title: Predictors of optimal cytoreduction in patients with newly diagnosed advanced-stage epithelial ovarian cancer: Time to incorporate laparoscopic assessment into the standard of care.
abstract: The standard management of advanced-stage ovarian cancer has been a subject of debate, and much controversy remains as to whether patients should have primary cytoreductive surgery followed by chemotherapy or neoadjuvant chemotherapy followed by interval cytoreductive surgery. In addition, there is increasing evidence that the patients who ultimately gain the most benefit from surgery are those with no residual disease at the completion of surgery (R0 resection). Therefore, to determine the best therapeutic strategy (primary cytoreductive surgery vs. neoadjuvant chemotherapy) for an individual patient, it is critically important to estimate the likelihood that primary cytoreductive surgery will leave no macroscopic residual disease. A number of studies have evaluated the use of serologic markers, such as CA-125, and imaging modalities, such as computed tomography (CT) or positron emission tomography/CT (PET/CT), to determine which patients are ideal candidates for primary cytoreductive surgery. More recently, laparoscopy has been proposed as a reliable predictor of R0 resection. In this report, we provide a review of the existing literature on the proposed criteria to predict the outcome of cytoreductive surgery and the role of laparoscopy-based scores in the management of advanced ovarian cancer.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Móstoles, Río Júcar s/n 28935, Móstoles, Madrid, Spain.
authors.forename: Natalia Rodriguez
authors.initials: NR
authors.lastname: Gómez-Hidalgo
authors.affiliation: School of Medicine and Health Sciences of Tecnologico de Monterrey - TEC Salud, Doctor Ignacio Morones Prieto Avenue 3000, Colonia Los Doctores, 64710 Monterrey, NL, Mexico.
authors.forename: Bertha Alejandra
authors.initials: BA
authors.lastname: Martinez-Cannon
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1362, Houston, TX 77030, United States.
authors.forename: Alpa M
authors.initials: AM
authors.lastname: Nick
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1362, Houston, TX 77030, United States.
authors.forename: Karen H
authors.initials: KH
authors.lastname: Lu
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1362, Houston, TX 77030, United States.
authors.forename: Anil K
authors.initials: AK
authors.lastname: Sood
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1362, Houston, TX 77030, United States.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Coleman
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1362, Houston, TX 77030, United States. Electronic address: peramire@mdanderson.org.
authors.forename: Pedro T
authors.initials: PT
authors.lastname: Ramirez
mesh_terms: D000077216:Carcinoma, Ovarian Epithelial; D065426:Cytoreduction Surgical Procedures / Q000379:methods* / Q000592:standards; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods / Q000592:standards; D006801:Humans; D010535:Laparoscopy / Q000379:methods / Q000592:standards; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000473:pathology / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D059039:Standard of Care
keywords: Laparoscopy; Ovarian cancer; Surgery
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