Most patients with epithelial cell cancer of the ovary are found to have advanced disease at the time of diagnosis (stage III or IV). Cytoreductive surgery should be attempted in all patients deemed appropriate surgical candidates. The goal of surgery is to remove as much tumor as feasible so that there are no isolated tumor implants within the abdominal cavity larger than 2 cm in diameter. Patients whose tumors can be resected to this extent are designated as having minimal residual disease (Group I). Patients in whom such cytoreductive surgery is not feasible or who are not appropriate surgical candidates usually have macroscopic residual disease (Group II). Group I patients, those with minimal residual disease, can be treated either with irradiation of the entire abdominal cavity or with systemic chemotherapy. The trend in most centers is to treat such patients with combination chemotherapy, although it remains unproven whether this is superior to radiation therapy. Group II patients, those with macroscopic residual disease, should not receive primary radiotherapeutic treatment. They may be treated with either single-agent or multiagent chemotherapy. While combination chemotherapy increases the chances of achieving a complete clinical response for individual patients, it is associated with increased toxicity. The risks associated with this toxicity must be considered in view of the fact that few of these patients will actually achieve such a response. The five-year survival rate for patients with epithelial cell cancer of the ovary has not changed for more than 30 years. Aggressive surgical, chemotherapeutic, and radiotherapeutic management is beginning to prolong survival. Hopefully, further investigation will allow the earlier diagnosis of patients with ovarian cancer and give the clinician new therapies for the management of this disease.
|Original language||English (US)|
|Number of pages||8|
|State||Published - Dec 1 1985|
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