Clinically localized ovarian cancer. Progress in management

A decade ago the five-year survival rate in patients with stage I ovarian carcinoma was only 60% to 70%. Significant advances in staging and treatment, however, promise an improvement. Initially, improvement will be seen because some patients with clinically localized ovarian cancer will be discovered to have subclinical or occult metastasis at initial surgical staging and thus will be upstaged and treated appropriately for more advanced disease. More encouraging are results of recent studies on adjuvant therapy, which indicate that in some patients the need for postoperative adjuvant therapy may be obviated. A major advance in diagnosis would be development of a serum test specific for ovarian cancer--a discovery that may be forthcoming.