Early ovarian cancer can be divided into low-risk and high-risk groups. Complete surgical staging impacts treatment decisions.
Patients with low-risk early-stage ovarian cancer do not require adjuvant chemotherapy. Adjuvant chemotherapy definitely benefits incompletely staged patients.
The need for adjuvant chemotherapy for completely staged patients with high-risk, stage I non-clear cell histology is controversial.
Carboplatin with paclitaxel is the preferred adjuvant regimen by extrapolation from treatment of advanced disease.
Three cycles of adjuvant treatment are sufficient for completely staged high-risk ovarian cancer patients.
Stage II patients should be treated as stage III. Clear cell histology requires special consideration.
The standard, preferred chemotherapy regimen for advanced disease is six cycles of carboplatin and paclitaxel.
Intraperitoneal chemotherapy is an alternative regimen that should be offered to patients with optimal residual stage III disease.
Maintenance chemotherapy should be discussed with patients who have achieved a complete response to frontline therapy in advanced disease.
Neoadjuvant chemotherapy is an option for patients with poor performance status and advanced disease.
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