Treatment of Invasive Epithelial Ovarian Cancers by Stage
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2021-01-08
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Treatment of Invasive Epithelial Ovarian Cancers, by Stage
The first step in treating most stages of ovarian cancer is surgery to remove and stage the cancer. Debulking is also done as needed. (See Surgery for Ovarian Cancer.) Because fallopian tube and primary peritoneal cancers have the same staging system as ovarian cancers they are included in this section.
Stage I cancers
The initial treatment for stage I ovarian cancer is surgery to remove the tumor. Most often the uterus, both fallopian tubes, and both ovaries are removed (a hysterectomy with bilateral salpingo-oophorectomy). The treatment after surgery depends on the sub-stage of the cancer.
Stages IA and IB (T1a or T1b, N0, M0): The treatment after surgery depends on the way the cancer cells looks in the lab (called the tumor grade).
For grade 1 (also called low grade) tumors, most women don't need any treatment after surgery. Women who want to be able to have children after treatment might be given the option of having an initial surgery that removes only the ovary containing the cancer along with the fallopian tube on the same side.
For grade 2 (high grade) tumors, patients are either watched closely after surgery without further treatment, or they are treated with chemotherapy (chemo). The chemo used most commonly is carboplatin and paclitaxel (Taxol) for 3-6 cycles, but cisplatin can be used instead of carboplatin, and docetaxel (Taxotere) can be used instead of paclitaxel.
For grade 3 (high grade) tumors, the treatment usually includes the same chemotherapy that is given for grade 2 Stage IA and IB cancers.
Stage IC (T1c, N0, M0): Standard surgery to remove the cancer is still the first treatment. After surgery, chemo is recommended, usually with 3 to 6 cycles of treatment with carboplatin and paclitaxel.
Stage I fallopian tube and primary peritoneal cancers are treated the same way as stage I ovarian cancer.
Stage II cancers
For stage II (including IIA and IIB) cancers, treatment starts with surgery for staging and debulking. This includes a hysterectomy and bilateral salpingo-oophorectomy. The surgeon will try to remove as much of the tumor as possible.
After surgery, chemo is recommended for at least 6 cycles. The combination of carboplatin and paclitaxel is used most often. Some women with stage II ovarian cancer are treated with intraperitoneal (IP) chemotherapy instead of intravenous (IV) chemotherapy.
Stage II fallopian tube and primary peritoneal cancers are also treated with surgery for staging and debulking, followed by chemo.
Stage III cancers
Stage III cancers (including IIIA1, IIIA2, IIIB, and IIIC) are generally treated similarly to stage II cancers.
First, the cancer is surgically staged and the tumor is debulked (like stage II). The uterus, both fallopian tubes, both ovaries, and omentum (fatty tissue from the upper abdomen near the stomach and intestines) are removed. The surgeon will also try to remove as much tumor as possible. The goal is to leave behind
The first step in treating most stages of ovarian cancer is surgery to remove and stage the cancer. Debulking is also done as needed. (See Surgery for Ovarian Cancer.) Because fallopian tube and primary peritoneal cancers have the same staging system as ovarian cancers they are included in this section.
Stage I cancers
The initial treatment for stage I ovarian cancer is surgery to remove the tumor. Most often the uterus, both fallopian tubes, and both ovaries are removed (a hysterectomy with bilateral salpingo-oophorectomy). The treatment after surgery depends on the sub-stage of the cancer.
Stages IA and IB (T1a or T1b, N0, M0): The treatment after surgery depends on the way the cancer cells looks in the lab (called the tumor grade).
For grade 1 (also called low grade) tumors, most women don't need any treatment after surgery. Women who want to be able to have children after treatment might be given the option of having an initial surgery that removes only the ovary containing the cancer along with the fallopian tube on the same side.
For grade 2 (high grade) tumors, patients are either watched closely after surgery without further treatment, or they are treated with chemotherapy (chemo). The chemo used most commonly is carboplatin and paclitaxel (Taxol) for 3-6 cycles, but cisplatin can be used instead of carboplatin, and docetaxel (Taxotere) can be used instead of paclitaxel.
For grade 3 (high grade) tumors, the treatment usually includes the same chemotherapy that is given for grade 2 Stage IA and IB cancers.
Stage IC (T1c, N0, M0): Standard surgery to remove the cancer is still the first treatment. After surgery, chemo is recommended, usually with 3 to 6 cycles of treatment with carboplatin and paclitaxel.
Stage I fallopian tube and primary peritoneal cancers are treated the same way as stage I ovarian cancer.
Stage II cancers
For stage II (including IIA and IIB) cancers, treatment starts with surgery for staging and debulking. This includes a hysterectomy and bilateral salpingo-oophorectomy. The surgeon will try to remove as much of the tumor as possible.
After surgery, chemo is recommended for at least 6 cycles. The combination of carboplatin and paclitaxel is used most often. Some women with stage II ovarian cancer are treated with intraperitoneal (IP) chemotherapy instead of intravenous (IV) chemotherapy.
Stage II fallopian tube and primary peritoneal cancers are also treated with surgery for staging and debulking, followed by chemo.
Stage III cancers
Stage III cancers (including IIIA1, IIIA2, IIIB, and IIIC) are generally treated similarly to stage II cancers.
First, the cancer is surgically staged and the tumor is debulked (like stage II). The uterus, both fallopian tubes, both ovaries, and omentum (fatty tissue from the upper abdomen near the stomach and intestines) are removed. The surgeon will also try to remove as much tumor as possible. The goal is to leave behind
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