Introduction

More than 50% of the women diagnosed with epithelial ovarian cancer will succumb to their disease. This high death rate is because of two substantial clinical problems:

1. A typically late detection of the disease.

2. The common resistance of ovarian tumors to current therapeutic strategies.

Indeed, the 5-year survival rate of patients with stage I disease is more than 90%, whereas patient diagnosed with stage III or IV disease have lower than a 30% survival rate (1). Unfortunately, because of the lack of distinctive symptoms and reliable biomark-ers, the vast majority of ovarian cancer patients are diagnosed with late stage disease. In addition, at diagnosis, about half the tumors are intrinsically resistant to chemotherapy, and up to half of the tumors initially responsive will develop resistance. Clearly, identification of biomarkers useful in early detection would have a significant impact on cancer survival. Moreover, the existence of markers that would be predictive of outcome may allow for improved, more targeted therapy. In this chapter, recent advances in the identification of biomarkers applicable to detection and prognosis (molecular correlates) of epithelial ovarian cancer will be discussed. Because sporadic ovarian cancer represents more than 90% of all the cases, concentration will be on sporadic cancers as opposed to hereditary cancers, which arise in families at risk (such as BRCA1/2 families).

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