الفهرس 
introduction and aim of workOnly 14 pages are availabe for public view
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Abstract
Ovarian cancer is the sixth most common cancer among women, and the second most common gynecological malignancy. It occurs most frequently in white, non-pregnant women with positive family history of ovarian, breast, or endometrial cancer, and who are between 40 and 65 years of age. Ovarian cancer is called a “silent killer” because symptoms usually develop after the disease had advanced and the chance of cure is poor. The detection of patients with early-stage disease remains the greatest challenge in ovarian cancer. It was reported that utilizing multimodal screening by performing annual CA125 testing, followed by ultrasound imaging has shown a high positive predictive value. However, it remains to be seen if such screening is effective to reduce mortality. Surgery is usually the initial treatment for women with suspected ovarian cancer. The type of surgery depends upon the stage of cancer, as well as the presumed type and grade of cancer. Surgery performed by a specialist in gynecologic oncology usually results in improved results. In advanced malignancy, where complete resection is not feasible, debulking surgery is done. Neoadjuvant chemotherapy is a reasonable approach for women who could not tolerate a lengthy operation and recovery period. Platinum-based chemotherapy drugs represent the core of first-line chemotherapy for patients with advanced ovarian cancer. Paclitaxel was next combined with platinum and resulted in an improved outcome. Overall survival was significantly prolonged for women who received an IP component to their chemotherapy. Most patients with advanced ovarian cancer will recur after first-line chemotherapy. Relapsed ovarian cancer is incurable; however, chemotherapy can improve quality of life and survival. Trials are currently under way for various novel compounds in the management of recurrent ovarian cancer, including pemetrexed, epothilones, telcyta, phenoxodiol, and trabectedin. Gene therapy, immunotherapy and signal transduction inhibitors are also potential future therapies that are being investigated in ongoing clinical research.