Epithelial ovarian cancer is the most lethal of all gynecologic malignancies. Most women have advanced stage disease. Access to appropriate initial surgical management by a gynecologic oncologist is important because treatment and survival are affected by appropriate surgical staging and debulking of tumor. After debulking/staging surgery, chemotherapy with platinum-taxane-based regimens is appropriate for most patients. Patients with early stage, low-risk tumors may be cured with surgery alone. Interval cytoreductive surgery may be appropriate for patients who are initially suboptimally cytoreduced and are stable or responding to chemotherapy. The role of second-look surgery remains to be defined. Patients with recurrent or relapsed ovarian cancer are incurable. There are several chemotherapy agents that can achieve disease responses, which may be associated with palliation of tumor-related symptoms. Participation in clinical trials is encouraged for all patients. Novel approaches to managing minimal residual disease are being tested in hopes of decreasing the number of patients who relapse after achieving complete clinical remission.
