Medical Health Encyclopedia

Following surgery, chemotherapy (e.g., paclitaxel plus carboplatin) is usually necessary in an attempt to eradicate residual cancer. A number of approaches are under investigation for reducing high rates of recurrence (about 80%), including the following: experimental chemotherapy agents, anti-angiogenic therapies, gene and biological therapies, intraperitoneally administered high-dose chemotherapy, neoadjuvant therapy (chemotherapy before surgery), high-dose chemotherapy and peripheral blood stem cell transplantation (to date this approach has proven to be very toxic with no convincing improvement in survival).

Stage IV

Stage IV is the most advanced. The cancer may have spread to the inside of the liver or spleen. There may be distant metastases, such as ovarian cancer cells in the fluid around the lungs. The average five-year survival rate for this stage is less than 10%.

Treatment Options: Tumor debulking may be performed before chemotherapy.

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Although not standard practice in the United States, a surgical procedure called retroperitoneal lymphadenectomy is sometimes performed. This procedure involves removal of aortic and pelvic lymph nodes from the rear of the abdomen. Results from a 2005 randomized controlled trial suggest that while retroperitoneal lymphadenectomy does help reduce cancer progression, it does not prolong survival.

Recurrent Ovarian Cancer

Treatment Options: If ovarian cancer returns, chemotherapy is the mainstay of treatment, although it is not generally curative in the setting of relapsed disease.

If the interval between the last platinum-containing chemotherapy (carboplatin or cisplatin) and relapse is long (greater than six months), it is reasonable to attempt a repeat trial of platinum-based chemotherapy, with or without paclitaxel.