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The Lancet, Volume 374, Issue 9698, Pages 1371 - 1382, 17 October 2009
doi:10.1016/S0140-6736(09)61338-6Cite or Link Using DOI

Ovarian cancer

Bryan T Hennessy MD a, Robert L Coleman MD b, Dr Maurie Markman MD a Corresponding AuthorEmail Address


The standard initial management of epithelial ovarian cancer consists of surgical staging, operative tumour debulking including total abdominal hysterectomy and bilateral salpingo-oophorectomy, and administration of six cycles of intravenous chemotherapy with carboplatin and paclitaxel. Extensive and largely retrospective experience has shown that optimum surgical debulking to leave residual tumour deposits that are less than 1 cm in size is associated with improved patient outcomes. However, 75% of patients present with advanced (stage III or IV) disease and, although more than 80% of these women benefit from first-line therapy, tumour recurrence occurs in almost all these patients at a median of 15 months from diagnosis. Second-line treatments can improve survival and quality of life but are not curative. Advances in screening and understanding of molecular pathogenesis of ovarian cancer and development of novel targeted therapies (eg, bevacizumab) and practical intraperitoneal techniques for drug delivery are most likely to improve patient outcomes.
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a Department of Gynecologic Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
b Department of Gynecologic Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Corresponding Author Information Correspondence to: Dr Maurie Markman, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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