Primary chemotherapy in epithelial ovarian cancer.

Ovarian cancer is an important disease due to its occurrence in women in the prime of life (40-70) and its responsiveness to therapy but generally poor outcome due to the emergence of drug-resistant cells. In early-stage disease, adjuvant therapies may improve outcome, but previous studies have concentrated more on the reduction of toxicity of therapy than on improved survival, although modern approaches are evaluating more aggressive intervention in these patients with good survival rates (40%-90% cure with surgery). In advanced disease, the most common presentation, it appears that more aggressive staging and surgical debulking as well as new classes of drugs for treatment have altered, albeit modestly, the outcome in this disease. Future approaches will evaluate taxol, a new active agent, as well as more dose-intense therapy and a continued search will be made for new active drugs and methods to overcome intrinsic and acquired drug resistance.