Editorial: Advances in ovarian cancer disease control

"Overall, when one considers the relative mortality to incidence annually, ovarian cancer is the second most lethal among women in the United States. It is estimated that in 2011, there will have been 21,990 new cases diagnosed and 15,460 ovarian cancer deaths [1]. Epithelial ovarian cancers and related malignancies, most predominantly high grade serous tumors, contribute most to this public health care burden [2], and thus will be the focus here. While it is beyond the scope to recognize all recent contributions, the purpose of this editorial is to report on several key advances in disease classification, public health, treatment, detection and prevention and to place these advances in context of pre-existing knowledge......"

full free access: Recent progress in the diagnosis and treatment of ovarian cancer - worth reading

Note: comments in brackets/italicized are blogger's comments; worthwhile reading with several key points of interest such as:

"It should be noted that stage II disease is the least commonly diagnosed stage of ovarian cancer. This is likely because there is no anatomic boundary between the pelvis and upper abdomen. If disease has spread outside of the ovary to pelvic structures, it is also likely to spread to the upper abdomen. In the past, trials of the Gynecologic Oncology Group (GOG) have combined stages I and II as a definition of “early” ovarian cancer, with stages III and IV designated as “advanced” ovarian cancer. However, given the observed higher recurrence rate seen for stage II disease, the GOG is now including stage II in the category of advanced disease for trial purposes."

"Studies (note: over decades) have documented that almost one-third (note: an average) of apparent early stage patients will have more advanced stage disease when full staging is done. In contrast, chemotherapy improves progression-free survival (PFS) for patients with stage IA or IB poorly differentiated disease, stage IC, or stage II disease, and these patients should receive adjuvant chemotherapy."

"There is a clear need for additional clinical trials to assess whether the clinical benefits such as quality of life, symptom control, and survival advantages outweigh the added exposure to the side effects of the agents or treatments used in the maintenance or consolidation setting."