Most ovarian cancers are treated the same way regardless of stage: surgery followed by chemotherapy. Stromal tumors are treated with surgery followed by chemotherapy or hormone therapy.

In most cases, the surgery removes the tumor, or as much of it as possible, plus the uterus, fallopian tubes and ovaries. Chemotherapy is sometimes given directly into the abdominal cavity rather than by infusion into the bloodstream through an arm.

If a woman isn’t well enough to undergo surgery, she may get chemotherapy first and then have surgery when she is able. In some cases, if the cancer has spread far beyond the ovary — for instance, to the liver — chemotherapy may be given before surgery to shrink the can- cer and make surgery easier.

In later-stage disease, surgery may involve removing the lining and boundary tissues from inside the upper abdomen, as well as parts of the intestines, liver, bladder or gallbladder.

Maintenance therapy is a type of treatment given after chemotherapy has been completed to try to keep the cancer from returning. The goal of maintenance therapy is to extend the length of time before the cancer returns or even to turn a temporary remission into a long-term cure.

Two types of drugs — poly adenosine diphosphate- ribose polymerase (PARP) inhibitors and the targeted drug Avastin (bevacizumab) — have been approved by the Food and Drug Administration for use as maintenance therapies in women with advanced ovarian, fallopian tube and primary peritoneal cancer if they have an inherited or tumor mutation in BRCA1 or BRCA2 or if the ovarian cancer has a tumor feature called homologous recombination repair deficiency. A relatively new type of ovarian cancer treatment, PARP inhibitors are oral drugs that block the PARP enzyme, which cells use to repair DNA damage. Clinical trials of other PARP inhibitors or new therapies may also be an option for some patients.

Germ cell tumors are also treated with surgery followed by chemotherapy. Stromal tumors are treated with surgery followed by chemotherapy or hormone therapy.