This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.Ovarian Cancer Screening
DysgerminomasStandard treatment options:Cisplatin-based chemotherapy has been used effectively for patients with recurrent dysgerminoma with and without adjuvant radiation therapy.Treatment options under clinical evaluation:Patients with recurrent pure dysgerminoma of the ovary are candidates for clinical trials, such as (GOG-90), which has been closed. Some consideration should be given to the use of high-dose regimens with rescue. Other Germ Cell TumorsStandard treatment options:Patients with recurrent germ cell tumors of the ovary other than pure dysgerminoma should be treated with chemotherapy, the type of which is determined by previous treatment. Radiation therapy is not effective in this setting. Cisplatin-based combination chemotherapy is effective.[1,3,4] Patients who do not respond to a cisplatin-based combination may still attain a durable remission with VAC or ifosfamide/cisplatin as salvage therapy. Newer potential treatments include an ifosfamide combination 
DysgerminomasStandard treatment options:Total abdominal hysterectomy and bilateral salpingo-oophorectomy with adjuvant chemotherapy.Unilateral salpingo-oophorectomy with adjuvant chemotherapy.For patients with stage IV dysgerminoma, total abdominal hysterectomy and bilateral salpingo-oophorectomy is recommended with removal of as much gross tumor in the abdomen and pelvis as can be done safely without resection of portions of the urinary tract or large segments of small or large bowel, although unilateral salpingo-oophorectomy should be considered in patients who wish to preserve fertility.[1,2] Chemotherapy with bleomycin/etoposide/cisplatin (BEP) can cure the majority of such patients. Stage IV dysgerminoma is not treated with radiation therapy, but rather with chemotherapy, preferably with three to four courses of cisplatin-containing combination chemotherapy such as BEP. A second-look operation following treatment is rarely beneficial. (Refer to the PDQ summary on Sexuality and
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.Editorial changes were made to this summary.
DysgerminomasStandard treatment options:Unilateral salpingo-oophorectomy with or without lymphangiography or computed tomography (CT).Unilateral salpingo-oophorectomy followed by observation.Unilateral salpingo-oophorectomy with adjuvant radiation therapy or chemotherapy.For patients with stage I dysgerminoma, unilateral salpingo-oophorectomy conserving the uterus and opposite ovary is accepted treatment of the younger patient who wants to preserve fertility or a pregnancy. Postoperative lymphangiography or CT is indicated before treatment decisions are made for patients who have not had careful surgical and pathological examination of pelvic and para-aortic lymph nodes during surgery. (Refer to the PDQ summary on Sexuality and Reproductive Issues for more information on fertility.)Patients who have been completely staged and have stage IA tumors may be observed carefully after surgery without adjuvant treatment. About 15% to 25% of these patients will relapse, but they can be treated
PathogenesisThe pathogenesis of ovarian carcinoma remains unclear. Several theories have been proposed to explain the epidemiology of ovarian cancer including the theory of incessant ovulation,[1,2] gonadotropin stimulation, excess androgenic stimulation, and inflammation. Associated risk factors for ovarian cancer support some or all of these hypotheses. Oral contraceptive use is consistently associated with a decreased risk of ovarian cancer and may operate through preventing the trauma from repeated ovulation by lowering exposure to gonadotropins. No one theory, however, explains all the associated risk factors.Protective Factors Factors associated with a decreased risk of ovarian cancer include: (1) using oral contraceptives, (2) having and breastfeeding children, (3) having a bilateral tubal ligation or hysterectomy, and (4) having a prophylactic oophorectomy.Oral contraceptives Multiple studies have consistently demonstrated a decrease in
For more information from the National Cancer Institute about ovarian germ cell tumors, see the following:Ovarian Cancer Home PageDrugs Approved for Ovarian CancerFor general cancer information and other resources from the National Cancer Institute, see the following:What You Need to Know About™ CancerUnderstanding Cancer Series: CancerCancer StagingChemotherapy and You: Support for People With CancerRadiation Therapy and You: Support for People With CancerCoping with Cancer: Supportive and Palliative CareQuestions to Ask Your Doctor About CancerCancer LibraryInformation For Survivors/Caregivers/Advocates
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.An editorial change was made to this summary.This summary is written and maintained by the PDQ Screening and Prevention Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.