Current management of ovarian cancer

Abstract

Cytoreductive surgery remains an accepted standard treatment of primary ovarian cancer. In advanced stages adjuvant platin/taxane chemotherapy with addition of anti-angiogenic agent, i.e., bevacizumab is recommended. The management of recurrent ovarian cancer remains a field of controversies. Surgery and/or systemic treatment are currently investigated in prospective trials. Retrospective data show prognosis improvement in patients who underwent complete cytoreduction. Thus, the selection of patients eligible for surgery in recurrent situation is the essential issue. The available predictors of complete resection depend on results of primary surgery and current patients situation. Women who fulfill these criteria have 76% likelihood of undergoing complete resection and survival prolongation. On the other hand there is a large group of patients in whom surgery might be too dangerous and demand an effective systemic treatment. Currently in a second-line several options are available, again including anti-angiogenic agents. The management of further recurrences is a subject of several clinical trials, nevertheless standards are still missing. Due to histological subtype and/or BRCA mutation status, the therapy in ovarian cancer might undergo revision in a near future.