[Treatment of advanced ovarian cancer]

Significant prolongation of survival time has been brought by cisplatin containing regimen, but no significant improvement of 5 year survival rate has been achieved. Concerning to four clinical problems we face to now, my opinion was described as follows. 1) Importance of chemotherapy in the treatment of advanced ovarian cancer: The most important factor for the cure of advanced ovarian cancer is the efficacy of the regimen used. 2) Regimen and number of cycles needed: Cisplatin and carboplatin are dose-dependent drugs and we should make effort to make dose up as much as possible. May be 6 cycles will be suitable number of administration. 3) Postoperative chemotherapy or preoperative chemotherapy (Neo-adjuvant)?: Serous adenocarcinoma is observed with high frequency around 70% and the efficacy rate of cisplatin containing regimen is exceeded more than 80%. Neo-adjuvant chemotherapy should be tried in advanced ovarian cancer. 4) Second line chemotherapy: At present, no effective drug is available for the treatment of true cisplatin refractory cancer. Therefore we should perform aggressive surgery and severe chemotherapy at the first time of treatment. By combination of surgery and chemotherapy, at least clinical CR (Complete resection or complete response) is indispensable for achieving significant improvement of 5 year survival rate, In this meaning, chemotherapeutic CR is necessary in postoperative chemotherapy and surgical CR is required in Neo-adjuvant chemotherapy.