Primary surgery or neoadjuvant chemotherapy followed by interval debulking surgery in advanced ovarian cancer.

摘要: Advanced ovarian cancer has a poor prognosis. De-bulking surgery and platinum-based chemotherapy are the cornerstones of treatment. Primary debulking been standard care in advanced cancer. Recently new strategy with neoadjuvant followed by interval developed. In recently published randomised trial EORTC-NCIC (European Organisation for Research Treatment Cancer - National Institute Canada) patients extensive stage IIIc IV it was shown that survival similar to compared primary surgery, chemotherapy. The post-operative complications mortality rates were lower after than surgery. most important independent prognostic factor overall no residual tumour or some obtaining goal at is difficult due chemotherapy-induced fibrosis. On other hand had very disease metastases smaller 5 cm tended be better Hence, selection correct important. Besides imaging CT, diffusion MRI and/or PET-CT, also laparoscopy can play an role patients. It should emphasised group included this study disease. Surgical skills, especially upper abdomen, remain pivotal treatment However, aggressive tailored according general condition extent Otherwise, type will result unnecessary postoperative morbidity without improving survival. not easy way out, but alternative option debulking. According current algorithm University Hospitals Leuven about 50% selected