gynecology and obstetrics
Ovarian, Fallopian Tube, and Peritoneal Cancer
Introduction
Ovarian cancer is often fatal because it is usually advanced when diagnosed. The most common histology—high-grade serous epithelial ovarian cancer—is considered as a single clinical entity along with fallopian tube and peritoneal cancers because of shared clinical features. Symptoms are usually absent or nonspecific. Evaluation usually includes ultrasonography, CT or MRI, and measurement of tumor markers (eg, cancer antigen 125). Diagnosis is by histologic analysis. Staging is surgical. Treatment requires hysterectomy, bilateral salpingo-oophorectomy, excision of as much involved tissue as possible (cytoreduction), and usually chemotherapy. In the United States, ovarian cancer is the second most common gynecologic cancer (affecting approximately 1/70 women). It is the fifth leading cause of cancer-related deaths in women and, in the United States, will cause an estimated 19,710 new cases and 13,270 deaths in 2023 ( General reference ). Incidence is higher in high-resource countries. 