Klin Onkol 2002; 15(4): 136-141.
Summary: Ovarian carcinoma (OC) remains the gynecological malignancy with the worst prognosis. Optimal OC treatment still consists of competent surgical procedure preferably without leaving a tumor residue and optimal chemotherapy, which is currently represented by the Taxol/Carboplatin or Taxol/Cisplatin regimens. However, the OC therapy is continually associated with a number of uncertainties and problems. The search goes on for a three drug combination to be employed as first line chemotherapy and it remains unclear whether six cycles of adjuvant chemotherapy are sufficient. Routine use of the second look operation has been abandoned and the place of intraperitoneal chemotherapy in the OC treatment is uncertain. A proficient regimen for consolidation therapy is yet to be discovered. Even the role of tumor marker monitoring after the treatment remains unclear. Testing of resistance to cytostatic agents might be used in the future especially in designing the regimens for second line chemotherapy. Interval debulking surgery (IDS) is being asserted, although its embodiment in the therapeutic process needs to be further investigated. In a certain group of patients, neoadjuvant chemotherapy followed by radical surgery appears to be another valid therapeutic approach. The therapy of OC relapse remains problematic and largely palliative. Whereas in the Pt sensitive patients the previous regimen can be applied repeatedly, chances to affect the recurrent disease in Pt resistant women remain dim. The place of surgical intervention in treatment of recurrent OC is still being discussed.
