The lifetime risk of ovarian cancer in the US population is about 1.4%
. The risk is increased in women who have a strong family history of t
he disease. Unfortunately no accurate screening tests are available. T
ransvaginal sonography and CA-125 determinations can be valuable in se
lected patients. Attempts at prevention with oral contraceptive use an
d indicated or proyhylactic ooyhorectomy should be seriously considere
d. Conservative treatment is appropriate in selected patients with ear
ly-stage ovarian cancer. However, because the majority of patients pre
sent with advanced disease, maximum cytoreductive surgery followed by
chemotherapy is usually required. Such an approach results in a high i
ncidence of initial clinical remission and can prolong survival to 2 o
r 3 years. Eventually, however, relapse and death often occur in spite
of additional therapy. Another operation may be needed for secondary
cytoreduction or palliation. Bowel obstruction, recurrent ascites, and
pleural effusion are often terminal events.