Update on the management of ovarian cancer.

Ovarian cancer remains the leading gynecologic cause of death in the United States and the Western world. Progression to metastatic disease prior to diagnosis contributes to the high mortality rate associated with ovarian cancer. The current article reviews surgical and drug therapies for ovarian cancer. Prognostic factors and preventative treatment are also discussed. Surgery is essential for accurate staging of ovarian cancer and treatment. Cytoreduction, combined with chemotherapy, may relieve symptoms associated with bowel obstruction and improve survival. Management of early-stage ovarian cancer depends upon risk status determined via comprehensive staging at the time of surgical resection. High-risk, but not low-risk, patients require adjuvant chemotherapy. Studies comparing various combinations of cytotoxic agents for the treatment of advanced stage ovarian cancer are described. Despite surgery and chemotherapy, ovarian cancer recurs in approximately 50% of patients. Management of recurrent ovarian cancer and maintenance therapy following remission are discussed.