Abstract
Ovarian cancer is the deadliest gynecologic cancer, in part due to late presentation. Many women have vague early symptoms and present with disseminated disease. Cytoreductive surgery can be extensive, involving multiple organ systems. Novel therapies and recent clinical trials have provided evidence that, compared to primary cytoreduction, neoadjuvant chemotherapy has equivalent survival outcomes with less morbidity. There is increasing need for validated tools and mechanisms for clinicians to determine the optimal management of ovarian cancer patients.
Highlights
Ovarian cancer represents only 1.3% of newly diagnosed cancers in the United States, it accounts for 2.3% of overall cancer related deaths [1]
This study found that Magnetic resonance imaging (MRI) was useful in determining the Peritoneal Cancer Index (PCI) and that it may have a role in predicting successful cytoreduction, but this study was limited with only 25 participants [76]
Improved surgical outcomes reported by the EORTC and the CHORUS trials have driven neoadjuvant chemotherapy as the initial treatment of choice for advanced stage ovarian cancers [15,109]
Summary
Ovarian cancer represents only 1.3% of newly diagnosed cancers in the United States, it accounts for 2.3% of overall cancer related deaths [1]. Within the last few years, poly ADP ribose polymerase (PARP) inhibitors have demonstrated improved survival and reduced risk of recurrent disease in newly diagnosed advanced ovarian, fallopian tube and peritoneal cancer after response to first-line platinum neoadjuvant chemotherapy in homologous recombinant deficiency populations [7]. This was based on prior trials that showed PARP inhibitors increased progression-free survival in platinum-sensitive recurrent ovarian cancer in both breast cancer gene (BRCA) mutated and non-BRCA mutated patients [8].
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