الفهرس 
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Abstract
The American Cancer Society Estimated That 22,430 New Cases Of Ovarian Cancer Will Occur In The United States In 2007 Forming 3% Of The Estimated Female New Cases; This Disease Is Expected To Lead To 15,280 Deaths In The Same Year, Forming 6% Of The Estimated Female Cancer Deaths Thus Ovarian Cancer Is The Most Lethal Gynecologic Malignancy. The Incidence Of This Disease Is Influenced By Country Of Origin, Race, And Age. The Highest Rates Are Found In Industrialized Countries, With The Exception Of Japan, And The Lowest Rates Are Seen In The Nonindustrialized World. The Only Standardized Cancer Registry In Egypt Was Conducted In Gharbia Showed That The Frequency Of Ovarian Cancer In Females Was 4.4%. At NCI, Cairo, Between January 2002 And December 2003, New Ovarian Cancer Cases Accounted For 4% Of All Newly Diagnosed Proven Malignant Female Cases. The Precise Cause Of Ovarian Carcinoma Is Not Known. However, Numerous Authors Have Reported Associations Between Ovarian Cancer And Environmental Factors, Including Exposure To Dietary, Viral, And Industrial Agents. An Increased Risk Of Ovarian Cancer Is Seen With Particular Reproductive History And Endocrinologic Profiles, Familial Syndromes, And Mutations In The Tumor Suppressor Genes BRCA1 And BRCA2. According To A Cancer Pathology Registry Which Included All Cases Presented To The Department Of Pathology, At NCI, Cairo, During The Years 2003-2004, Surface Epithelial Carcinomas Is Forming 73.3% Of Ovarian Cancer. The FIGO Staging System For Ovarian Cancer Is Used Uniformly In All Developed Countries. It Is Based On The Results Of A Properly Performed Exploratory Laparotomy. Inadequate Surgical Staging Has Been And Continues To Be A Significant Problem. Different Prognostic Factors Have Resulted In High Rates Of Recurrence And Affected Patient’s Survival. Advanced Stage, Suboptimal Debulking Of Patients, Mucinous Or Clear Cell Tumors, Elevated CA 125, Overexpression Of Her2/Neu And P53, Performance Status And Old Age Have Been Associated With Poor Prognosis. Our Study Included Patients With Pathologically Proven Epithelial Ovarian Cancer Having A Locally Advanced Or A Metastatic Disease. It Was Carried Out In A Retrospective And A Prospective Manner. The Retrospective Part Included 43 Eligible Patients Who Presented To NCI, Cairo University, Between January 1996 And December 2001 While The Prospective Part Included 40 Eligible Patients Randomized In 2 Arms To Receive Either Cisplatin & Cyclophosphamide Or Docetaxel & Cisplatin. In The Retrospective Part, The Median Age Was 46. Serous Adenocarcinoma Was Diagnosed In 47% Of Patients, While Mucinous Adenocarcinoma Was Diagnosed In 23%. Seventy Four Percent Of Patients Were Stage III Disease, While 26% Were Stage IV Disease. Seventy Seven Percent Of Patients Received Paclitaxel Combinations, And Showed An Overall Response Rate Of 60%. Adverse Events Were Reported Mainly Nausea, Vomiting, Fatigue, Alopecia, Neuropathy, Diarrhea, Neutropenia And Anaemia. The Disease Free Survival Duration Had A Median Of 18 Months, While The Overall Survival Duration Had A Median Of 28 Months. In The Prospective Part, In The Docetaxel And Cisplatin Arm, The Median Age Was 46.5. Serous Adenocarcinoma Was Diagnosed In 70% Of Patients, While Mucinous Adenocarcinoma Was Diagnosed In 15%. CA 125 Was Elevated In 70% Of Patients. Ninety Percent Of Patients Were Stage III Disease, While 10% Were Stage IV Disease. The Overall Response Rate Was 60%. Adverse Events Were Reported Mainly Nausea, Vomiting, Fatigue, Alopecia, Neuropathy, Diarrhea, Neutropenia And Anaemia. The Disease Free Survival Duration Had A Median Of 15 Months, While The Overall Survival Duration Had A Median Of 26 Months. In The Cisplatin And Cyclophosphamide Arm, The Median Age Was 52. Serous Adenocarcinoma Was Diagnosed In 55% Of Patients, While Mucinous Adenocarcinoma Was Diagnosed In 30% Of Patients. CA 125 Was Elevated In 90% Of Patients. Sixty Percent Of Patients Were Stage III Disease, While 40% Were Stage IV Diseas. The Overall Response Rate Was 55%. Adverse Events Were Reported Mainly Nausea, Vomiting, Fatigue, Alopecia, Neuropathy, Diarrhea, Neutropenia And Anaemia. The Disease Free Survival Duration Had A Median Of 15 Months, While The Overall Survival Duration Had A Median Of 18 Months. Blocks Of 31 Patients Were Available On Which Overexpression Of Her2/Neu And P53 Were Studied. Twenty Seven Patients (87%) Showed Negative Results (Score 0, +1, +2) For Her2/Neu, While 4 Patients (13%) Showed Positive Results (Score +3). There Was A Statistically Significant Difference Between Her2/Neu Negative And Positive Patients As Regard Disease Free Survival (P=0.0003) And Overall Survival Duration (P=0.0000). Twenty Five Patients (81%) Showed Negative Results For P53, While 6 Patients (19%) Showed Positive Results. There Was Not A Statistically Significant Difference (P=0.1999) Between P53 Negative And Positive Patients As Regard Disease Free Survival But There Was A Statistically Significant Difference (P=0.0402) Between P53 Negative And Positive Patients As Regard Overall Survival Duration. Finally, Paclitaxel And Carboplatin Remains The Standard First-Line Chemotherapy In Treatment Of Epithelial Ovarian Cancer. While Docetaxel And Cisplatin Is An Effective, Well Tolerated Regimen In Treatment Of Epithelial Ovarian Cancer, A Phase III Trial Is Needed To Compare The Standard Regimen With This Combination Regimen.