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The Treatment of Epithelial Ovarian Cancer

Source: caonline.amcancersoc.org
Topic: Ovaries
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Sort Desciption: Epithelial ovarian cancer is the most common lethal malignancy of the female genital tract. In 1995 it is estimated that 26,600 new cases will be diagnosed and 14,500 deaths will occur from ovarian cancer in the United States. ...

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Epithelial ovarian cancer is the most common lethal malignancy of the female genital tract. In 1995 it is estimated that 26,600 new cases will be diagnosed and 14,500 deaths will occur from ovarian cancer in the United States. Survival is directly correlated with stage, and treatment is also stage dependent. Thus, a basic understanding of the staging of ovarian cancer is essential (Table 1). The high mortality is largely related to absence of symptoms during earlystage disease (stage I and II), with 76 percent of patients having disease discovered when it has spread beyond the ovaries to involve the abdominoperitoneal cavity, liver parenchyma, and/or pleural cavities (stage III or IV). The role of early diagnosis and screening has been discussed elsewhere in this issue, but at a recent consensus conference on ovarian cancer, the panel recommended screening only those patients with some form of hereditary ovarian cancer, which accounts for less than 10 percent of all epithelial ovarian malignancies. Even within the category of earlystage disease, five-year survival ranges from 50 to 95 percent depending, in large measure, on the intactness of the ovarian capsule and the degree of tumor differentiation and, less clearly, on treatment. Advanced-stage ovarian cancer is responsive to multiple cytotoxic drugs. Nevertheless, less than 25 percent of these patients are alive and free of disease at the fifth year after diagnosis. This is primarily due to drug resistance, both intrinsic and acquired. Thus, there is ready justification for the intensive research that is attempting to find new drugs, identify new drug combinations, abrogate drug resistance of active agents, and increase the intensity (anticipating an increase in efficacy) of currently used drugs. In this review we will discuss current and experimental approaches to the treatment of all stages of ovarian cancer. ...

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