In regards to surgery it is recommended to perform total omentectomy since subclinic metastasis have been documented in 10 - 30 % of all cases , and systematic limphadenectomy , necessary to be able to obtain an adequate surgical staging .
Minimal invasion surgery is not a recommended procedure for the treatment of advanced ovarian cancer .
Radiotherapy can be used to palliate symptoms .
In the present , there is not a st and ardized screening method .
Diagnosis in early stages means a better survival .
Radiotherapy can be indicated to palliate symptoms
INTRODUCTION Ovarian cancer ( OC ) is the third most common gynecologic malignancy worldwide .
Most of cases it is of epithelial origin .
At the present time there is not a st and ardized screening method , which makes difficult the early diagnosis .
The 5-year survival is 90 % for early stages , however most cases present at advanced stages , which have a 5-year survival of only 5 - 20 % .
GICOM collaborative group , under the auspice of different institutions , have made the following consensus in order to make recommendations for the diagnosis and management regarding to this neoplasia .
Until now , laparoscopy for diagnostic-staging surgery is not well known as a recommended method .
In advanced stages , primary cytoreduction is recommended as initial treatment .
Phase III randomized study of cisplatin versus paclitaxel versus cisplatin and paclitaxel in patients with suboptimal stage III or IV ovarian cancer: a gynecologic oncology group study.
PURPOSE To assess progression-free survival ( PFS ) and overall survival ( OS ) in patients with suboptimally debulked epithelial ovarian cancer receiving cisplatin ( 100 mg/m(2 ) ) or 24-hour infusion paclitaxel ( 200 mg/m(2 ) ) or the combination of paclitaxel ( 135 mg/m(2 ) ) followed by cisplatin ( 75 mg/m(2 ) ) . PATIENTS AND METHODS After stratification for disease measurability , patients were r and omized to receive six cycles of one of the treatments every 3 weeks . If measurable , complete response ( CR ) or partial response ( PR ) was determined . RESULTS Six hundred fourteen of 648 patients who entered onto the trial were eligible . Monotherapies were discontinued more frequently ( cisplatin because of toxicity or patient refusal [ 17 % ] , and paclitaxel because of progression [ 20 % ] ) compared with the combination therapy ( 7 % and 6 % , respectively ) . Neutropenia , fever , and alopecia were more severe with paclitaxel-containing regimens ; whereas anemia , thrombocytopenia , neurotoxicity , nephrotoxicity , and gastrointestinal toxicity were more severe with cisplatin-containing regimens . The CR/PR rates on paclitaxel monotherapy were significantly lower compared with the cisplatin regimens ( 42 % v 67 % , respectively ; P < .001 ) . The relative hazard ( RH ) of first progression or death was significantly greater among those r and omized to paclitaxel ( RH = 1.41 ; 95 % confidence interval [ CI ] , 1.15 to 1.73 ; P < .001 ) when compared with cisplatin ; however , RH did not differ significantly between the two cisplatin regimens ( RH = 1.06 ; 95 % CI , 0.895 to 1.30 ) . Relative to cisplatin , the death rate on paclitaxel was 15 % greater ( RH = 1.15 ; 95 % CI , 0 . 929 to 1.42 ) , and the death rate on the combination treatment was 1 % less ( RH = 0.99 ; 95 % CI , 0.795 to 1.23 ) . These differences among treatment groups were not statistically significant ( P = .31 ) . CONCLUSION Cisplatin alone or in combination yielded superior response rates and PFS relative to paclitaxel . However , OS was similar in all three arms , and the combination therapy had a better toxicity profile . Therefore , the combination of cisplatin and paclitaxel remains the preferred initial treatment option
In regards to surgery it is recommended to perform total omentectomy since subclinic metastasis have been documented in 10 - 30 % of all cases , and systematic limphadenectomy , necessary to be able to obtain an adequate surgical staging .
Minimal invasion surgery is not a recommended procedure for the treatment of advanced ovarian cancer .
Radiotherapy can be used to palliate symptoms .
In the present , there is not a st and ardized screening method .
Diagnosis in early stages means a better survival .
Radiotherapy can be indicated to palliate symptoms
INTRODUCTION Ovarian cancer ( OC ) is the third most common gynecologic malignancy worldwide .
Most of cases it is of epithelial origin .
At the present time there is not a st and ardized screening method , which makes difficult the early diagnosis .
The 5-year survival is 90 % for early stages , however most cases present at advanced stages , which have a 5-year survival of only 5 - 20 % .
GICOM collaborative group , under the auspice of different institutions , have made the following consensus in order to make recommendations for the diagnosis and management regarding to this neoplasia .
Until now , laparoscopy for diagnostic-staging surgery is not well known as a recommended method .
In advanced stages , primary cytoreduction is recommended as initial treatment .