The natural history of ovarian cancer may depend on different anatomo-clinical and biological factors. Residual disease, when less than 1 cm, is another important prognostic factor, being significantly associated to the survival and, progression free, improvement in the survival. The exception to this rule is when cisplatin regimen is assessed, as it can highly reduce the relapse rate while the survival is not significantly influenced.
Ovarian cancers disseminate, primarily by continuity.
At the time of diagnosis, bone or brain metastases are rarely present and their presence is not related to the histology or grading of the tumor. Although the exact mechanism of ovarian carcinogenesis is unknown, some risk factors exist. It has been hypothesized that continuous ovulation causes entrapment of the germinal epithelium within the stroma, resulting in the formation of an epithelial inclusion cyst. Subsequently, genetic changes in cancer-related genes produces malignant transformation. The main reasons for the inability for the early diagnosis of ovarian are either paucity of and insidious development of symptoms, or the absence of a suitable test which can be routinely used.