Key Points

Ovarian cancer is the leading cause of death from all gynecologic cancers in the United States. Median age of diagnosis is 63 years. Survival is related to race, age, and stage at diagnosis. Risk factors for ovarian cancer can be categorized as genetic, environmental, and reproductive. Nulliparity and infertility have been associated with an increased risk of ovarian cancer, whereas oral contraceptive use has a strong protective association.

Family history is the most significant known risk factor. Hereditary breast-ovarian cancer syndrome and hereditary nonpolyposis colorectal cancer syndrome are the two clinically distinct syndromes associated with ovarian cancer.

Environmental factors such as diet, obesity, and endometriosis have been associated with increased risk of ovarian cancer.

The most common presenting symptoms include abdominal distention and bloating. Palpable pelvic mass is a common presenting sign.

Serous papillary histology is the most common subtype of ovarian cancer, whereas mucinous and endometrioid histologies have been associated with improved prognosis in comparison. Optimal cytoreduction defined by residual disease less than 1 cm is associated with improved survival.

CA-125 is well established for assessment of tumor response and detection of recurrent disease.

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