Multimodality therapy of early-stage (FIGO I-II) ovarian cancer: review of surgical management and postoperative adjuvant treatment

Two surgical aspects in the treatment of early-stage ovarian cancer deserve attention: the likelihood of retroperitoneal node involvement and the possibility of conservative surgery in young patients who desire to preserve reproductive function. Although lymph node involvement has been thought to be infrequent in ovarian cancer, recent reports have documented retroperitoneal node metastases in 9.5-25% of patients with early-stage ovarian cancer. A current prospective randomized trial in Italy, comparing systematic para-aortic and pelvic lymphadenectomy with sample biopsies of retroperitoneum in patients with early disease, should reveal whether systematic lymphadenectomy merely adds to knowledge of the natural history of the disease or whether it will influence subsequent therapy and prognosis. Most researchers agree that conservative surgery should be performed in young patients with borderline tumors and stage I, grade 1 ovarian cancer. Our experience over a 10-year period in which 56% of 99 women aged