Advances in treatment of epithelial ovarian cancer.
Since most cases of epithelial ovarian cancer are advanced at diagnosis, this disease is one of the most lethal malignancies of the female genital tract. In recent years, aggressive cytoreductive surgery and chemotherapy have been employed in an attempt to improve the survival rate in patients with epithelial ovarian cancer. Introduction of platinum anticancer drugs increased survival rate, and several randomized studies have been tried to establish the better combination of anticancer drugs. As a result, the combination of paclitaxel and carboplatin was considered as standard regimen for the first-line treatment of patients with advanced ovarian cancer. Since International Federation of Gynecology and Obstetrics (FIGO) accepted a postoperative staging system in 1988, staging laparotomy needs hysterectomy, bilateral adnexectomy, omentectomy, and pelvic and para-aorta lymphadenectomy. However, the influence of lymphadenectomy on survival still remains controversial. Complete resection of the tumor is often difficult since the disease has spread to the abdominal cavity. In such cases, interval debulking surgery is performed after chemotherapy to remove tumors completely. The effectiveness of neoadjuvant chemotherapy and interval debulking surgery still remains unclear. This review will describe the advances in surgical procedures and chemotherapy in treatment of ovarian cancer patients.
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsurumai-cho 65, Showa-ku, Nagoya 466-8550, Japan. kikkawaf@med.nagoya-u.ac.jp
Fumitaka
F
Kikkawa
Akihiro
A
Nawa
Kazuhiko
K
Ino
Kiyosumi
K
Shibata
Hiroaki
H
Kajiyama
Seiji
S
Nomura
D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D010052:Ovariectomy; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis