Diagnosis and management of epithelial cancer of the ovary.

Epithelial ovarian cancer is a lethal disease that is asymptomatic in the early stages and a diagnostic problem even in an advanced stage. Aggressive cytoreductive surgery ("debulking"), followed by intensive multiagent chemotherapy, offers the best chance of cure or prolonged survival. "Second-look" surgery is appropriate for select patients, and radiotherapy may be useful in a small number of patients. Terminal care focuses on nutrition support, pain control and symptomatic management of recurrent ascites and bowel obstruction.