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 .
Clinical evidence for topotecan-paclitaxel non--cross-resistance in ovarian cancer.
PURPOSE A large , r and omized study comparing the efficacy and safety of topotecan versus paclitaxel in patients with relapsed epithelial ovarian cancer showed that these two compounds have similar activity . In this study , a number of patients crossed over to the alternative drug as third-line therapy , ie , from paclitaxel to topotecan and vice versa . We therefore were able to assess the degree of non-cross-resistance between these two compounds . PATIENTS AND METHODS Patients who had progressed after one platinum-based regimen  were r and omized to either topotecan ( 1.5 mg/m(2)/d ) x 5 every 21 days ( n = 112 ) or paclitaxel ( 175 mg/m(2 ) over 3 hours ) every 21 days ( n = 114 ) . A total of 110 patients received cross-over therapy with the alternative drug ( 61 topotecan , 49 paclitaxel ) as third-line therapy . RESULTS Response rates to third-line cross-over therapy were 13.1 % ( 8 of 61 topotecan ) and 10.2 % ( 5 of 49 paclitaxel ; P = .638 ) . Seven patients who responded to third-line topotecan and four patients who responded to paclitaxel had failed to respond to their second-line treatment . Median time to progression ( from the start of third-line therapy ) was 9 weeks in both groups , and median survival was 40 and 48 weeks for patients who were receiving topotecan or paclitaxel , respectively . The principal toxicity was myelosuppression ; grade 4 neutropenia was more frequent with topotecan ( 81.4 % of patients ) than with paclitaxel ( 22.9 % of patients ) . CONCLUSION Topotecan and paclitaxel have similar activity as second-line therapies with regard to response rates and progression-free and overall survival . We demonstrated that the two drugs have a degree of non-cross-resistance . Thus , there is a good rationale for incorporating these drugs into future first-line regimens
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 .