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 II clinical trial of bevacizumab and low-dose metronomic oral cyclophosphamide in recurrent ovarian cancer: a trial of the California, Chicago, and Princess Margaret Hospital phase II consortia.
PURPOSE Vascular endothelial growth factor ( VEGF ) plays an important role in the biology of ovarian cancer ( OC ) . Inhibitors of VEGF suppress tumor growth in OC models . Metronomic chemotherapy , defined as frequent administration of low doses of cytotoxic chemotherapy , suppresses tumor growth , possibly by inhibiting angiogenesis . A phase II trial was conducted to evaluate the antitumor activity and adverse effects of bevacizumab and metronomic oral cyclophosphamide in women with recurrent OC . PATIENTS AND METHODS Patients with measurable disease and prior treatment with a platinum-containing regimen were eligible . Up to two different regimens for recurrent disease were allowed . Treatment consisted of bevacizumab 10 mg/kg intravenously every 2 weeks and oral cyclophosphamide 50 mg/d . The primary end point was progression-free survival at 6 months . Plasma levels of VEGF , E-selectin , and thrombospondin-1 were obtained serially . RESULTS Seventy patients were enrolled . The probability of being alive and progression free at 6 months was 56 % ( + /- 6 % SE ) . A partial response was achieved in 17 patients ( 24 % ) . Median time to progression and survival were 7.2 and 16.9 months , respectively . The most common serious toxicities were hypertension , fatigue , and pain . Bevacizumab-related toxicities included four episodes of gastrointestinal perforation or fistula , two episodes each of CNS ischemia and pulmonary hypertension , and one episode each of gastrointestinal bleeding and wound healing complication . There were three treatment-related deaths . Levels of VEGF , E-selectin , and thrombospondin-1 were not associated with clinical outcome . CONCLUSION The combination of bevacizumab and metronomic cyclophosphamide is active in recurrent OC . Further study of this combination is warranted
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 .