ABSTRACT
The primary treatment of ovarian cancer has become bothmore effective and less toxic over the past two decades (1,2). The sequential introduction of aggressive debulking surgery, cisplatin (CDDP), carboplatin, and taxanes has increased the expected survival from 6-12 months to 3-5 years, while the toxicity burden of treatment has been decreased (Fig. 1). Unfortunately, 20-30% of advanced disease patients will still not achieve a complete response to primary therapy. Even for the patients who achieve a complete response, the prospects for cure are limited. A majority will still relapse with ovarian cancer and eventually succumb to their disease. Consequently, the management of recurrent or persistent disease will involve most of the patients with ovarian cancer. Despite all of the advances in therapy of the past two decades, patients with disease after the end of primary therapy are incurable by present methods. However, the vast majority can be managed in a chronic disease condition for years. Skillful management of patients with relapsed ovarian cancer can lead to years of symptom-free and productive life. It is essential that risk of toxicity and loss of function considerations assume a prominent place in the decision making by these patients and their healthcare providers.
