Epithelial Ovarian Cancer

Although relatively uncommon, epithelial ovarian cancer is the most lethal gynaecological malignancy, partly due to its insidious presentation but also because of its intrinsic histological and molecular heterogeneity. The 5-year survival rate has recently improved to almost 50%, predominantly through optimal specialist surgical intervention and the use of platinum-based chemotherapy. However, for the majority of patients, the disease will relapse following initial treatment and become increasingly chemotherapy resistant with each episode of recurrence. Future treatment strategies, as well as improving response to front-line therapy, are focusing on ways to overcome chemotherapy resistance in the relapsed setting, with the judicious use of novel cytotoxic and/or targeted therapies. These options become more feasible with improvements in our understanding of the molecular behaviour of the disease and of its various histological subtypes. We summarize the current status quo in the surgical and medical management of ovarian cancer and present results of a number of key studies that have explored genetically, molecularly and histologically targeted strategies in the treatment of this disease. © 2012 John Wiley and Sons, Ltd..