full free access: Recent surgical management of ovarian cancer - Journal of Obstetrics and Gynaecology Research

Abstract (also full free access):

Ovarian cancer is the second most common gynecological malignancy in the USA, and the majority of patients with newly diagnosed ovarian cancer present with advanced-stage disease. The standard treatment of these patients involves primary cytoreduction followed by combination chemotherapy. As the evidence has accumulated regarding the benefit of surgical cytoreduction, and as the definition of optimal cytoreduction has evolved, the surgical techniques have expanded in order to achieve this goal. This article discusses the different facets of the surgical management of ovarian cancer, with a special emphasis on the most recent additions to our current knowledge.

Ovarian cancer affects 1 in 70 women, being the second most common gynecological malignancy in the USA. The majority of patients with newly diagnosed ovarian cancer present with advanced-stage disease.1 The standard treatment of these patients involves primary cytoreduction followed by combination chemotherapy.2 As the evidence accumulated regarding the benefit of surgical cytoreduction, and as the definition of optimal cytoreduction evolved, the surgical techniques expanded in order to achieve this goal.

Regardless of the debate on whether it is the biology of the tumor rather than the surgical effort that allows optimal cytoreduction,3,4 and regardless of whether the patient has already received a course of neoadjuvant chemotherapy,5 once the decision to proceed with surgery is taken, its goal should be to achieve maximal cytoreduction.

This article will review the different facets of the surgical management of ovarian cancer, with a special emphasis on the most recent additions to our current knowledge. The data reviewed pertain mainly to high-grade serous carcinoma. Discussing the role of primary versus interval debulking is beyond the scope of this article and will not be reviewed here.