title: Beyond the beyond: first case of 9 cytoreductive surgeries in a long-surviving ovarian cancer patient: case report.
abstract: BACKGROUND
  The role of surgery in recurrent ovarian cancer (ROC) is debated. Multiple prospective and retrospective series reported improved survival with optimal secondary surgical cytoreduction, but definitive results from randomized trials are needed. Up to the fourth cytoreductive surgery for recurrent disease in an attempt to improve patients' prognosis has been reported.
  
  
  METHODS
  We report the first case of multiple ROC in an Italian woman, 50 years old at diagnosis, who underwent 9 cytoreductive surgeries during her 17 years of disease with no serious postoperative complications.
  
  
  CONCLUSIONS
  Multiple surgeries should not be considered as the standard treatment for ROC. In carefully selected patients, optimal cytoreductive surgery performed by highly specialized gynecologic oncologists might represent a useful tool in adjunction to chemotherapy for the management of ROC.
authors.affiliation: Department of Obstetrico-Gynecological and Urologic Sciences, "Sapienza" University of Rome, Rome - Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Salerno
authors.affiliation: Department of Obstetrico-Gynecological and Urologic Sciences, "Sapienza" University of Rome, Rome - Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Marchetti
authors.affiliation: Department of Obstetrico-Gynecological and Urologic Sciences, "Sapienza" University of Rome, Rome - Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Bevilacqua
authors.affiliation: Department of Obstetrico-Gynecological and Urologic Sciences, "Sapienza" University of Rome, Rome - Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Musella
authors.affiliation: Department of Obstetrico-Gynecological and Urologic Sciences, "Sapienza" University of Rome, Rome - Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Riganelli
authors.affiliation: Department of Obstetrico-Gynecological and Urologic Sciences, "Sapienza" University of Rome, Rome - Italy.
authors.forename: Ilary
authors.initials: I
authors.lastname: Ruscito
authors.affiliation: Department of Obstetrico-Gynecological and Urologic Sciences, "Sapienza" University of Rome, Rome - Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Perniola
authors.affiliation: Department of Obstetrico-Gynecological and Urologic Sciences, "Sapienza" University of Rome, Rome - Italy.
authors.forename: Ludovico
authors.initials: L
authors.lastname: Muzii
authors.affiliation: Department of Obstetrico-Gynecological and Urologic Sciences, "Sapienza" University of Rome, Rome - Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Benedetti Panici
mesh_terms: D014408:Biomarkers, Tumor; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery*; D019233:Retreatment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor