Management of early ovarian cancer

Epithelial ovarian cancer is the leading cause of death from gynecologic malignancies in the United States due, in large part, to the advanced stage at which it is commonly diagnosed. However, approximately one-third of cases are discovered at an early stage, when tumor is limited to the pelvis. Certain prognostic factors have been identified, which place patients with early disease at risk for recurrence and warrant the use of adjuvant therapy. Systemic chemotherapy remains the most commonly used adjuvant therapy in this setting, and several randomized European trials have recently suggested a benefit to its use. These studies, however, suffered from the lack of comprehensive staging, which must be considered when interpreting the literature on early-stage disease. Ideally, these patients should have access to a gynecologic oncologist prior to their initial surgical procedure.