Stage I and II Ovarian Epithelial Cancer
Stage III and IV Ovarian Epithelial Cancer

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Treatment of stage I and stage II ovarian epithelial cancer may include the following:

• Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. Lymph nodes and other tissues in the pelvis and abdomen are removed and examined under the microscope to look for cancer cells.
• Total abdominal hysterectomy, unilateral salpingo-oophorectomy, and omentectomy. Lymph nodes and other tissues in the pelvis and abdomen are removed and examined under the microscope to look for cancer cells.
• A clinical trial of internal or external radiation therapy.
• A clinical trial of chemotherapy.
• A clinical trial of surgery followed by chemotherapy or watchful waiting (closely monitoring a patient's condition without giving any treatment until symptoms appear or change).
• A clinical trial of a new treatment.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I ovarian epithelial cancer ¹ and stage II ovarian epithelial cancer ². For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ³.

Treatment of stage III and stage IV ovarian epithelial cancer may be surgery to remove the tumor, total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. After surgery, treatment depends on how much tumor remains.

When the tumor that remains is 1 centimeter or smaller, treatment is usually combination chemotherapy, including intraperitoneal (IP) chemotherapy.

When the tumor that remains is larger than 1 centimeter, treatment may include the following:

• Combination chemotherapy, including intraperitoneal (IP) chemotherapy.
• A clinical trial of combination chemotherapy, including IP chemotherapy, before and after second-look surgery (surgery performed after the initial surgery to determine whether tumor cells remain).
• A clinical trial of biologic therapy or targeted therapy following combination chemotherapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III ovarian epithelial cancer ⁴ and stage IV ovarian epithelial cancer ⁵. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ³.

Glossary Terms

The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

Surgery to remove both ovaries and both fallopian tubes.

Treatment to boost or restore the ability of the immune system to fight cancer, infections, and other diseases. Also used to lessen certain side effects that may be caused by some cancer treatments. Agents used in biological therapy include monoclonal antibodies, growth factors, and vaccines. These agents may also have a direct antitumor effect. Also called biological response modifier therapy, biotherapy, BRM therapy, and immunotherapy.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

A measure of length in the metric system. There are 100 centimeters in a meter and 2½ centimeters in an inch.

Treatment with drugs that kill cancer cells.

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.

Treatment using more than one anticancer drug.

A type of radiation therapy that uses a machine to aim high-energy rays at the cancer from outside of the body. Also called external-beam radiation therapy.

A type of radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called brachytherapy, implant radiation therapy, and radiation brachytherapy.

Treatment in which anticancer drugs are put directly into the abdominal cavity through a thin tube.

A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.

Surgery to remove part or all of the omentum.

Cancer that occurs in the cells on the surface of the ovary. Also called epithelial ovarian cancer.

The lower part of the abdomen, located between the hip bones.

Surgery performed after primary treatment to determine whether tumor cells remain.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

Cancer that began in tissue covering the ovary and is found in one or both of the ovaries. Stage I is divided into stages IA, IB, and IC. In stage IA, cancer is found in a single ovary. In stage IB, cancer is found in both ovaries. In stage IC, cancer is found in one or both ovaries and one of the following is true: (1) cancer is found on the outside surface of one or both ovaries; or (2) the capsule (outer covering) of the tumor has ruptured (broken open); or (3) cancer cells are found in fluid from the peritoneal cavity (the body cavity that contains most of the organs in the abdomen).

Cancer that began in tissue covering the ovary and has spread from one or both ovaries into other areas of the pelvis. Stage II is divided into stages IIA, IIB, and IIC. In stage IIA, cancer has spread to the uterus and/or the fallopian tubes. In stage IIB, cancer has spread to other tissues within the pelvis. In stage IIC, cancer has spread to the uterus and/or fallopian tubes and/or other tissue within the pelvis and cancer cells are found in fluid from the peritoneal cavity (the body cavity that contains most of the organs in the abdomen).

Cancer that began in tissue covering the ovary and has spread from one or both ovaries to other parts of the abdomen. Stage III is divided into stages IIIA, IIIB, and IIIC. In stage IIIA, the tumor is found in the pelvis only, but cancer cells have spread to the surface of the peritoneum (tissue that lines the abdominal wall and covers most of the organs in the abdomen). In stage IIIB, cancer has spread to the peritoneum and is 2 centimeters or smaller in diameter. In stage IIIC, cancer has spread to the peritoneum and is larger than 2 centimeters in diameter and/or has spread to lymph nodes in the abdomen. Cancer that has spread to the surface of the liver is stage III disease.

Cancer that began in tissue covering the ovary is found in one or both ovaries and has spread beyond the abdomen to distant parts of the body. Ovarian cancer that is found in tissues of the liver is stage IV disease.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

A type of treatment that uses drugs or other substances, such as monoclonal antibodies, to identify and attack specific cancer cells without harming normal cells. Targeted therapy may be less harmful to normal cells than other types of cancer treatments

A group or layer of cells that work together to perform a specific function.

Surgery to remove the entire uterus, including the cervix. Also called complete hysterectomy.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.

Surgery to remove the ovary and fallopian tube on one side of the body.

Closely monitoring a patient's condition but withholding treatment until symptoms appear or change. Also called active surveillance, expectant management, and observation.