SAN FRANCISCO—The “preponderance of the evidence” supports intraperitoneal chemotherapy as the preferred treatment for small-volume residual ovarian cancer after surgical debulking, Robert S. Mannel, MD, said at a debate session of the 2008 Oncology Congress. J. Tate Thigpen, MD, who took the con side of the debate, argued that IP chemotherapy remains experimental because of flaws in the design of the three major trials of IP therapy and its “formidable toxicity.” More>>

Given that in the 21st century many believe 70 years of age is the new 60 and 80 years of age is the new 70, any article on ovarian cancer in the elderly depends on one’s definition of elderly. To put this in a 21st century perspective, in a thoughtful article on aging in The New Yorker (“The Way We Age Now,” April 30, 2007), Atul Gawande points out, “for most of our hundred-thousand-year existence—all but the past couple of hundred years—the average life span of human beings has been 30 years... More>>

Piver gives his perspective on the management of epithelial ovarian cancer in the elderly. This subject has been dealt with previously by numerous authors, with a general consensus that advancing age is an independent negative prognostic factor when multivariate statistics are applied to the multiple parameters affecting outcome More>>

Dr. Piver presents a personal look at the issues he believes to be important in managing ovarian carcinoma in the elderly patient. He begins with an attempt to define elderly. More>>

Ortho Biotech recently announced the submission of a new drug application (NDA) to the US Food and Drug Administration (FDA) for trabectedin (Yondelis) when administered in combination with liposomal doxorubicin (Doxil) for the treatment of women with relapsed ovarian cancer. More>>

Conventional therapy for advanced-stage ovarian cancer—ie, aggressive cytoreductive surgery followed by aggressive chemotherapy—was established more than 3 decades ago [Editor’s note: See Dr. Schwartz’s article, “Cytoreductive Surgery in the Management of Ovarian Cancer,” in last month’s issue of ONCOLOGY]. Since that time, no prospective randomized trials have been reported to confirm the efficacy of this treatment strategy. More>>

The question of a well-defined role for the use of neoadjuvant chemotherapy in the treatment of ovarian cancer is recognized to be one of the most hotly debated issues in the management of female pelvic malignancies.[1-3] One group of oncologists would argue that it should be the rare patient (eg, with severe comorbidity) who is not a candidate for an initial attempt at maximal cytoreduction.[1] More>>

Ovarian cancer is a unique malignancy. While the disease can spread hematogenously or via the lymphatic system, the bulk of the tumor is found on peritoneal surfaces. This peritoneal disease results from shedding of ovarian tumor cells into the peritoneal cavity, circulation of these cells throughout the abdomen and pelvis, and eventual implantation onto peritoneal surfaces. More>>

The standard management for advanced-stage ovarian cancer was established in the mid-1970s. At a 1974 National Cancer Institute Consensus Conference on Ovarian Cancer, Griffiths presented data supporting the role for aggressive cytoreductive surgery as the first step in the management of this disease, followed by cytotoxic chemotherapy. More>>

The magnitude of the role surgical exploration and extirpation play in the contemporary management of patients with advanced ovarian cancer is hard to overstate. Beyond diagnostic confirmation, the aggressive posture taken to remove bulk disease provides—among other benefits—symptomatic relief, theoretically enhanced immunologic integrity, chemosensitivity, and improved survival characteristics. More>>