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Upon completion of the chapter, the reader will be able to:

  1. Demonstrate understanding the etiology and risk factors associated with the development of ovarian cancer.

  2. Justify the risk and benefits of the surgical and chemoprevention options available for decreasing the potential risk of developing ovarian cancer.

  3. Interpret and understand the utility of the screening tests and serologic markers for diagnosing ovarian cancer.

  4. Distinguish the nonspecific physical signs and symptoms of ovarian cancer.

  5. Recommend the appropriate surgical and chemotherapy treatment options for newly diagnosed and relapsed ovarian cancer patients.

  6. Compare and contrast chemotherapy options for women with recurrent platinum-resistant ovarian cancer.

  7. Compare and contrast the treatment options for management of hot flushes in ovarian cancer patients.

  8. Devise a plan for the management of common complications associated with advanced and recurrent ovarian cancer.




  • Image not available. Ovarian cancer is a sporadic disease; fewer than 10% of ovarian cancers can be attributed to heredity.

  • Image not available. Because CA-125 is a nonspecific marker, there is no standard recommendation for routine screening for prevention of ovarian cancer.

  • Image not available. Ovarian cancer is denoted "the silent killer" because of its nonspecific signs and symptoms.

  • Image not available. Surgery is the primary treatment intervention for ovarian cancer.

  • Image not available. Ovarian cancer is staged surgically using the International Federation of Gynecology and Obstetrics (FIGO) staging algorithm.

  • Image not available. After initial surgery, the gold standard of care is six cycles of a taxane/platinum-containing regimen.

  • Image not available. Although majority of patients will initially achieve a complete response, disease will recur within the first 2 years in more than 50% of patients.

  • Image not available. Because the efficacy of the agents is similar, the selection of agent for treatment of recurrent platinum-resistant ovarian cancer depends on residual toxicities, clinician preference, and patient convenience.

  • Image not available. Precaution should be used in removal of ascites because of the potential complications associated with rapid fluid shifts.

  • Image not available. In ovarian cancer patients, small bowel obstruction (SBO) is a common complication of progressive disease (PD). In general, laxatives should not be used in patients with SBOs.




Ovarian cancer is relatively uncommon but is the most fatal gynecologic cancer. The primary reason for the high mortality rate associated with ovarian cancer is the nonspecific symptoms and difficulty for early detection or screening that result in patients presenting with advanced disease. The majority of ovarian cancers are of epithelial origin. Each time ovulation occurs, the epithelium of the ovary is broken followed by occurrence of cell repair. The incessant ovulation hypothesis proposes that the increasing number of times the ovary epithelium undergoes cell repair is associated with the increasing risk of mutations and ultimately ovarian cancer. Ovarian cancer is often denoted as the "silent killer" because although the majority of patients will achieve a complete response (CR) to primary surgery and chemotherapy, disease recurs in more than 50% of patients in the first 2 years after completion of primary treatment. Ovarian cancers often cause metastasis via the lymphatic and blood systems to ...

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