CURRENT RECOMMENDATIONS FOR THE DIAGNOSIS AND TREATMENT OF EPITHELIAL OVARIAN CANCER

Svintsitsky V.S., Nespryadko S.V., Renkas O.P.

• National Cancer Institute, Kyiv, Ukraine

Ovarian cancer (OC) is one of the most common malignant neoplasms of the female reproductive system and is the first in the structure of wo­men’s mortality from cancer and gynecological pathology. Over the past 10 years, the incidence of OC has been 11.5% and remains high today with no apparent downward trend. Objective: Analytical review of current scientific information on the risk factors for the development of RA, its screening and diagnosis, treatment of patients in the initial stages, with common forms, recurrence of OC. Object and methods: 2014–2019 scientific publications (PubMed search) were analyzed, data on OC patients treated at the National Cancer Institute (Kyiv, Ukraine), clinical guidelines of the European Association of Medical Oncology (European Society for Medical Oncology, ESMO) for 2016, the US National Comprehensive Cancer Network (NCCN) for 2019. Results: Stage, degree of differentiation and histological type of malignant tumor are the main factors for prognosis and choice of treatment method for patients with epithelial OC. Screening for high-risk in women can reduce the incidence of OC. The use of modern methods of instrumental diagnostics, pathomorphological and immunohistochemical studies, identification of tumor markers, detection of mutations and adequate staging all play a key role in the choice of tactics of treatment of OC. The standard is surgery with subsequent chemotherapy treatment, the extent and tactics of which depend on the stage of the disease, the degree of differentiation and histological type of the tumor, the individual characteristics of the patient (age, concomitant pathology, reproductive plans, etc.). In common forms of OC, the basis of surgical treatment is complete cytoreduction. The efficacy of targeted therapy (bevacizumab) in the adjuvant and neoadjuvant regimens for the common forms of epithelial OC and its relapses has been demonstrated. It is recommended to use maintenance therapy with PARP inhibitors to treat not only patients with BRCA-mutations but also patients in the general population. Conclusions: Adequate staging is essential in choosing treatment tactics based on its key methods. The importance of genetic and molecular studies is increasing, as a result of which one can predict an increased risk of developing OC, individualize and adjust treatment regimens.