Approach to survivors of epithelial ovarian, fallopian tubal, or peritoneal carcinoma
- Linda R Duska, MD
Linda R Duska, MD
- Associate Professor
- Fellowship Director
- Gynecologic Oncology
- University of Virginia
- Section Editors
- Larissa Nekhlyudov, MD, MPH
Larissa Nekhlyudov, MD, MPH
- Section Editor — Cancer Survivorship
- Associate Professor
- Department of Medicine
- Brigham & Women’s Hospital
- Harvard Medical School
- Barbara Goff, MD
Barbara Goff, MD
- Section Editor — Gynecologic Oncology
- Professor of Gynecologic Oncology
- University of Washington
- Don S Dizon, MD, FACP
Don S Dizon, MD, FACP
- Section Editor – Gynecologic Oncology
- Head of Women's Cancers, Lifespan Cancer Institute
- Director of Medical Oncology, Rhode Island Hospital
- Associate Professor of Medicine, Warren Alpert Medical School of Brown University
- Deputy Editors
- Sadhna R Vora, MD
Sadhna R Vora, MD
- Deputy Editor — Oncology
- Instructor in Medicine
- Harvard Medical School
- Sandy J Falk, MD, FACOG
Sandy J Falk, MD, FACOG
- Director, Editorial Relations — UpToDate
- Deputy Editor — Obstetrics, Gynecology and Women's Health
- Instructor of Obstetrics, Gynecology and Reproductive Biology, Part-time
- Harvard Medical School
Ovarian cancer is the second most common gynecologic malignancy and the most common cause of gynecologic cancer death in the United States. Epithelial ovarian carcinoma is the most common histologic type of ovarian cancer and is closely related to fallopian tubal and peritoneal carcinomas. These will be referred to as a single entity here, as epithelial ovarian carcinoma (EOC).
Five-year survival rates for stage III or IV EOC are <50 percent and <20 percent, respectively (table 1). However, in 2016 there were more than 230,000 EOC survivors in the United States and there are some long-term survivors of EOC .
Issues pertaining to survivorship in EOC are not well-studied. This may be due to the overall poor prognosis of women with ovarian cancer and smaller populations of affected individuals compared with patients with other cancers (eg, endometrial or breast cancer). Additionally, there are many studies of ovarian cancer survivors and their difficulties, but there are few data to guide management. Nevertheless, survivorship-related issues are important to address in this growing population of women.
The approach to survivors of EOC will be reviewed here. Related topics are discussed in detail separately, including:
●Overview, diagnosis, and treatment:
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- OVERVIEW OF TREATMENT
- POSTTREATMENT SURVEILLANCE
- Risk of recurrence
- Role of CA 125 surveillance
- No role for routine imaging
- Breast cancer risk management in BRCA mutation carriers with EOC
- COORDINATION OF CARE
- QUALITY OF LIFE AMONG SURVIVORS
- LONG-TERM PHYSICAL EFFECTS
- Neurologic effects
- - Neurotoxicity
- - Cognitive dysfunction
- Gastrointestinal toxicity
- - Surgical complications
- - Medical complications
- - Unrelated causes
- Gynecologic effects
- - Loss of fertility
- - Sexual dysfunction
- - Menopause
- Systemic menopausal symptoms or effects
- Genitourinary syndrome of menopause
- PSYCHIATRIC AND PSYCHOSOCIAL ISSUES
- Other issues
- PROMOTING A HEALTHY LIFESTYLE
- SUMMARY AND RECOMMENDATIONS