[Update of ovarian carcinoma]

Correct histopathologic diagnosis of ovarian carcinoma is essential, because biological behavior of the disease varies by the histologic subtype and its grade of differentiation. The standard treatment modality of advanced ovarian carcinoma has consisted of an initial maximal surgical effort and subsequent platinum-based chemotherapy, followed by a secondary surgery. "Maximal surgical effort" is a convenient term but it does not define a surgical procedure. In USA, since 1996, paclitaxel/cisplatin had become a 1st-line regimen. Introduction of other potent agents including topotecan/CPT-11 and previous evidence of the efficacy of doxorubicin have made it difficult to decide which regimen is the most potent. A maximal effort should be made at the second surgical attempt after completing a planned 1st regimen. Finally, we should obtain a pathologically complete response with the combined use of surgery and chemotherapy to achieve long-term survival in patients with advanced ovarian carcinoma.