title: Surgical treatment of advanced ovarian cancer.
abstract: BACKGROUND
  The classical treatment for advanced ovarian cancer (OC) consists of a optimal cytoreductive surgery (when the postoperative residual tumor is under 1 cm.), followed by adjuvant chemotherapy based on platinum or paclitaxel derivatives. The 5-year survival rate in case of advanced OC with secondary peritoneal carcinomatosis (PC) is below 25%. The treatment of PC (interpreted as a local-regional disease and not as a systemic disease) is based on an aggressive surgical act (a full or maximal cytoreduction without residual tumor), followed by local chemotherapy or hypertermic intraperitoneal chemotherapy. This is a retrospective study which reassesses the surgical treatment of advanced OC within the period January 2004 - December 2010 in the Center of General Surgery and Liver Transplantation within Fundeni Institute.
  
  
  METHODS
  In the period January 2004 - December 2010 in the Center of General Surgery and Liver Transplantation within Fundeni Institute were operated 405 patients with advanced ovarian cancer. In 105 patients (25.9%) intraperitoneal chemotherapy with Cisplatin was performed.
  
  
  RESULTS
  Overal survival was calculated for a subsample of 297 patients, for whom it was possible to properly ensure the follow-up, being of 43 months in the patients with intraperitoneal chemotherapy (p = 0.02) and 37 months in the patients without intraperitoneal chemotherapy.
  
  
  CONCLUSIONS
  The maximal cytoreduction associating IPCH is an aggressive multidisciplinary therapeutic approach in advanced OC, reserved for difficult cases, considered in the past without solution. In properly selected cases, this shows a clear increase in survival rate.
authors.affiliation: Centrul de Chirurgie Generala si Transplant Hepatic "Dan Setlacec", Institutul Clinic Fundeni, Bucharest, Romania.
authors.forename: L
authors.initials: L
authors.lastname: David
authors.forename: Irina
authors.initials: I
authors.lastname: Dinu
authors.forename: G
authors.initials: G
authors.lastname: Vatachki
authors.forename: V
authors.initials: V
authors.lastname: Lungu
authors.forename: C
authors.initials: C
authors.lastname: Toader
authors.forename: I
authors.initials: I
authors.lastname: Popescu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000556:secondary; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D010053:Ovary / Q000187:drug effects / Q000473:pathology / Q000601:surgery*; D010534:Peritoneal Neoplasms / Q000556:secondary; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult