Foreword

Ovarian cancer is a significant cause of morbidity and mortality in women. Ovarian cancer is distinct from other malignancies in some specific characteristics. For example, the origin of primary ovarian cancer can be from multiple sites, the tumor cells can disseminate by exfoliation from the ovaries or the tubes and migrate through the peritoneum, and secondary tumors do not have additional genetic mutations from that of the primary tumors. Due to the lack of specific signs and symptoms at the early stages of the disease, ovarian cancer is usually diagnosed late, and peritoneal and distant metastases are common at diagnosis. Ovarian cancer is a heterogenous disease. The World Health Organization categorizes ovarian cancer into three groups: epithelial, germ cell, and sex-cord stromal. Tumors in each of these categories have distinct epidemiology, pathophysiology, and molecular biology. Heterogeneity is a key feature of these tumors, explaining, in part, the lack of successful treatment. Although these subtypes are distinct, they are clinically managed as a single entity, with cytoreductive surgery followed by platinum-taxane combination chemotherapy. The response rate to first-line therapy is around 80-90%, but most patients relapse and develop chemotherapy resistance contributing to a poor 5-year survival rate. Another key aspect of advanced ovarian cancers is malignant ascites as more than one-third of the patients develop this condition. CONTINUE READING.....