[Primary therapy of advanced ovarian carcinoma: current status and perspectives]

Standard therapy of advanced ovarian cancer includes staging laparotomy with aggressive debulking, possibly pelvic and para-aortic lymphadenectomy, and postoperative chemotherapy. Until present, combination chemotherapy with cis-/carboplatin and cyclophosphamide has been standard. Due to the positive results emerging from recent clinical trials, paclitaxel in combination with platinum might soon emerge as a new standard for patients with advanced ovarian cancer. The role of high-dose chemotherapy is currently under investigation. Pretherapeutic chemosensitivity testing, using a third-generation assay, is studied in randomized trials. Since the cost/benefit ratio is increasingly playing an important role, a cost comparison of the six most commonly used chemotherapy protocols is presented.