41. Ovarian cancer

Ovarian cancer is a relatively uncommon type of cancer, and the most common form of it (90 %) is epithelial. Other histotypes include non-epithelial and metastatic tumours. Epithelial ovarian cancers form a heterogeneous group with high-grade serous carcinoma (HGSC) being the most common subtype, which we now assume originates in the distal part of the fallopian tube. In the absence of specific early symptoms, most patients with ovarian cancer are diagnosed with advanced stage disease. Standard therapy for ovarian cancer comprises a combination of surgery and chemotherapy. In most European countries, surgical therapy for patients with ovarian cancer is centralised in specialised hospitals, which often provide chemotherapy in conjunction with neighbouring hospitals. This allows more cases to be handled and surgical expertise to be concentrated. Despite an initial response, most patients develop resistance to chemotherapy. The prognosis of patients with ovarian cancer is therefore unfavourable and ten-year survival has not improved recently. Innovative therapeutic strategies – such as ones based on genetic and molecular subtyping – are increasingly being developed to improve treatment outcome.