D, Siesto G, Bulletti C, Accardi A, Levi Setti PE. Gynecological fertility-sparing surgery. Placenta. 2011;32 Suppl 3:S224–31.
Trimbos JB, Parmar M, Vergote I, Guthrie D, Bolis G, Colombo N, International Collaborative Ovarian Neoplasm 1, European Organisation for Research and Treatment of Cancer Collaborators-Adjuvant ChemoTherapy un Ovarian Neoplasm, et al. International Collaborative Ovarian Neoplasm trial 1 and Adjuvant ChemoTherapy In Ovarian Neoplasm trial: two parallel randomized phase III trials of adjuvant chemotherapy in patients with early-stage ovarian carcinoma. J Natl Cancer Inst. 2003;95(2):105–12.
Griffiths CT. Surgical resection of tumor bulk in the primary treatment of ovarian carcinoma. J Natl Cancer Inst Monogr. 1975;42:101–4.
Eisenhauer EL, Abu-Rustum NR, Sonoda Y, Levine DA, Poynor EA, Aghajanian C, et al. The addition of extensive upper abdominal surgery to achieve optimal cytoreduction improves survival in patients with stages IIIC-IV epithelial ovarian cancer. Gynecol Oncol. 2006;103(3):1083–90.
Chi DS, Eisenhauer EL, Zivanovic O, Sonoda Y, Abu-Rustum NR, Levine DA, et al. Improved progression-free and overall survival in advanced ovarian cancer as a result of a change in surgical paradigm. Gynecol Oncol. 2009;114(1):26–31.
Vergote I, Tropé CG, Amant F, Kristensen GB, Ehlen T, Johnson N, European Organization for Research and Treatment of Cancer-Gynaecological Cancer Group, NCIC Clinical Trials Group, et al. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N Engl J Med. 2010;363(10):943–53.
Katsumata N, Yasuda M, Takahashi F, Isonishi S, Jobo T, Aoki D, Japanese Gynecologic Oncology Group, et al. Dose-dense paclitaxel once a week in combination with carboplatin every 3 weeks for advanced ovarian cancer: a phase 3, open-label, randomised controlled trial. Lancet. 2009;374(9698):1331–8.
Armstrong DK, Bundy B, Wenzel L, Huang HQ, Baergen R, Lele S, Gynecologic Oncology Group, et al. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med. 2006;354(1):34–43.
Perren TJ, Swart AM, Pfisterer J, Ledermann JA, Pujade-Lauraine E, Kristensen G, ICON7 Investigators, et al. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med. 2011;365(26):2484–96.
Burger RA, Brady MF, Bookman MA, Fleming GF, Monk BJ, Huang H, Gynecologic Oncology Group, et al. Incorporation of bevacizumab in the primary treatment of ovarian cancer. N Engl J Med. 2011;365(26):2473–83.
Parmar MK, Ledermann JA, Colombo N, du Bois A, Delaloye JF, Kristensen GB, et al. Paclitaxel plus platinum-based chemotherapy versus conventional platinum-based chemotherapy in women with relapsed ovarian cancer: the ICON4/AGO-OVAR-2.2 trial. The ICON and AGO Collaborators. Lancet. 2003;361(9375):2099–106.
Pfisterer J, Plante M, Vergote I, du Bois A, Hirte H, Lacave AJ, AGO-OVAR, NCIC CTG, EORTC GCG, et al. Gemcitabine plus carboplatin compared with carboplatin in patients with platinum-sensitive recurrent ovarian cancer: an intergroup trial of the AGO-OVAR, the NCIC CTG, and the EORTC GCG. J Clin Oncol. 2006;24(29):4699–707.
Wagner U, Marth C, Largillier R, Kaern J, Brown C, Heywood M, et al. Final overall survival results of phase III GCIG CALYPSO trial of pegylated liposomal doxorubicin and carboplatin vs paclitaxel and carboplatin in platinum-sensitive ovarian cancer patients. Br J Cancer. 2012;107(4):588–91.
Harter P, Sehouli J, Reuss A, Hasenburg A, Scambia G, Cibula D, et al. Prospective validation study of a predictive score for operability of rec urrent ovarian cancer: the Multicenter Intergroup Study DESKTOP II. A project of the AGO Kommission OVAR, AGO Study Group, NOGGO, AGO-Austria, and MITO. Int J Gynecol Cancer. 2011;21(2):289–95.
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Mould, T. (2014). Strategies for the Management of Ovarian Cancer. In: Farghaly, S. (eds) Advances in Diagnosis and Management of Ovarian Cancer. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-8271-0_6
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DOI: https://doi.org/10.1007/978-1-4614-8271-0_6
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