Surgical management of ovarian cancer

Ovarian cancer affects over 25,000 women each year in the United States. Th e performance of appropriate surgery for ovarian cancer is critical in dire cting further therapies and improving survival. Systematic surgical staging must be performed in patients who appear to have early stage ovarian cance r because a significant proportion of these women have occult metastases. A marked improvement in survival has been demonstrated in patients with bulk y disease if all masses larger than 2 cm can be surgically removed. Despite the dramatic effect of surgery on the subsequent course of the disease, re cent studies show that only a minority of women with ovarian cancer receive appropriate initial surgery. We review the evidence and rationale for syst ematic surgical treatment of ovarian cancer. (C) 1999 Wiley-Liss, Inc.