NCCN Guidelines for Patients® | Ovarian Cancer - page 67

Part 7: Recurrence treatment
NCCN Guidelines for Patients
: Ovarian cancer
Version 1.2013
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Adjuvant treatment:
Treatment given after the
main treatment used to rid
the body of cancer
A protein with
sugar molecules that is
made by ovarian cancer
cells as well as normal cells
Staging procedures:
Procedures done during
surgery that are used to
find out how far the cancer
has spread
Surgical evaluation:
Surgery to find out how far
cancer has spread in the
body and to see if surgery
to remove all of the cancer
is a safe and good option
The chart above describes the recommended treatment for borderline ovarian cancer
that has come back after responding to initial treatment. After a clinical relapse, you
may have surgery so your doctor can see where the cancer has spread. Surgery may
also remove as much of the cancer as possible, called debulking surgery.
The treatment options for borderline ovarian cancer recurrence depend on whether
the cancer has grown into supporting tissues (invasive) or not (noninvasive). If it
is not invasive, then the cancer is less likely to cause physical (clinical) symptoms.
Therefore, your doctor will watch the cancer closely with follow-up tests. If it is invasive,
then you will have surgical treatment and staging procedures, followed by adjuvant
chemotherapy. See page 23 for details on surgical staging procedures. Surgical
treatment will remove as much cancer as possible, as well as the remaining ovary,
Fallopian tube, and uterus. After surgery, chemotherapy recommendations are the
same as those for ovarian cancer, described on page 46.
Next steps:
For noninvasive disease, see page 55 for recommended follow-up tests.
For invasive disease, see page 46 for recommended chemotherapy treatment after
Borderline ovarian cancer recurrence
Tumor status
Clinical relapse
relapse based on
symptoms, imaging
test results, or increase
in CA-125 levels
Surgical evaluation +
debulking if needed
Observation with
follow-up tests
Surgical treatment
and staging +
CA-125 =
Cancer antigen
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