New therapeutic approaches in gynecologic oncology

Early-stage epithelial ovarian cancer, although elusive in screening programs, is readily controlled by resection and limited duration chemotherapy. Extensive cytoreductive surgery and multiagent chemotherapy, now including paclitaxel, show significant, although still modest, improvement in the survival of advanced-stage epithelial cancer. The role of radiation therapy for intermediate risk and advanced-stage endometrial cancer is debatable. Tailored hysterectomy for early-stage cervical cancer is replacing radiation therapy in many instances, whereas advanced cancer is being treated with combination chemoradiation. Smaller, less disfiguring procedures are being used successfully for vulvar squamous cell cancers and melanomas.