Current therapy of ovarian carcinoma: an overview.

Significant advances in the management of ovarian carcinoma have been developed over the last decade of research. The advanced nature of the disease in a majority of the patients has underlined the importance of systemic therapy in the treatment of patients with ovarian carcinoma. The last decade has seen the identification of cisplatin-based combinations of drugs as superior to single alkylating agents in the treatment of advanced disease. The importance of aggressive surgical bulk reduction in terms of improved response to chemotherapy and survival has been demonstrated, and the necessity for careful surgical staging of disease both before chemotherapy and at the completion of treatment has been emphasized. A number of exciting new alternative therapies are currently being investigated: intraperitoneal chemotherapy, whole abdominal radiotherapy, biologic response modifiers, and in vitro drug sensitivity testing with the human tumor stem cell assay. The role of these various alternatives is not clear at this time, but their potential for significant contributions to the treatment of ovarian carcinoma holds major promise. For the present, the essentials of management of these patients include careful staging including laparotomy, aggressive surgical bulk reduction, and cisplatin-based combination chemotherapy.