Cancer Treatment Results  Survival Rates Cancer Treatments / Therapy Results
Cancer
 
Ovarian Cancer

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Introduction

Epithelial ovarian cancer is the leading cause of death from gynecologic cancer in the U.S.  In 2004, 25,580 new cases were diagnosed and 16,090 women died from this disease.  The incidence of this cancer increases with each decade and peaks for women in their eighties.  Each pregnancy reduces the ovarian cancer risk by about 10% and breast feeding and tubal ligation also appear to reduce the risk. 

Most patients with ovarian cancer are first diagnosed when the disease has already spread beyond the true pelvis.  The occurrence of abdominal pain, bloating, and urinary symptoms usually indicates advanced disease.  Localized ovarian cancer is generally asyptomatic (has no symptoms). 

Patients with early ovarian cancers (stages I and II) are commonly curable with conventional therapy. 

Laparotomy is often the primary procedure used to establish the diagnosis. (A laparotomy is a surgical incision into the abdominal cavity.)

Staging and Prognosis

Stage
Description
Frequency
5-year Survival
I
Cancer confined to the ovary or ovaries
23%
90%
II
Cancer confined to the true pelvis
13%
70%
III
Cancer spread into but confined to the abdomen
47%
15-20%
IV
Cancer spread outside the pelvis and abdomen
16%
1-5%

Treatment

Choice of therapy depends upon the stage, extent of residual tumor, and histologic grade.  Generally, patients are divided into one of three separate treatment groups:

  1. Those with early stage (I and II) and microscopic or no residual disease.  These patients with well or moderately differentiated tumors typically need no adjuvant therapy after definitive surgery; patients with poorer histologic grades are typically administered chemotherapy.
  2. Those with advanced stage (III) but minimal residual disease (<1 cm) after initial surgery.  Primary treatment for these patients is combination chemotherapy.
  3. Patients with bulky residual tumor and advanced (III or IV) disease.  For these patients, the primary treatment  is combination chemotherapy.

Patients with advanced disease whose cancer recurs after initial treatment are usually not curable by conventional means.

Patients with tumor of low malignant potential, even with advanced stage disease, have longer survival when managed with surgery alone.  The added value of radiation and chemotherapy has not been shown.

The Cancer Monthly database currently has the results (survival, side effects, etc.) for 20 recent therapies for ovarian cancer. 

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Source: Robert C. Young, Gynecologic Malignancies, in Harrison’s Principles of Internal Medicine, pt. 5 § 83, at 553-557 (Dennis L. Kasper, M.D. et al., eds, 16th ed 2005).