Clinical experience in gynecological cancer management. d). Ovarian tumors--1) Epithelial: report from the Gynaecological Institutes of Padua University (1963-1990).

A complete review of case series from 1963 to 1990 allows some considerations and conclusions on the clinical management of epithelial ovarian cancer. In the aim of early diagnosis, the ovarian condition must be evaluated also by ultrasound scans, in every woman, at every gynaecological control, and every ovarian or pelvic mass must be carefully examined and removed. Staging is generally recognized as reliable only by surgical pathological evaluation, (SPS) as in post-surgical FIGO staging. Therapy is based on adequate chemosurgical strategy. Surgery, performed in maximum effort, must aim at radicality or adequate debulking, avoiding, however too heavy mutilations, almost always useless for prognosis. Lymphadenectomy, in advanced cases, should be selectively and not systematically performed. Cyclophosphamide and Cis-Platinum appear to be, today too, the most effective regimens as first line chemotherapy. Neoadjuvant chemotherapy must still be well evaluated in its cost-benefit balance and personalized in particular cases. Second laparotomic look must be personalized in respect to residual disease after primary surgery and tumoral aggressiveness factors.