Epithelial ovarian cancer: Prevention, diagnosis, and treatment

Authors

  • Dr. Edward E. Partridge MD,

    1. Partridge is Vice Chairman, Department of Obstetrics & Gynecology, and Director, Division of Gynecologic Oncology, The University of Alabama at Birmingham, AL
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  • Dr. Mack N. Barnes MD

    1. Barnes is Assistant Professor, Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, The University of Alabama at Birmingham, AL
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Abstract

The leading cause of death from gynecologic malignancies in the United States is epithelial ovarian cancer. The significant risk factor for development of ovarian cancer is advancing age, although there is clearly a genetic predisposition—often associated with the BRCA1 and BRCA2 genes—in at least 5% to 10% of all epithelial ovarian cancers.

Oral contraceptives are known to reduce the risk for development of ovarian cancer and should be considered as a method of birth control in women at increased risk. Currently, there is no acceptable method of screening for this disease, although measurement of CA-125 level and transvaginal ultrasound have been utilized.

Ovarian cancer is a surgically staged disease. In apparent early-stage disease, complete surgical staging is critical for the selection of adjunctive therapy. In advanced-stage disease, the goal is primary cytoreduction.

Standard postoperative therapy for advanced-stage ovarian cancer includes platinum-based chemotherapy with the substitution of paclitaxel for cyclophosphamide occurring in the last decade. Despite these advances in chemotherapy, ovarian cancer continues to be fatal in far too many cases.

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