Ovarian cancer

Обзор 
Теория 
Диагноз 
Лечение 
Последующее наблюдение 
Источники 

Войдите в учетную запись или оформите подписку, чтобы получить полноценный доступ к BMJ Best Practice

Последний просмотренный: 13 Apr 2026

Last updated: 20 Feb 2026

Epithelial ovarian cancer is the most common histologic subtype of ovarian cancer, and is the primary focus of this topic.

Patients often present with vague, nonspecific symptoms such as abdominal bloating, early satiety, and dyspepsia (suggestive of upper abdominal disease). Other symptoms are more suggestive of pelvic disease, such as pelvic pain, abdominal or pelvic pressure, low back pain, and urinary urgency.

Women with a suspicious pelvic mass should be referred to a gynecologic oncologist for further evaluation.

Definitive diagnosis typically entails pathologic analysis of a surgical specimen. Fine-needle aspiration (FNA) is not routinely recommended for definitive diagnosis as this procedure can disseminate tumor cells into the peritoneal cavity.

Surgery is typically required for definitive diagnosis, staging, and tumor debulking.

Adjuvant chemotherapy may be required to eradicate residual disease following debulking surgery. Bevacizumab and/or a poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitor may be considered for maintenance therapy following initial treatment.

Определение

The primary focus of this topic is epithelial ovarian cancer, the most common histologic subtype of ovarian cancer (accounting for approximately 90% of cases).[1]

Epithelial ovarian cancer develops when there is malignant transformation of the epithelium covering the ovarian capsule and distal fallopian tube.[2][3][4] The epithelium covering the ovary and fallopian tubes consists of the same epithelial cells that line the peritoneal cavity. Thus, epithelial ovarian cancer and primary peritoneal cancer occur via the same pathophysiology and are treated with the same basic principles.

For the purpose of this topic, ovarian cancer also refers to fallopian tube cancer and primary peritoneal cancer.

Nonepithelial ovarian cancers (e.g., germ cell tumors and sex cord stromal tumors) are not specifically addressed in this topic.

Анамнез и осмотр

Ключевые диагностические факторы

pelvic mass
ascites
pleural effusion

Полная информация

Другие диагностические факторы

gastrointestinal symptoms
urinary urgency or frequency
symptom duration >3 months
abdominal distention
pelvic/abdominal pain or pressure

Полная информация

Факторы риска

genetic mutations associated with hereditary ovarian cancer
increasing age
family history of ovarian, breast, and/or other cancers
never used combined oral contraceptives
nulliparity
obesity
hormone therapy
endometriosis

Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

pelvic ultrasound
CA-125
histopathology

Полная информация

Исследования, проведение которых нужно рассмотреть

genetic testing
MRI
CT scan
fluorodeoxyglucose (FDG) PET-CT or FDG PET-MRI
biomarker tests

Полная информация

Алгоритм лечения

Острый

surgical candidate, intraoperative histology confirmed disease

poor surgical candidate, biopsy confirmed disease

ПРОДОЛЖЕНИЕ

platinum-sensitive recurrent disease

platinum-resistant recurrent or refractory disease

Составители

Авторы

Sareena Singh, MD

Gynecologic Oncologist

Aultman Medical Group

Northeast Ohio Medical University

Canton

Раскрытие информации

SS declares that she has no competing interests.

Выражение благодарностей

Dr Sareena Singh would like to gratefully acknowledge Dr Justin C. Chura and Dr Allison E. Axtell, previous contributors to this topic.

Раскрытие информации

JCC and AEA declare that they have no competing interests.

Рецензенты

Michael P. Hopkins, MD, MEd

Chairman

Obstetrics and Gynecology

Northeast Ohio Universities of Medicine (NEOMED)

Rootstown

Раскрытие информации

MPH declares that he has no competing interests.

Ritu Salani, MD

Gynecologic Oncology Fellow

Johns Hopkins Medical Institutions

Baltimore

Раскрытие информации

RS declares that she has no competing interests.

Susan A. Davidson, MD

Associate Professor

Chief, Gynecologic Oncology

Department of Obstetrics & Gynecology (UCD)

University of Colorado Cancer Center

Aurora

Раскрытие информации

SAD declares that she has no competing interests.

Khadra Galaal, MBChB, MPH, MRCOG

Consultant Gynaecological Oncologist

Northern Gynaecological Oncology Centre

Queen Elizabeth Hospital

Gateshead

Раскрытие информации

KG is co-author of a systematic review of follow-up strategies after primary treatment in ovarian cancer. This is not referenced in this topic.

Jill Tseng, MD

Assistant Clinical Professor of Gynecologic Oncology

University of California, Irvine

Orange

Раскрытие информации

JT declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: ovarian cancer including fallopian tube cancer and primary peritoneal cancer [internet publication].Полный текст

González-Martín A, Harter P, Leary A, et al. Newly diagnosed and relapsed epithelial ovarian cancer: ESMO clinical practice guideline for diagnosis, treatment and follow-up. Ann Oncol. 2023 Oct;34(10):833-48.Полный текст Аннотация

Gaillard S, Lacchetti C, Armstrong DK, et al. Neoadjuvant chemotherapy for newly diagnosed, advanced ovarian cancer: ASCO guideline update. J Clin Oncol. 2025 Mar;43(7):868-91.Полный текст Аннотация

Renz M, Friedlander M, Berek JS. Cancer of the ovary, fallopian tube, and peritoneum: 2025 update. Int J Gynaecol Obstet. 2025 Sep;171(suppl 1):6-35.Полный текст Аннотация

Tew WP, Lacchetti C, Kohn EC, et al. Poly(ADP-Ribose) polymerase inhibitors in the management of ovarian cancer: ASCO guideline rapid recommendation update. J Clin Oncol. 2022 Nov 20;40(33):3878-81.Полный текст Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Отличия
- Irritable bowel syndrome (IBS)
- Metastases to the ovary
- Endometriosis
Больше Отличия
Рекомендации
- ACR appropriateness criteria: staging and follow-up of ovarian cancer
- Neoadjuvant chemotherapy for newly diagnosed, advanced ovarian cancer: ASCO guideline update
Больше Рекомендации
Лифлеты для пациента
Ovarian cancer: what is it?
Ovarian cancer: what are the treatment options?
Больше Лифлеты для пациента
Войдите в учетную запись или оформите подписку, чтобы получить полноценный доступ к BMJ Best Practice

Использование этого контента попадает под действие нашего заявления об отказе от ответственности

Ovarian cancer

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

Другие диагностические факторы

Факторы риска

Диагностические исследования

Исследования, которые показаны в первую очередь

Исследования, проведение которых нужно рассмотреть

Алгоритм лечения

surgical candidate, intraoperative histology confirmed disease

poor surgical candidate, biopsy confirmed disease

platinum-sensitive recurrent disease

platinum-resistant recurrent or refractory disease

Составители

Авторы

Sareena Singh, MD

Раскрытие информации

Выражение благодарностей

Раскрытие информации

Рецензенты

Michael P. Hopkins, MD, MEd

Раскрытие информации

Ritu Salani, MD

Раскрытие информации

Susan A. Davidson, MD

Раскрытие информации

Khadra Galaal, MBChB, MPH, MRCOG

Раскрытие информации

Jill Tseng, MD

Раскрытие информации

Peer reviewer acknowledgements

Disclosures

Список литературы

Основные статьи

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Отличия

Рекомендации

Лифлеты для пациента

Войдите в учетную запись или оформите подписку, чтобы получить полноценный доступ к BMJ Best Practice

Войдите в учетную запись или оформите подписку, чтобы получить полноценный доступ к BMJ Best Practice

Войдите в учетную запись, чтобы получить полноценный доступ к BMJ Best Practice