2 Indications and current treatments
2.1 Ovarian cancer is the leading cause of death from gynaecological cancer in the UK, and its incidence is rising. It is the fifth most common cancer in women, with a lifetime risk of about 2% for women in England and Wales.
2.2 Early symptoms of ovarian cancer are non-specific and include persistent bloating, pain in the pelvis and lower abdomen, and urinary frequency and/or urgency. Most women who have ovarian cancer are diagnosed with advanced disease and the outcome is generally poor, with an overall 5‑year survival rate of less than 35%. The stage of the disease at diagnosis is the most important factor affecting outcome.
2.3 The main treatments for advanced ovarian cancer are surgery and chemotherapy. 'Standard' (sometimes referred to as 'radical') surgery involves bilateral salpingo-oophorectomy, total abdominal hysterectomy, omentectomy and lymphadenectomy. Potentially curative surgery requires resection of all macroscopic disease. More commonly, the goal is to remove all areas of tumour tissue greater than 1 cm in diameter (optimal cytoreduction, also known as optimal debulking).