TREATMENT OPTIONS BY STAGE
Stage I and II Ovarian Epithelial Cancer
Treatment of stage I and stage II ovarian epithelial cancer may include the following:
- Total abdominal hysterectomy, bilateral
salpingo-oophorectomy, and omentectomy. Lymph nodes and other tissues in the pelvis and abdomen are removed and examined under the microscope to look for cancer cells.
- Total abdominal hysterectomy, unilateral
salpingo-oophorectomy, and omentectomy. Lymph nodes and other tissues in the pelvis and abdomen are removed and examined under the microscope to look for cancer cells.
- A clinical trial of internal or external radiation therapy.
- A clinical trial of chemotherapy.
- A clinical trial of surgery followed by chemotherapy or watchful waiting (closely monitoring a patient's condition without giving any treatment until symptoms appear or change).
- A clinical trial of a new treatment.
Stage III and IV Ovarian Epithelial Cancer
Treatment of stage III and stage IV ovarian epithelial cancer may be surgery to remove the tumor, total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. After surgery, treatment depends on how much tumor remains.
When the tumor that remains is 1 centimeter or smaller, treatment is usually combination chemotherapy, including intraperitoneal (IP) chemotherapy.
When the tumor that remains is larger than 1 centimeter, treatment may include the following:
- Combination chemotherapy, including intraperitoneal (IP) chemotherapy.
- A clinical trial of combination chemotherapy, including IP chemotherapy, before and after second-look surgery (surgery performed after the initial surgery to determine whether tumor cells remain).
- A clinical trial of biologic therapy or targeted therapy following combination chemotherapy.
Stage I Ovarian Germ Cell Tumors
Treatment depends on whether the tumor is dysgerminoma (the most common ovarian germ cell tumor) or another type of germ cell tumor.
Treatment of dysgerminoma may include the following:
- Unilateral salpingo-oophorectomy with or without lymphangiography (an x-ray study of the lymph system, the tissues and organs that filter and destroy harmful substances and help fight infection and disease) or CT scan (a series of detailed pictures of areas inside the body, created by a computer linked to an x-ray machine).
- Unilateral salpingo-oophorectomy followed by observation (closely monitoring a patient´s condition without giving any treatment until symptoms appear or change).
- Unilateral salpingo-oophorectomy followed by radiation therapy.
- Unilateral salpingo-oophorectomy followed by chemotherapy.
Treatment of other germ cell tumors may be either:
- unilateral salpingo-oophorectomy followed by careful observation; or
- unilateral salpingo-oophorectomy, sometimes followed by combination chemotherapy.
Stage II Ovarian Germ Cell Tumors
Treatment depends on whether the tumor is dysgerminoma or another type of germ cell tumor.
Treatment of dysgerminoma may be either:
- total abdominal hysterectomy and bilateral salpingo-oophorectomy followed by radiation therapy or combination chemotherapy; or
- unilateral salpingo-oophorectomy followed by chemotherapy.
Treatment of other germ cell tumors may include the following:
- Unilateral salpingo-oophorectomy followed by combination chemotherapy.
- Second-look surgery (surgery performed after primary treatment to determine whether tumor cells remain).
- A clinical trial of new treatment options.
Stage III Ovarian Germ Cell Tumors
Treatment depends on whether the tumor is dysgerminoma or another type of germ cell tumor.
Treatment of dysgerminoma may include the following:
- Total abdominal hysterectomy and bilateral salpingo-oophorectomy, with removal of as much of the cancer in the pelvis and abdomen as possible.
- Unilateral salpingo-oophorectomy followed by chemotherapy.
Treatment of other germ cell tumors may include the following:
- Total abdominal hysterectomy and bilateral salpingo-oophorectomy, with removal of as much of the cancer in the pelvis and abdomen as possible. Chemotherapy will be given before and/or after surgery.
- Unilateral salpingo-oophorectomy followed by chemotherapy.
- Second-look surgery (surgery performed after primary treatment to determine whether tumor cells remain).
- A clinical trial of new treatment options.
Stage IV Ovarian Germ Cell Tumors
Treatment depends on whether the tumor is dysgerminoma or another type of germ cell tumor.
Treatment of dysgerminoma may include the following:
- Total abdominal hysterectomy and bilateral salpingo-oophorectomy followed by chemotherapy, with removal of as much of the cancer in the pelvis and abdomen as possible.
- Unilateral salpingo-oophorectomy followed by chemotherapy.
Treatment of other germ cell tumors may include the following:
- Total abdominal hysterectomy and bilateral salpingo-oophorectomy, with removal of as much of the cancer in the pelvis and abdomen as possible. Chemotherapy will be given before and/or after surgery.
- Unilateral salpingo-oophorectomy followed by chemotherapy.
- Second-look surgery (surgery performed after primary treatment to determine whether tumor cells remain).
- A clinical trial of new treatment options.
Glossary
Total hysterectomy: Surgery to remove the
entire uterus, including the cervix. Sometimes, not all of the cervix is
removed. Also called complete hysterectomy.
Bilateral salpingo-oophorectomy: Surgery to remove both ovaries and
both fallopian tubes.
Unilateral salpingo-oophorectomy: Surgery to remove the ovary and
fallopian tube on one side of the body.
Omentectomy: Surgery to remove part or all of the omentum.
Reference:
National Cancer Institute, USA.
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