SYMPOSIUM ON SOLID TUMORS
Current Management Strategies for Ovarian Cancer
Section snippets
Categories
The 3 categories of ovarian cancer are named for their cell of origin. Ninety percent of ovarian cancers arise from cells that make up the epithelial layer that covers the surface of the ovaries. These are known as epithelial cancers. In general, when the term ovarian cancer is used, it implies epithelial ovarian cancer, the focus of this review. The other 2 types are germ cell tumors and stromal tumors. Stromal tumors arise in the hormonally active elements within the connective tissue stroma
Clinical Presentation
Symptoms. The symptoms of ovarian cancer are fairly nonspecific and often occur when the disease is already spread throughout the abdominal cavity. Abdominal discomfort or vague pain, abdominal fullness, bowel habit changes, early satiety, dyspepsia, and bloating are frequent presenting symptoms.37 Occasionally, patients may present with bowel obstruction due to intra-abdominal masses or shortness of breath due to pleural effusion. Early-stage disease is usually asymptomatic, and the diagnosis
TREATMENT
The first step in the management of patients with epithelial ovarian cancer is an accurate diagnosis and thorough staging, with optimal surgical cytoreduction of metastatic disease. Postoperative taxane- and platinum-based chemotherapy is then administered to patients with a significant risk of recurrence. In this section we review the role of surgery and chemotherapy in the management of patients with ovarian cancer. We highlight surgical approaches to obtain optimal tumor cytoreduction in
CONCLUSION
Symptoms of ovarian cancer are fairly nonspecific and often occur after the disease has spread throughout the abdominal cavity. The presence of a pelvic mass at physical examination is the most important sign of ovarian cancer. The serum CA-125 level has been widely used as a marker for a possible epithelial ovarian cancer in the primary assessment of a pelvic mass. The predominant use of CA-125 measurement is to monitor disease status of patients with ovarian cancer, such as detecting early
Acknowledgments
We are indebted to Vicki Shea for her help and expertise in the preparation of the submitted manuscript. We dedicate this review to our patients with ovarian and primary peritoneal cancer.
REFERENCES (239)
- et al.
Focus on epithelial ovarian cancer
Cancer Cell
(2004) - et al.
BRCA1, BRCA2, and hereditary nonpolyposis colorectal cancer gene mutations in an unselected ovarian cancer population: relationship to family history and implications for genetic testing
Am J Obstet Gynecol
(1998) - et al.
Prevalence and penetrance of germline BRCA1 and BRCA2 mutations in a population series of 649 women with ovarian cancer
Am J Hum Genet
(2001 Mar) - et al.
Contribution of BRCA1 and BRCA2 to familial ovarian cancer: a Gynecologic Oncology Group study
Gynecol Oncol
(2002) - et al.
BRCA1 and BRCA2 mutation analysis of 208 Ashkenazi Jewish women with ovarian cancer
Am J Hum Genet
(2000 Apr) - et al.
Risks of cancer in BRCA1-mutation carriers
Lancet
(1994) - et al.
Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case series unselected for family history: a combined analysis of 22 studies
Am J Hum Genet
(2003 May) - et al.
Surgical risk reduction: prophylactic salpingo-oophorectomy and prophylactic mastectomy
Am J Obstet Gynecol
(2004) - et al.
Current status of the molecular characterization of the ovarian cancer antigen CA125 and implications for its use in clinical screening
Gynecol Oncol
(2003) - et al.
Comparative hybridization of an array of 21,500 ovarian cDNAs for the discovery of genes overexpressed in ovarian carcinomas
Gene
(1999)
Combining CA 125 and SMR serum markers for diagnosis and early detection of ovarian carcinoma
Gynecol Oncol
Increased serum levels of macrophage colony-stimulating factor in ovarian cancer
Am J Obstet Gynecol
Human kallikrein 6 (zyme/protease M/neurosin): a new serum biomarker of ovarian carcinoma
Clin Biochem
Human kallikrein 10: a novel tumor marker for ovarian carcinoma?
Clin Chim Acta
The efficacy of transvaginal sonographic screening in asymptomatic women at risk for ovarian cancer
Gynecol Oncol
Screening for ovarian cancer: a pilot randomised controlled trial
Lancet
Design and evolution of the data management systems in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial
Control Clin Trials
Ovarian cancer screening in the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial: findings from the initial screen of a randomized trial [published correction appears in Am J Obstet Gynecol. 2005;193:2183-2184]
Am J Obstet Gynecol
Borderline ovarian tumors: key points and workshop summary
Hum Pathol
Long-term survival and patterns of care in women with ovarian tumors of low malignant potential
Gynecol Oncol
Is it justified to classify patients to Stage IIIC epithelial ovarian cancer based on nodal involvement only?
Gynecol Oncol
Epithelial ovarian carcinoma: principles of primary surgery
Gynecol Oncol
Cytoreductive surgery for ovarian cancer
Surg Clin North Am
“Optimal” cytoreduction for advanced epithelial ovarian cancer: a commentary
Gynecol Oncol
What are the current surgical objectives, strategies, and technical capabilities of gynecologic oncologists treating advanced epithelial ovarian cancer?
Gynecol Oncol
Does debulking surgery improve survival in biologically aggressive ovarian carcinoma?
Gynecol Oncol
The effect of bowel resection on survival in advanced epithelial ovarian cancer
Gynecol Oncol
Radical oophorectomy with primary stapled colorectal anastomosis for resection of locally advanced epithelial ovarian cancer
J Am Coll Surg
Splenectomy and surgical cytoreduction for ovarian cancer
Gynecol Oncol
Resection of diaphragmatic peritoneum and muscle: role in cytoreductive surgery for ovarian cancer
Gynecol Oncol
Hepatic resection for metachronous metastases from ovarian carcinoma
Gynecol Oncol
Role of rectosigmoidectomy and stripping of pelvic peritoneum in outcomes of patients with advanced ovarian cancer
J Am Coll Surg
Diaphragm resection for ovarian cancer: technique and short-term complications
Gynecol Oncol
Surgical treatment of diaphragm disease correlates with improved survival in optimally debulked advanced stage ovarian cancer
Gynecol Oncol
Splenectomy as part of cytoreductive surgery in ovarian cancer
Gynecol Oncol
Cancer statistics, 2006
CA Cancer J Clin
Cancer of the ovary
N Engl J Med
Ovarian sex cord-stromal tumors
Cancer of the ovary. Cancer Stat Fact Sheets. National Cancer Insitute SEER
Hormonal etiology of epithelial ovarian cancer, with a hypothesis concerning the role of androgens and progesterone
J Natl Cancer Inst
Tubal ligation, hysterectomy, and risk of ovarian cancer: a prospective study
JAMA
Ovarian tumors in a cohort of infertile women
N Engl J Med
Infertility, fertility drugs, and ovarian cancer: a pooled analysis of case-control studies
Am J Epidemiol
BRCA1 and BRCA2 mutations account for a large proportion of ovarian carcinoma cases
Cancer
Hereditary cancer predisposition syndromes
J Clin Oncol
Breast and ovarian cancer risks due to inherited mutations in BRCA1 and BRCA2
Science
Recommendations for the care of individuals with an inherited predisposition to Lynch syndrome: a systematic review
JAMA
A systematic review and meta-analysis of family history and risk of ovarian cancer
Br J Obstet Gynaecol
Location of BRCA1 in human breast and ovarian cancer cells [letter]
Science
Population genetics of BRCA1 and BRCA2 [editorial]
Am J Hum Genet
Cited by (187)
-
Methoxybenzamide derivative of nimesulide from anti-fever to anti-cancer: Chemical characterization and cytotoxicity
2022, Saudi Pharmaceutical Journal -
Involvement of small extracellular vesicle-derived TIE-1 in the chemoresistance of ovarian cancer cells
2021, Cancer Treatment and Research Communications -
Downshifting nanoprobes with follicle stimulating hormone peptide fabrication for highly efficient NIR II fluorescent bioimaging guided ovarian tumor surgery
2020, Nanomedicine: Nanotechnology, Biology, and Medicine -
Das Ovarialkarzinom: Score-Werte zur Definition von Risikopatientinnen
2024, Geburtshilfe und Frauenheilkunde
-
This study was supported by a grant (R01 CA86888) from the National Institutes of Health and grants from the Andersen Foundation and the Minnesota Ovarian Cancer Alliance.