The role of interval debulking surgery in ovarian cancer.
The mainstay of treatment for advanced ovarian cancer is the multimodality approach of debulking surgery and paclitaxel--platinum chemotherapy. The size of residual lesions after primary surgery remains the most important prognostic factor for survival. Optimal primary debulking surgery can be performed in approximately 40% of patients and up to 80% if it is done by gynecologic oncologists, but sometimes at the cost of considerable morbidity and even mortality. Based on a trial conducted by the European Organization for Research and Treatment of Cancer, optimal as well as suboptimal interval debulking surgery increases overall (P=0.0032) and progression-free survival (P=0.0055). However, not all patients who have undergone suboptimal primary debulking surgery seem to benefit from interval debulking surgery. Preliminary data from the Gynecologic Oncology Group interval debulking study (GOG-152) indicate that, if the gynecologic oncologist makes a maximal effort to resect the tumor, patients who have undergone suboptimal debulking surgery probably gain little benefit from interval debulking surgery.
van der Burg
Maria E L
ME
Department of Medical Oncology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, Netherlands. m.e.l.vanderburg@erasmusmc.nl
Vergote
Ignace
I
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D017239:Paclitaxel / Q000008:administration & dosage; D011379:Prognosis; D016387:Women's Health
D017239:Paclitaxel; D002945:Cisplatin