The majority of new therapies aimed at treating suspected epithelial ovarian, fallopian tube, and primary peritoneal cancer are in the postchemotherapy stage, which is further proof for the current treatment practice and standards of care.
EOC was underinvestigated in the families tested. It may be that it occurs with a significant frequency outside families and is associated with known familial factors. Consideration needs to be given to screening for EOC in families of women with EOC, considering that a subset of women with EOC do not have classic EOC histology and are more susceptible to be undertreated if left untreated.
About 37,500 people per year are treated for SEOC/PPOC and only 16,600 receive treatment. For comparison, the general U.S. population is estimated to have 10,000 SEOC/PPOC cases per year with about 10,000 new patients per year in the United States. This article shows how many people get SEOC/PPOC annually and what treatment is given.
There are no clear evidence-based guidelines linking treatments to specific outcomes for patients with epithelial ovarian, fallopian tube, or primary peritoneal cancer. It is important that patients and clinicians have a basic understanding of the current scope of evidence and that they be informed about and understand the potential problems of treatment as well as the therapeutic opportunities to be benefited by adjuvant therapies for optimally selected patients.
In patients presenting with epithelial ovarian carcinoma, there is a high percentage of suspicion for another ovarian tumor. Aspects of initial presentation, such as adnexal tenderness, suggest a probable second ovarian neoplasm. In this way, initial treatment aimed at ovarian carcinoma is modified when a primary or metastatic ovarian tumor is identified only late in the course of treatment.
Patients with suspected epithelial ovarian, fallopian tube, or primary peritoneal cancer have many common clinical features. They may also have other signs such as abdominal tenderness, bowel or urinary urgency, and lower abdominal symptoms.
EOC, EOTC, and PPC are the three most common cancers in the Netherlands. In our hospital PPC is the third most frequent cancer after M1 primary peritoneal cancer and EOC. There are significant differences between patient groups for cancer sites investigated and symptomatology. Cancer prevention of EOC and EOTC is based on the Amsterdam guidelines; cancer prevention of PPC is based on the St Gallen guidelines. PPC is the least responsive to current treatment because POCS is more aggressive malignancy. The same applies for M1 primary peritoneal cancer, and for other malignancies, such as stomach cancer.
These data suggest that [(18)F]fluorodopa is likely to be as effective as the placebo in facilitating detection of malignant ovarian cancer and detecting fluorodeoxyglucose uptake in fluorodeoxyglucose uptake-positive malignancies.
As a PET tracer, [(18)F] FAN is a useful diagnostic tool to diagnose and localize ovarian, fallopian tube, or primary peritoneal cancer. It is also helpful in tracking efficacy of tumor treatments.
When patients with a diagnosis of EOC were included, and when [18F]fluorodeoxyglucose PET is used to detect metastatic lesion within the abdomen, the addition of a [18F]fluorodopa PET/CT scan does reveal uptake in the liver. No uptake is observed in patients without metastatic disease, suggesting that a lack of [18F]fluorodopa uptake is specific for patients with metastatic disease. A subset of patients with EOC will be eligible for ongoing, prospective trials of new treatments that focus on [18F]fluorodopa metabolism within liver metastases.
Despite the advantages of [(18)F]fluorotate, such as shorter exposure time and ease of administration, no significant benefits were observed in comparison with [(18)F]FLT. The use of (18)Fluorotate or 3-deaza-(18)Fluorocytidine cannot replace conventional treatments as the only therapeutic modality, particularly in the salvage or recurrent setting.