Management of ovarian cancer: a 75-year-old woman who has completed treatment.

Ovarian cancer includes primary tumors of epithelial, sex cord-stromal, or germ cell origin as well as metastatic tumors that frequently originate in the gastrointestinal tract. Approximately 90% of ovarian cancer is epithelial in origin and constitutes a major therapeutic challenge because of its advanced stage of presentation in most patients. Epithelial ovarian cancer is the most lethal gynecologic malignancy and the fifth most common cause of female cancer death in the United States, with approximately 1 in 70 women developing this disease in their lifetime. Several important advances in surgical and medical management of this disease have led to prolongation of survival and improvement of quality of life of patients with ovarian cancer. Using the case of Ms W, we discuss the signs, symptoms, risk factors, and prognostic factors of epithelial ovarian cancer; review the evidence for surgical and postoperative medical management; and present the current recommendations for screening and follow-up.