What is the role of cytoreductive surgery in the treatment of ovarian cancer?

Updated: Aug 10, 2020
  • Author: Andrew E Green, MD; Chief Editor: Yukio Sonoda, MD  more...
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Cytoreductive surgery should be performed by a gynecologic oncologist at the time of initial laparotomy. The volume of residual disease at the completion of surgery represents one of the most powerful prognostic factors.

According to the National Comprehensive Cancer Network (NCCN) ovarian cancer guidelines, in newly diagnosed invasive epithelial ovarian cancer that involves the pelvis and upper abdomen, residual disease of less than 1 cm is evidence of optimal cytoreduction, although the greatest possible effort should be made to remove all obvious disease. [45] The NCCN notes that one or more of the following procedures may be considered for optimal surgical cytoreduction:

  • Bowel resection and/or appendectomy
  • Stripping of the diaphragm or other peritoneal surfaces
  • Splenectomy
  • Partial cystectomy and/or ureteroneocystotomy
  • Partial hepatectomy
  • Partial gastrectomy
  • Cholecystectomy
  • Distal pancreatectomy

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