Epithelial ovarian cancer (EOC) stands as the second leading cause of gynecological cancer mortality. Largely due to the lack of early symptoms, about 75% of EOC is detected at an advanced stage. The formulation of an effective therapeutic strategy post-diagnosis necessitates a comprehensive evaluation encompassing variables such as disease stage, age, physical performance status, life expectancy, and comorbidities. Current treatment modalities include surgery, chemotherapy, radiotherapy, novel targeted molecular therapies, or a combination of these modalities. However, despite considerable advancements in EOC management, inclusive of extensive cytoreductive surgery and novel adjunctive therapies, the prognosis remains poor. Stage III patients yield an overall survival rate of a mere 40%, while that for Stage IV plunges to an abysmal 20%. The initial treatment decision for advanced epithelial ovarian cancer is considered to have a significant impact on the prognosis of ovarian cancer patients.
In terms of preoperative evaluation, several image-based assessment models as well as laparoscopic grading evaluation, play a significant role in achieving complete cytoreduction with debulking surgery in advanced ovarian cancer. But the actual practice is full of uncertainties. These models included different radiological criteria, such as peritoneal thickening, ascites, and so on. The role and value of imaging in preoperative evaluation may vary in different medical institutions. Laparoscopic surgery is mainly used for the diagnosis and evaluation of advanced ovarian cancer (stage III, stage IV). More research is urgently needed to address the controversies regarding the indications, timing, and standards of laparoscopic ovarian cancer reduction surgery. Neoadjuvant chemotherapy followed by interval debulking surgery is another method to reduce the tumor burden. However, the optimal number of cycles of neoadjuvant chemotherapy in patients with advanced ovarian cancer remains controversial, and more prospective trials are needed to determine it. Secondary laparotomy (SLL) is used to evaluate the primary surgical and pathological treatment for ovarian cancer in patients who are in a clinical complete response. Nevertheless, it is still unclear whether SLL improves disease-free survival or overall survival, and whether a complete lymphadenectomy should be performed during SLL. The role of radiotherapy in the management of ovarian cancer is also a controversial topic. For epithelial ovarian cancer patients with lung metastasis, it remains unclear whether the main treatment method should be surgery or radiation therapy alone. Therefore, the choice of treatment modality for advanced epithelial ovarian cancer patients is particularly important.
In this Research Topic, we aim to consolidate insightful perspectives on the initial treatment of advanced epithelial ovarian cancer, discuss the controversies, and explore new developments in hopes of improving the prognosis. We invite submissions of Original Research, Review, Mini Review, Case Analysis, Case report, and Perspective Articles that cover, but are not limited to:
? Preoperative evaluation methods for advanced ovarian cancer
? Opinions, case reports, or research on the type or scope of surgery for advanced ovarian cancer
? Regimen and cycle number for neoadjuvant chemotherapy in advanced ovarian cancer and applicable populations
? The role of radiotherapy in the management of advanced ovarian cancer
? Combination therapy and comprehensive management of advanced ovarian cancer
Please note: manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of scope for this section and will not be accepted as part of this Research Topic.
Epithelial ovarian cancer (EOC) stands as the second leading cause of gynecological cancer mortality. Largely due to the lack of early symptoms, about 75% of EOC is detected at an advanced stage. The formulation of an effective therapeutic strategy post-diagnosis necessitates a comprehensive evaluation encompassing variables such as disease stage, age, physical performance status, life expectancy, and comorbidities. Current treatment modalities include surgery, chemotherapy, radiotherapy, novel targeted molecular therapies, or a combination of these modalities. However, despite considerable advancements in EOC management, inclusive of extensive cytoreductive surgery and novel adjunctive therapies, the prognosis remains poor. Stage III patients yield an overall survival rate of a mere 40%, while that for Stage IV plunges to an abysmal 20%. The initial treatment decision for advanced epithelial ovarian cancer is considered to have a significant impact on the prognosis of ovarian cancer patients.
In terms of preoperative evaluation, several image-based assessment models as well as laparoscopic grading evaluation, play a significant role in achieving complete cytoreduction with debulking surgery in advanced ovarian cancer. But the actual practice is full of uncertainties. These models included different radiological criteria, such as peritoneal thickening, ascites, and so on. The role and value of imaging in preoperative evaluation may vary in different medical institutions. Laparoscopic surgery is mainly used for the diagnosis and evaluation of advanced ovarian cancer (stage III, stage IV). More research is urgently needed to address the controversies regarding the indications, timing, and standards of laparoscopic ovarian cancer reduction surgery. Neoadjuvant chemotherapy followed by interval debulking surgery is another method to reduce the tumor burden. However, the optimal number of cycles of neoadjuvant chemotherapy in patients with advanced ovarian cancer remains controversial, and more prospective trials are needed to determine it. Secondary laparotomy (SLL) is used to evaluate the primary surgical and pathological treatment for ovarian cancer in patients who are in a clinical complete response. Nevertheless, it is still unclear whether SLL improves disease-free survival or overall survival, and whether a complete lymphadenectomy should be performed during SLL. The role of radiotherapy in the management of ovarian cancer is also a controversial topic. For epithelial ovarian cancer patients with lung metastasis, it remains unclear whether the main treatment method should be surgery or radiation therapy alone. Therefore, the choice of treatment modality for advanced epithelial ovarian cancer patients is particularly important.
In this Research Topic, we aim to consolidate insightful perspectives on the initial treatment of advanced epithelial ovarian cancer, discuss the controversies, and explore new developments in hopes of improving the prognosis. We invite submissions of Original Research, Review, Mini Review, Case Analysis, Case report, and Perspective Articles that cover, but are not limited to:
? Preoperative evaluation methods for advanced ovarian cancer
? Opinions, case reports, or research on the type or scope of surgery for advanced ovarian cancer
? Regimen and cycle number for neoadjuvant chemotherapy in advanced ovarian cancer and applicable populations
? The role of radiotherapy in the management of advanced ovarian cancer
? Combination therapy and comprehensive management of advanced ovarian cancer
Please note: manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of scope for this section and will not be accepted as part of this Research Topic.