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 .
Long-term survival advantage for women treated with pegylated liposomal doxorubicin compared with topotecan in a phase 3 randomized study of recurrent and refractory epithelial ovarian cancer.
OBJECTIVE Provide long-term follow-up data for women treated in a r and omized multicenter study of  pegylated liposomal doxorubicin compared with topotecan . METHODS Patients with epithelial ovarian cancer that recurred after or failed to respond to first-line platinum-based chemotherapy were r and omized to receive  pegylated liposomal doxorubicin 50 mg/m(2 ) every 28 days ( n = 239 ) or topotecan 1.5 mg/m(2 ) per day for 5 days every 21 days ( n = 235 ) . Patients were stratified prospect ively based on response to initial platinum-based chemotherapy as well as the presence or absence of bulky disease . Most patients had been previously treated with platinum and taxanes ( 74 % in the pegylated liposomal doxorubicin group and 72 % in the topotecan group ) .  Survival data are mature : 87 % of patients have died ( n = 413 ) . RESULTS There was an 18 % reduction in the risk of death for patients treated with pegylated liposomal doxorubicin ( median survival 62.7 weeks for pegylated liposomal doxorubicin and 59.7 weeks for topotecan-treated patients ; HR = 1.216 ; 95 % confidence interval ( CI ) 1.000 - 1.478 ; P = 0.050 ) . The hazard ratio for all r and omized subjects ( includes those r and omized , but never treated ; n = 481 ) was 1.23 ( median survival 63.6 weeks for pegylated liposomal doxorubicin and 57.0 weeks for topotecan-treated patients ; 95 % CI 1.01 - 1.50 ; P = 0.038 ) . For patients with platinum-sensitive disease , there was a 30 % reduction in the risk of death for the pegylated liposomal doxorubicin-treated group ( median survival 107.9 weeks for pegylated liposomal doxorubicin and 70.1 weeks for topotecan-treated patients ; HR = 1.432 ; 95 % CI 1.066 - 1.923 ; P = 0.017 ) . In patients with platinum-refractory disease , survival was similar between treatment groups . CONCLUSION Long-term follow-up demonstrates that treatment with pegylated liposomal doxorubicin significantly prolongs survival compared with topotecan in patients with recurrent and refractory epithelial ovarian cancer . The survival benefit is pronounced in patients with platinum-sensitive disease
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 .