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Review
. 2025 Jun:210:104704.
doi: 10.1016/j.critrevonc.2025.104704. Epub 2025 Mar 17.

Management of early-stage ovarian cancer: Open questions and debated issues

V Salutari  1 , E Giudice  2 , E Rapisarda  3 , M Pavone  3 , V Ghizzoni  1 , M T Perri  1 , S M Boccia  1 , S Lardino  3 , V Gallotta  1 , A Fagotti  4 , G Scambia  4 , D Lorusso  5
Affiliations
Review

Management of early-stage ovarian cancer: Open questions and debated issues

V Salutari et al. Crit Rev Oncol Hematol. 2025 Jun.

Abstract

Introduction: The management of epithelial ovarian cancer (EOC) is linked to the histological subtypes. However, literature did not provide strong evidence to support the best subtype-specific therapeutic strategy. In this review, we aim to summarizethe available evidenceto better guide the surgical and medical management of each specific EOC subtypes.

Methods: The article cited in this review were obtained quering the pubmed database in the English language between January 2007 and December 2024.

Results: Laparotomy remains the standard for surgical management of early-stage EOC. The roleof adjuvant chemotherapy remains an open issue due to outdated studies with small sample size.

Conclusions: Laparoscopy for the surgical management of early-staged EOC seems to be associated with equivalent oncologic outcome compared with laparotomy. The benefit of adjuvant chemotherapy is dependent on the histological subtype. Furthermore, targeted agents may replace adjuvant chemotherapy and clinical trials are urgently awaited.

Keywords: Adjuvant treatment; Early-stage ovarian cancer; Epitelial ovarian cancer; Ovarian cancer; Surgery.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Vanda Salutari reports a relationship with AstraZeneca that includes: speaking and lecture fees. Vanda Salutari reports a relationship with Merck & Co Inc that includes: speaking and lecture fees. Vanda Salutari reports a relationship with Eisai Inc that includes: speaking and lecture fees. Vanda Salutari reports a relationship with GSK that includes: speaking and lecture fees. Vanda Salutari reports a relationship with Merck & Co Inc that includes: travel reimbursement. Vanda Salutari reports a relationship with Menarini Research that includes: travel reimbursement. Vanda Salutari reports a relationship with AstraZeneca that includes: travel reimbursement. Vanda Salutari reports a relationship with Merck & Co Inc that includes: consulting or advisory. Vanda Salutari reports a relationship with ImmunoGen Inc that includes: consulting or advisory. Vanda Salutari reports a relationship with GSK that includes: consulting or advisory. Vanda Salutari reports a relationship with Eisai Inc that includes: consulting or advisory. Domenica Lorusso reports a relationship with AstraZeneca that includes: consulting or advisory and speaking and lecture fees. Domenica Lorusso reports a relationship with Clovis Oncology that includes: consulting or advisory and speaking and lecture fees. Domenica Lorusso reports a relationship with Corcept Therapeutics Inc that includes: consulting or advisory and speaking and lecture fees. Domenica Lorusso reports a relationship with Daiichi Sankyo Inc that includes: consulting or advisory and speaking and lecture fees. Domenica Lorusso reports a relationship with Genmab US Inc that includes: consulting or advisory and speaking and lecture fees. Domenica Lorusso reports a relationship with GSK that includes: consulting or advisory and speaking and lecture fees. Domenica Lorusso reports a relationship with ImmunoGen Inc that includes: speaking and lecture fees. Domenica Lorusso reports a relationship with Merck & Co Inc that includes: consulting or advisory and speaking and lecture fees. Domenica Lorusso reports a relationship with Novartis that includes: consulting or advisory and speaking and lecture fees. Domenica Lorusso reports a relationship with Seagen Inc that includes: consulting or advisory and speaking and lecture fees. Domenica Lorusso reports a relationship with Sutro Biopharma Inc that includes: consulting or advisory and speaking and lecture fees. Giovanni Scambia reports a relationship with AstraZeneca that includes: consulting or advisory. Giovanni Scambia reports a relationship with Olympus Europa SE & Co KG that includes: speaking and lecture fees. Giovanni Scambia reports a relationship with Covidien AG that includes: consulting or advisory. Giovanni Scambia reports a relationship with Baxter Healthcare that includes: speaking and lecture fees. Giovanni Scambia reports a relationship with Intuitive Surgical Inc that includes: speaking and lecture fees. Giovanni Scambia reports a relationship with GlaxoSmithKline SpA that includes: speaking and lecture fees. Giovanni Scambia reports a relationship with Tesaro Inc that includes: consulting or advisory. Giovanni Scambia reports a relationship with Johnson & Johnson MedTech that includes: consulting or advisory. Giovanni Scambia reports a relationship with Clovis Oncology Italy Srl that includes: paid expert testimony. Viola Ghizzoni reports a relationship with GSK that includes: travel reimbursement. Maria Teresa Perri reports a relationship with AstraZeneca that includes: travel reimbursement. Elena Giudice reports a relationship with Merck & Co Inc that includes: travel reimbursement. Elena Giudice reports a relationship with GSK that includes: speaking and lecture fees. Serena Maria Boccia reports a relationship with PharmaMar SA that includes: travel reimbursement. Serena Maria Boccia reports a relationship with Merck & Co Inc that includes: travel reimbursement. Serena Maria Boccia reports a relationship with AstraZeneca that includes: speaking and lecture fees. Serena Maria Boccia reports a relationship with PharmaMar SA that includes: speaking and lecture fees. Serena Maria Boccia reports a relationship with GSK that includes: speaking and lecture fees. Anna Fagotti reports a relationship with AstraZeneca that includes: funding grants. Anna Fagotti reports a relationship with Johnson & Johnson MedTech that includes: consulting or advisory. Anna Fagotti reports a relationship with A Menarini Pharmaceutical Industries Riunite that includes: speaking and lecture fees. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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