Ovarian cancer.
Ovarian cancer accounts for 4% of all cancers in women and is the leading cause of death from gynaecologic malignancies. Because early-stage ovarian cancer is generally asymptomatic, approximately 75% of women present with advanced disease at diagnosis. Survival is highly dependent on stage of disease: 5-year survival in patients with early-stage is 80-90% compared to 25% for patients with advanced-stage disease. For all patients, a comprehensive surgical staging should be performed to obtain the histological confirmation of diagnosis and to evaluate the extent of disease. Patients with early-stage should both be optimally staged and be treated with adjuvant platinum-based chemotherapy if they have a medium or high-risk tumour. For advanced disease the currently recommended management is primary cytoreductive surgery followed by platinum-paclitaxel combination chemotherapy. Appropriate salvage therapy is based on the timing and nature of recurrence and the extent of prior chemotherapy. Surgical resection should be considered in patients with long-term remission, especially in those with isolated recurrences and good performance status. Platinum-based combination represents the standard second-line chemotherapy in patients with platinum-sensitive relapsed ovarian cancer. Salvage chemotherapy in platinum-refractory patients usually results in low response rates and short survival.
Colombo
Nicoletta
N
European Institute of Oncology, Division of Gynecology, Via Ripamonti 435, Milan, Italy. nicoletta.colombo@ieo.it
Van Gorp
Toon
T
Parma
Gabriella
G
Amant
Frederic
F
Gatta
Gemma
G
Sessa
Cristiana
C
Vergote
Ignace
I
D000970:Antineoplastic Agents / Q000627:therapeutic use; D015415:Biomarkers; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D015994:Incidence; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D012307:Risk Factors; D016879:Salvage Therapy
D000970:Antineoplastic Agents; D015415:Biomarkers