Indicazioni per un approccio multidisciplinare alla gestione del carcinoma ovarico

A multidisciplinary approach in the mangement of ovarian cancer. Ovarian cancer is one of the most lethalgynecologic malignancies mainly because of the advanced tumor stage at diagnosis. The outcome for women with ovarian cancer is generally poor, with an overall 5-year survival rate <35%. Disease stage is the most important factor affecting outcome. The woman's general health at the time of presentation is also important, because it affects the choice of treatment options. The contribution of imaging techniques in patient management is gaining acceptance for the staging of ovarian cancer, the selection of candidates suitable for cytoreductive surgery and the macroscopic documentation of residual tumor after primary surgery. Recent reports have demonstrated that, besides utilizing CA125 as a predictor of optimal cytoreduction and response to treatment, diagnostic accuracy may be improved utilizing a new biomarker, the human epidydimis protein 4, whose expression closely relates to the presence of epithelial ovarian cancer in women. Despite the relatively poor overall survival rate for ovarian cancer, there was a two-fold increase in survival over the last 30 years, which has coincided with the advent of effective chemotherapy, and, particularly, the introduction of platinum-based agents, as well as changes in surgical practice. More recently, there has been a significant shift towards greater specialization in the delivery of care, resulting from the implementation of the cancer service guidance improving outcomes in gynecologic cancers