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Abstract:
There has been steady progress in improving the survival stage by stage for women with ovarian carcinoma. Part of this is the "Will Rogers" phenomenon: the improvement in results among two groups by movement of a subset of patients from one stage to the other stage. For those stage I patients at low risk (stage I-A1, I-B1, well or moderately differentiated) for recurrence, the exceeding of 90% survival rates in these carefully staged patients without postoperative radiation or chemotherapy represents significant progress in comparison to results a decade ago. Moreover, those patients thought to be stage I or II but found to have upper abdominal metastasis by careful surgical staging will now receive the best therapy for stage III ovarian cancer. The combination of the small volume of upper abdominal tumor discovered in these latter patients and the effects of receiving the best therapy for stage III disease should result in improved survival for this subset of patients. The impact of cisplatin-based chemotherapy has already impacted positively on improved survival for women with stage III and IV ovarian carcinoma. With more surgeons now trained in the techniques of debulking surgery in advanced ovarian carcinoma, the recent survival rates for patients receiving cisplatin-based chemotherapy should improve significantly in the next decade.