Treatment of Stage I Ovarian Cancer
Patients diagnosed with stage I ovarian cancer have cancer that appears to be limited to the ovaries and has not spread to other pelvic or abdominal organs, lymph nodes, or sites outside of the abdomen. A variety of factors will ultimately influence your decision to receive treatment of cancer. The purpose of receiving cancer treatment may be to improve symptoms through local control of the cancer, increase your chance of cure, or prolong your survival. The potential benefits of receiving cancer treatment must be carefully balanced with the potential risks of receiving cancer treatment.
The following is a general overview of the treatment of stage I ovarian cancer. Circumstances unique to your situation and prognostic factors of your cancer may ultimately influence how these general treatment principles are applied. The information on this website is intended to help educate you about your treatment options and to facilitate a mutual or shared decision-making process with your treating cancer physician.
Stage I ovarian cancer is curable in the majority of patients with optimal surgical removal of the cancer. Despite surgical removal of the cancer, up to 40 percent of patients with stage I ovarian cancer will experience a recurrence of their cancer. This is because some patients with stage I cancer have microscopic cancer cells that have spread outside the ovary and therefore were not removed by surgery.
Undetectable areas of cancer outside the ovary are referred to as micrometastases. The presence of these micrometastases causes the relapses that follow treatment with surgery alone. Following surgery, some patients may benefit from additional treatment with chemotherapy to further decrease the risk of cancer recurrence.
Treatment with Adjuvant Chemotherapy
Because small amounts of cancer may have spread into the lymph nodes and were not removed during surgery, an effective treatment is needed to cleanse the body of micrometastases to improve duration of survival and potential for cure. The delivery of cancer treatment following local treatment with surgery is referred to as "adjuvant" therapy.
Following surgery, adjuvant chemotherapy for ovarian cancer is administered to decrease the risk of cancer recurrence. Chemotherapy typically involves the administration of one or more anticancer drugs following recovery from surgery. Clinical trials have demonstrated that adjuvant chemotherapy treatment for patients with stage I ovarian cancer improves survival compared to treatment with surgery alone.
Several factors may affect your decision regarding the recommendation to receive adjuvant chemotherapy.
Low-Risk Stage I Ovarian Cancer
Patients with stage I ovarian cancer are considered to be at low risk of cancer recurrence if the cancer appears to be of low or moderate grade (aggressiveness) under a microscope and no cancer cells were found in the abdominal fluid or on the surface of the ovary. Local treatment with surgery cures the majority of individuals with low-risk stage I ovarian cancer. A few patients, however, will already have developed micrometastases.
Adjuvant chemotherapy with the combination of Taxol® or OnxolTM (paclitaxel) Taxotere® (docetaxel) and a platinum chemotherapy compound Platinol® (cisplatin) or Paraplatin® (carboplatin) is the standard chemotherapy treatment for patients with all stages of ovarian cancer. Clinical trials, however, have not currently shown any benefit of adjuvant chemotherapy administered to patients with low-risk stage I ovarian cancer. This is because more than 90 percent of patients with low-grade stage IA or IB ovarian cancer will be alive and without evidence of cancer 5 years after treatment with surgery alone.
Chemotherapy may be beneficial in some women with low-risk stage I ovarian cancer; however, because surgery cures more than 90 percent of patients, it is difficult to demonstrate additional benefit from chemotherapy treatment for all patients.
High-Risk Stage I Ovarian Cancer
Patients with stage I ovarian cancer are considered high risk if the cancer appears high grade under the microscope, has a "clear cell" histology, or if cancer cells were found in the abdominal fluid or on the surface of the ovary. Although local treatment with surgery cures the majority of individuals with high-risk stage I ovarian cancer, up to 40 percent of patients may experience recurrence.
Some, but not all, clinical trials have shown a further reduction in cancer recurrences following adjuvant chemotherapy treatment in patients with high-risk stage I ovarian cancer. Approximately 80 percent of patients with high-risk stage I ovarian cancer treated with surgery and adjuvant chemotherapy will be alive and without evidence of cancer 5 years from surgery.
Before deciding to receive adjuvant chemotherapy treatment, you should ensure that you understand the answer to the following three questions:
- What is my prognosis (risk of cancer recurrence) without adjuvant chemotherapy treatment?
- How will my prognosis be improved with chemotherapy treatment?
- What are the risks of chemotherapy treatment?
This content was last modified on
July 23, 2007
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