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from PART II - CLINICAL RESEARCH
Published online by Cambridge University Press: 05 June 2012
The three major classes of gynecologic malignancies include ovarian, endometrial, and cervical cancer. Although most women with ovarian cancer will present with metastatic disease (75%–80% of patients), a relatively small percentage of women with endometrial cancer have metastatic disease at diagnosis (20% of patients). For women with cervical cancer, 60 percent will have metastatic disease when they are initially diagnosed. Ovarian cancer is the most lethal of the gynecologic malignancies, as its pattern of spread is intraperitoneal and often causes the patient few readily identifiable symptoms. Endometrial cancer has the best prognosis overall, as it is usually detected at an early stage when it can be treated with surgery alone. Cervical cancer, despite its prevalence worldwide, is uncommon in the developed world and is treatable and often curable, given its sensitivity to radiation, even after locally advanced spread.
Each of the gynecologic malignancies presents the practitioner with unique clinical and treatment challenges. Advances in imaging techniques, surgical techniques, chemotherapy administration, and the development of targeted therapies have led to improved treatment options for patients diagnosed with gynecologic malignancies. This chapter highlights common patterns of metastasis for each of the major tumor types, diagnostic modalities, and the standard and emerging treatments for ovarian, endometrial, and cervical cancer.
EPITHELIAL OVARIAN CANCER
An estimated 21,550 new cases of ovarian cancer were diagnosed in 2009, with 14,600 estimated deaths, making ovarian cancer the most lethal of the gynecologic malignancies. The majority (95%) of cancers arising from the ovary are epithelial in origin.
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