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 .
Effective palliative radiation therapy in advanced and recurrent ovarian carcinoma.
PURPOSE To retrospectively review our experience using radiation therapy as a palliative treatment in ovarian carcinoma . METHODS AND MATERIAL S Eighty patients who received radiation therapy for ovarian carcinoma between 1983 and 1998 were review ed . The indications for radiation therapy , radiation therapy techniques , details , tolerance , and response were recorded . A complete response required complete resolution of the patient 's symptoms , radiographic findings , palpable mass , or CA-125 level . A partial response required at least 50 % resolution of these parameters . The actuarial survival rates from initial diagnosis and from the completion of radiation therapy were calculated . RESULTS The median age of the patients was 67 years ( range 26 to 90 years ) . A median of one laparotomy was performed before irradiation . Zero to 20 cycles of a platinum-based chemotherapy regimen were delivered before irradiation ( median = 6 cycles ) . The reasons for palliative treatment were : pain ( n = 22 ) , mass ( n = 23 ) , obstruction of ureter , rectum , esophagus , or stomach ( n = 12 ) , a positive second-look laparotomy ( n = 9 ) , ascites ( n = 8) , vaginal bleeding ( n = 6 ) , rectal bleeding ( n = 1 ) , lymphedema ( n = 3 ) , skin involvement ( n = 1 ) , or brain metastases with symptoms ( n = 11 ) . Some patients received treatment for more than one indication . Treatment was directed to the abdomen or pelvis in 64 patients , to the brain in 11 , and to other sites in 5 . The overall response rate was 73 % . Twenty-eight percent of the patients experienced a complete response of their symptoms , palpable mass , and /or CA-125 level . Forty-five percent had a partial response . Only 11 % suffered progressive disease during therapy that required discontinuation of the treatment . Sixteen percent had stable disease . The duration of the responses and stable disease lasted until death except in 10 patients who experienced recurrence of their symptoms between 1 and 21 months ( median = 9 months ) . The 1- , 2- , 3- , and 5-year actuarial survival rates from diagnosis were 89 % , 73 % , 42 % , and 33 % , respectively . The survival rates calculated from the completion of radiotherapy were 39 % , 27 % , 13 % , and 10 % , respectively . Five percent of patients experienced Grade 3 diarrhea , vomiting , myelosuppression , or fatigue . Fourteen percent of patients experienced Grade 1 or 2 diarrhea , 19 % experienced Grade 1 or 2 nausea and vomiting , and 11 % had Grade 1 or 2 myelosuppression . CONCLUSIONS In this series of radiation therapy for advanced ovarian carcinoma , the response , survival , and tolerance rates compare favorably to those reported for current second- and third-line chemotherapy regimens . Cooperative groups should consider evaluating prospect ively the use of radiation therapy before nonplatinum and /or nonpaclitaxel chemotherapy in these patients
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 .