Novel diagnostic and therapeutic approaches to the treatment of ovarian cancer

Abstract

Introduction. Ovarian cancer is an intra-abdominal, chemosensitive, chronic disease and according to current protocols, it is primarily treated with surgery followed by adjuvant chemotherapy. In Serbia, 820 cases of ovarian cancer are newly diagnosed annually. The aim of the study is to present the results of surgical treatment in 304 patients with ovarian cancer, treated during a 15-year period (2003-2017) at the Clinic of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad. Material and Methods. Before the operation, clinical, gynecological, ultrasonography examination and analysis of cancer antigen 125 blood concentrations were performed in all patients. Based on basic diagnostics, additional pelvic, abdominal and thoracic computed tomography or magnetic resonance imaging studies, together with colonoscopy if needed, were performed. The selection of the type and extent of surgical procedure was based on intraoperative assessment of the stage of disease, intraoperative histopathological confirmation of ovarian cancer, wish for fertility preservation and general patient's condition. Exclusion criteria were histopathologically confirmed benign or borderline ovarian tumors, i. e. absence of cancer in the final microscopic specimen. Results. The patients' age ranged from 19-88 years, with a median of 53.4 years. According to the International Fede-International Federation of Gynecology and Obstetrics staging, most patients had stage III-98 (33.1%) and epithelial ovarian cancer-240 (84.2%). The most common surgical procedures were hysterectomy with bilateral adnexectomy and omentectomy, whereas cytological analysis was performed in 138 (45.4%) treated patients. Complications were recorded in 13 (4.3%) operated patients with inflammation and wound seroma being the most common (4 patients-1.3% of cases). Conclusion. Ovarian cancer treatment is planned individually, depending on the stage of the disease, histological tumor type, patient's general condition, wish for fertility-sparing treatment and technical capacity of the institution where the treatment is performed.