title: Hepatic resection during cytoreductive surgery for primary or recurrent epithelial ovarian cancer.
abstract: OBJECTIVE
  Surgical cytoreduction remains a cornerstone in the management of patients with advanced and recurrent epithelial ovarian cancer. Parenchymal liver metastases determine stage VI disease and are commonly considered a major limit in the achievement of an optimal cytoreduction. The purpose of this manuscript was to discuss the rationale of liver resection and the morbidity related to this procedure in advanced and recurrent ovarian cancer.
  
  
  METHODS
  A search of the National Library of Medicine's MEDLINE/PubMed database until March 2015 was performed using the keywords: "ovarian cancer," "hepatic," "liver," and "metastases."
  
  
  RESULTS
  In patients with liver metastases, hepatic resection is associated with a similar prognosis as stage IIIC patients. The length of the disease-free interval between primary diagnosis and occurrence of liver metastases, as well as residual disease after resection, is the most important prognostic factors. In addition, the number of liver lesions, resection margins, and the gynecologic oncology group performance status seem to play also an important role in determining outcome.
  
  
  CONCLUSIONS
  In properly selected patients, liver resections at the time of cytoreduction increase rates of optimal cytoreduction and improve survival in advanced-stage and recurrent ovarian cancer patients.
authors.affiliation: Department of Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy.|Department of Obstetrics and Gynecology, Inselspital, Berne University, Berne, Switzerland.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Gasparri
authors.affiliation: Department of Obstetrics and Gynecology, University of Modena, Modena, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Grandi
authors.affiliation: Department of Obstetrics and Gynecology, Inselspital, Berne University, Berne, Switzerland.
authors.forename: Daniele
authors.initials: D
authors.lastname: Bolla
authors.affiliation: Department of Surgery, Inselspital, Berne University, Berne, Switzerland.
authors.forename: Beat
authors.initials: B
authors.lastname: Gloor
authors.affiliation: Department of Obstetrics and Gynecology, Inselspital, Berne University, Berne, Switzerland.
authors.forename: Sara
authors.initials: S
authors.lastname: Imboden
authors.affiliation: Department of Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Pierluigi Benedetti
authors.initials: PB
authors.lastname: Panici
authors.affiliation: Department of Obstetrics and Gynecology, Inselspital, Berne University, Berne, Switzerland.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Mueller
authors.affiliation: Department of Obstetrics and Gynecology, Inselspital, Berne University, Berne, Switzerland. andrea.papadia@insel.ch.
authors.forename: Andrea
authors.initials: A
authors.lastname: Papadia
mesh_terms: D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery; D009375:Neoplasms, Glandular and Epithelial / Q000473:pathology / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D012008:Recurrence
keywords: Cytoreduction; Debulking surgery; Hepatectomy; Liver metastases; Ovarian cancer; Recurrent ovarian cancer