Modern management of recurrent ovarian carcinoma. A systematic approach to a chronic disease.
The management of ovarian cancer entails a complex blend of medical and surgical interventions. Managing patients with recurrent ovarian cancer increases the complexity of therapies and adds palliative interventions. The presence of recurrent ovarian cancer is both emotionally and physically taxing for patients as well as their caregivers. With an increasingly informed patient population, a balance must be achieved between easily accessible information enabling patients to know that they now have an incurable disease and support for their hopes and desires to still overcome their cancer. The decision tree in the management of recurrent ovarian cancer blends many different factors. This discussion will separate those factors as if they are pure elements. We will address management based on response to primary therapy and time to recurrence, the location of recurrence, symptoms of recurrence, the patient's histopathology, and the patient's primary stage as it relates to the extent of disease present at the start of chemotherapy.
Michener
Chad M
CM
The Cleveland Clinic Foundation, Division of Gynecologic Oncology, Cleveland, Ohio 44195, USA.
Belinson
Jerome L
JL
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage / Q000627:therapeutic use; D002277:Carcinoma / Q000473:pathology / Q000628:therapy*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000628:therapy*; D017239:Paclitaxel / Q000008:administration & dosage / Q000627:therapeutic use; D016879:Salvage Therapy; D055502:Secondary Prevention; D019772:Topotecan / Q000008:administration & dosage / Q000627:therapeutic use
D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D019772:Topotecan; D016190:Carboplatin; D017239:Paclitaxel