Surgical Interventions and Chemotherapy in Advanced Ovarian Cancer
Summary
Advanced ovarian cancer often presents at an advanced stage with widespread peritoneal involvement, making curative therapy challenging. The cornerstone of management is maximal cytoreductive surgery, whereby visible tumour deposits are removed to leave minimal residual disease, combined with platinum‐taxane chemotherapy to eradicate microscopic foci. Complete cytoreduction, defined by residual tumour nodules ≤1 cm, is strongly correlated with prolonged progression‐free and overall survival. Where extensive disease precludes upfront complete resection, neoadjuvant chemotherapy followed by interval debulking has emerged as a validated strategy to reduce tumour burden and improve surgical outcomes. Recent years have seen refinements in preoperative imaging and intraoperative scoring systems to optimise patient selection, as well as the adoption of ultraradical techniques—including peritonectomy, multivisceral resections and upper abdominal procedures—to extend the possibility of complete cytoreduction. Parallel advances in pathology, notably histological chemotherapy response scoring, have provided new prognostic markers that may inform personalised treatment sequencing. Together, these developments are converging on a more precise and individualised standard of care, aiming to balance maximal tumour clearance with acceptable morbidity and improved quality of life.
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Surgical Interventions and Chemotherapy in Advanced Ovarian Cancer publication trend
The graph below shows the total number of articles in surgical interventions and chemotherapy in advanced ovarian cancer across all publications each year (not limited to Nature Index journals).
Technical terms
Cytoreductive surgery: Surgical removal of macroscopic tumour deposits to achieve minimal residual disease.
Optimal cytoreduction: State after surgery in which residual tumour nodules measure ≤1 cm.
Neoadjuvant chemotherapy: Systemic chemotherapy administered before surgical debulking to shrink tumour burden.
Peritoneal Cancer Index (PCI): Quantitative scoring system assessing tumour distribution and volume across 13 abdominal regions.
Chemotherapy Response Score (CRS): Histopathological grading system that evaluates tumour regression in surgical specimens after chemotherapy.
References
- The Peritoneal Cancer Index is a Strong Predictor of Incomplete Cytoreductive Surgery in Ovarian Cancer. Annals of Surgical Oncology (2020).
- Neoadjuvant chemotherapy versus primary debulking surgery in advanced epithelial ovarian cancer: A meta-analysis of peri-operative outcome. PLOS ONE (2017).
- Pathological Chemotherapy Response Score in Patients Affected by High Grade Serous Ovarian Carcinoma: The Prognostic Role of Omental and Ovarian Residual Disease. Frontiers in Oncology (2019).
- Hepatobiliary Disease Resection in Patients with Advanced Epithelial Ovarian Cancer: Prognostic Role and Optimal Cytoreduction. Annals of Surgical Oncology (2020).
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