Surgery for Recurrent Epithelial Ovarian Cancer

Author:

Fotopoulou ChristinaORCID,Eriksson Ane Gerda,Yagel Itai,Chang Suk-Joon,Lim Myong Cheol

Abstract

Abstract Purpose of Review To review evidence around the value and challenges of surgery for recurrent epithelial ovarian cancer (ROC). Both cytoreductive and palliative aspects will be addressed Recent Findings Prospective and retrospective evidence demonstrates a significantly longer remission derived from the combination of surgical and systemic modalities as opposed to systemic treatment alone in carefully selected ROC-patients who have relapsed more than 6 months from the end of their 1st line platinum-based chemotherapy. Nevertheless, this benefit appears to be limited when total macroscopic tumor clearance is not achieved. Selection algorithms to identify optimal surgical candidates are of paramount importance to prevent surgical morbidity without the equivalent oncological benefit. In the palliative setting, the risks and benefits of salvage surgery need to be counterbalanced with the advances of conservative techniques for optimal care. Summary Well-defined selection algorithms to identify those who will benefit from surgery in the relapsed setting appear to be the key to oncologic and surgical success.

Publisher

Springer Science and Business Media LLC

Subject

Oncology

Reference39 articles.

1. Hall M, Savvatis K, Nixon K, et al. Maximal-effort cytoreductive surgery for ovarian cancer patients with a high tumor burden: variations in practice and impact on outcome. Ann Surg Oncol. 2019;26(9):2943–51.

2. • Baek MH, Park EY, Ha HI, Park SY, Lim MC, Fotopoulou C, Bristow RE. Secondary cytoreductive surgery in platinum-sensitive recurrent ovarian cancer: a meta-analysis. J Clin Oncol. 2022;40(15):1659–70. https://doi.org/10.1200/JCO.21.02085. This meta-analysis presents all evidence around the value of secondary cytoreductive surgery in epithelial ovarian cancer relapse. Eligible indications and patients selection algorithms are being discussed here.

3. Colombo N, Sessa C, Bois AD, Ledermann J, McCluggage WG, McNeish I, Morice P, Pignata S, Ray-Coquard I, Vergote I, Baert T, Belaroussi I, Dashora A, Olbrecht S, Planchamp F, Querleu D; ESMO–ESGO Ovarian Cancer Consensus Conference Working Group. ESMO-ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease Int J Gynecol Cancer. 2019: ijgc-2019–000308. https://doi.org/10.1136/ijgc-2019-000308.

4. Fotopoulou C, Khan T, Bracinik J, Glasbey J, Abu-Rustum N, Chiva L, Fagotti A, Fujiwara K, Ghebre R, Gutelkin M, Konney TO, Ng J, Pareja R, Kottayasamy Seenivasagam R, Sehouli J, Surappa STS, Bhangu A, Leung E, Sundar S; CovidSurg Gynecological Cancer Collaborators. Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: an international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study Am J Obstet Gynecol 2022: 227(5):735.e1–735.e25. https://doi.org/10.1016/j.ajog.2022.06.052

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