Nonsurgical management of platinum-sensitive ovarian cancer
Andreas du Bois, MD, PhD

A 59-year-old oncology nurse presented to her gynecologist with vague pelvic discomfort and abdominal bloating, and is diagnosed with stage IIIB epithelial ovarian cancer.  

• Surgery: Complete surgical debulking (TAH, BSO, omentectomy, bilateral pelvic and periaortic lymph node dissection with no residual peritoneal implants
• Pathology: Grade 3, papillary adenocarcinoma
• Chemotherapy: Paclitaxel + carboplatin x 6 cycles. Evaluation after completion of chemotherapy shows no evidence of disease, CA125 level is normal (clinical complete response).
• Clinical Course: 14 months following completion of chemotherapy, at a routine follow-up visit, the patient reports mild abdominal discomfort that began 1 month ago.
• Labs: CA125 level is elevated at 125 U/mL. CBC and biochemical profile WNL
• Radiology: CT scan of abdomen and pelvis shows nodularity of the pelvic peritoneum with nodules up to 2 cm, a 2-cm x 3-cm right inguinal node and minimal ascites (small volume estimated less than 200 mL).
• History: No comorbid illnesses
• ECOG performance status: 0