Ovarian Cancer

Abstract

Ovarian cancer is a catchall term encompassing a wide variety of relatively uncommon heterogeneous diseases notable for having a gradual decrease in incidence over the past decade. Epithelial ovarian carcinoma predominates, especially the high-grade serous variant distinguished by few reliable signs or symptoms, exceptional difficulty in early detection, and poor prognosis despite aggressive surgery and chemotherapy. The recent discovery that many of these tumors actually arise from the fallopian tube has led to rapid acceptance of opportunistic salpingectomy as a convenient, low-risk method of prevention. Other advances in genetic testing, minimally invasive surgery, and novel-targeted therapies have greatly expanded the management of this disease in the past few years. Sex cord-stromal tumors, chiefly the granulosa cell variant, are rarely encountered, occur across a wide range of ages, are largely impervious to chemotherapy, and yet highly curable. Malignant ovarian germ cell tumors are even rarer, generally present during the teens, are exquisitely sensitive to chemotherapy, and also very curable. Providing expert care to women with ovarian cancer has become increasingly complex due to emerging practice-changing data at multiple points of diagnosis, treatment, and surveillance. Fortunately, the past few years have greatly expanded our understanding of this dreaded disease. This review contains 5 tables, and 29 references. Key Words: epithelial ovarian cancer, maintenance therapy, neoadjuvant chemotherapy, primary debulking surgery