Maximal Cytoreduction in Patients With FIGO Stage IIIC to Stage IV Ovarian, Fallopian, and Peritoneal Cancer in Day-to-Day Practice

Abstract

The findings confirm that complete cytoreduction is the criterion standard of surgery in the management of advanced ovarian, peritoneal, and fallopian tube cancer, whatever the timing of surgery. With experienced teams, surgery was completed, without evident residual tumor in 71% of the cases.

Effectiveness and Safety of Cytoreduction Surgery in Advanced Ovarian Cancer: Initial Experience at a University General Hospital

“…The extent of surgery in patients with advanced ovarian cancer should thus be determined by the performance status and the capacity of the patient to tolerate this very aggressive surgery, as well as by the capacity of a competent surgical team to carry it out with diligence, more than by reason of ages, location, or extent of the illness present at the time of surgery. In spite of the short follow-up time period in these patients, the results obtained are in line with other published studies, and although some results may not be statistically significant, upon comparing complete cytoreduction surgeries with those that were not, a tendency is found towards a gained benefit in terms of intervals free of disease, as has been the case in studies previously cited [22].…”

Serum CA 125 Level after Neoadjuvant Chemotherapy is Predictive of Prognosis and Debulking Surgery Outcomes in Advanced Epithelial Ovarian Cancer

“…The prognosis of ovarian cancer is related to cytoreduction, which represents one of the most important treatment factors related to surgery and may even be important in cases of recurrent disease 12,13 . Quality of life, efficacy of subsequent chemotherapy, and median survival each depend on residual tumor volume after cytoreductive surgery 14,15 .…”

The optimal time for surgery in women with serous ovarian cancer

“…8,9 Although previous reports have suggested that neoadjuvant chemotherapy improves the rate of optimal surgical cytoreduction, none have demonstrated that this translates into improved survival. [20][21][22]28,32 In our study, women in the NAC group had a significantly higher rate of optimal cytoreduction than chemothereapy-naive patients undergoing primary cytoreduction. Yet, this did not confer a survival advantage.…”

“…[18][19][20][21][22][23][24][25][26][27][28] By contrast, several studies have shown that patients treated with neoadjuvant chemotherapy have a worse survival than those treated with primary surgery. [32][33][34] Overall, controversy remains about the use of neoadjuvant chemotherapy as a first-line treatment strategy for women with newly diagnosed HGSC. Resistant to platinum-based chemotherapy Sensitive -< 0.001* --Cycles of primary chemotherapy > 6 ≤ 6 1.92 (1.43-2.56) < 0.001 --CI = confidence interval, HR = hazard ratio; NAC = neoadjuvant chemotherapy and interval cytoreductive surgery; PCS = primary cytoreductive surgery and adjuvant chemotherapy.…”

“…[29][30][31] Importantly, several studies addressing the use of primary surgery versus neoadjuvant chemotherapy indicated that patients in the NAC group have inferior overall survival than patients in the PCS group. [32][33][34] Bristow and Chi 16 conducted a meta-analysis that suggested the number of neoadjuvant chemotherapy cycles before surgery was inversely proportional to the median overall survival. In addition, these authors demonstrated that although the difference in survival between the NAC and PCS groups did not reach statistical significance in previous studies, survival was often reduced by up to half in the NAC group.…”