The incidence of major complications after the performance of extensive upper abdominal surgical procedures during primary cytoreduction of advanced ovarian, tubal, and peritoneal carcinomas

Objective.

To assess the morbidity and mortality associated with extensive upper abdominal surgery (EUAS) performed during primary cytoreduction for advanced ovarian carcinoma.

Cochrane Collaboration review: Cytoreductive surgery plus chemotherapy versus chemotherapy alone for recurrent epithelial ovarian cancer

Plain language summary

Secondary surgical efforts to remove recurrent ovarian cancer in women who are no longer in remission
Ovarian cancer is the sixth most common cancer among women. Epithelial ovarian cancer is a disease in which malignant cells form in the tissue covering the ovary. It accounts for about 90% of ovarian cancers., the remaining 10% arise from germ cells and the sex cord and stroma of the ovary. Women with epithelial ovarian cancer that has returned after primary surgery (recurrent disease) may need secondary surgery to remove all or part of the cancer. The option of surgery (debulking or cytoreductive surgery) is currently offered to a select group of women with recurrent ovarian cancer. It is important to ascertain whether this surgery helps women with recurrent disease to survive for longer than if they only got chemotherapy.

We searched for studies that compared secondary cytoreductive surgery and chemotherapy with chemotherapy alone in women with recurrent epithelial ovarian cancer. Although we checked 1431 possible articles, we found no relevant studies. Therefore there is currently no evidence to determine if secondary cytoreductive surgery is better or worse than chemotherapy alone in terms of prolonging life.

The review highlights the need for good quality studies comparing secondary cytoreductive surgery to chemotherapy.

Perioperative morbidity and outcome of secondary cytoreduction for recurrent epithelial ovarian cancer.

CONCLUSION:
Secondary cytoreduction in relapsed ovarian cancer is safe and feasible and perioperative outcome is not inferior compared to primary cytoreduction. Surgery-associated morbidity should represent a minor aspect in the selection and counselling of patients regarding treatment options for recurrent ovarian cancer.

Clinical Update - Ovarian Cancer (commentary - Australia)- Secondary cytoreductive surgery in the management of platinum-sensitive recurrent epithelial ovarian cancer ...

Note: abstract plus commentary from Australian specialist/Associate Professor Jim Nicklin; includes reference to upcoming trial results