Management of early-stage epithelial ovarian cancer

Key content • Approximately 30% of women presenting with epithelial ovarian cancer will have early-stage (stage I) disease. • The multidisciplinary team is central to deciding the optimal management for these women. • Comprehensive surgical staging is important in determining the need for chemotherapy. • Although the combined ACTION and ICON 1 studies of chemotherapy showed an improved overall survival, both included large numbers of incompletely staged women. Learning objectives • To understand the problems in diagnosing early-stage ovarian cancer and the need for referral to a multidisciplinary team in deciding on management. • To understand the importance of correct surgical staging and the possible need for chemotherapy. • To gain an understanding and awareness of the role of minimal access surgery and fertility-sparing surgery. Ethical issues • Difficulties in diagnosing early-stage ovarian cancer can lead to incomplete staging and, ultimately, have a negative effect on prognosis. Please cite this article as: Nagar H, Dobbs S. Management of early-stage epithelial ovarian cancer. The Obstetrician & Gynaecologist 2007;9:243–247.