[Advances in the comprehensive treatment of ovarian cancer]

In recent years, chemotherapy has markedly advanced after cisplatin became available. In addition, it has recently been found that the efficacy of chemotherapy differs according to the diameter of the residual tumor (less than 2 approximately 3 cm). For these reasons, debulking or cytoreduction surgery has been frequently carried out in advanced cancer cases to reduce the diameter of tumors. Basic procedures adopted by an increasing number of medical institutions are bilateral adnexectomy + simple total hysterectomy and omentectomy. In addition, since lymph node metastasis is found even in early cancer cases, dissection of lymph nodes extending from the pelvic lymph node to the paraaortic lymph node is now considered to be essential, and is referred to also by the FIGO's new classification of cancer stages. SLO is also important in judging the necessity of excising a residual tumor and assessing therapeutic efficacy. In chemotherapy, high effectiveness rates have been reported chiefly for cisplatin + CAP therapy in epithelial tumor cases and cisplatin + VAC or VBP therapy in germ cell tumor cases. However, since the effect of cisplatin in second and third lines is not satisfactory, development of new platinum compounds and studies of more effective regimens (such as massive cisplatin therapy) are now being performed. Radiation therapy, on the other hand, is merely an auxiliary therapy at present.