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Debate 21B - Should Tertiary Debulking be Performed for Patients with Recurrent Ovarian Cancer?

No

from Section III - Ovarian Cancer

Published online by Cambridge University Press:  20 July 2023

Dennis S. Chi
Affiliation:
Memorial Sloan-Kettering Cancer Center, New York
Nisha Lakhi
Affiliation:
Richmond University Medical Center, Staten Island
Nicoletta Colombo
Affiliation:
University of Milan-Bicocca
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Summary

Surgery is considered a cornerstone in the treatment of advanced ovarian cancer. The absence of macroscopic residual tumor at the end of surgery is associated with a better outcome in primary debulking surgery and secondary cytoreduction for patients with a first relapse. Despite the absence of randomized clinical trials in the front-line setting, nobody questions the value of surgery in the initial management of primary advanced ovarian cancer due to extensive data showing a clear benefit in overall survival of complete cytoreduction after primary debulking surgery and interval debulking surgery. In the first relapse, three randomized clinical trials have produced apparently contradictory results. It is important to mention (for the best understanding of the question that we are dealing with), that only the studies including clearly defined selection criteria for cytoreduction, AGO-OVAR DESKTOP-III and SOC1, have produced a positive result in terms of progression-free survival. In addition, the AGO-OVAR study has also shown a benefit in overall survival.

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Publisher: Cambridge University Press
Print publication year: 2023

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References

Fotopoulou, C, et al. Value of tertiary cytoreductive surgery in epithelial ovarian cancer: an international multicenter evaluation. Ann Surg Oncol 2013;20:13481354.CrossRefGoogle ScholarPubMed
Fanfani, F, et al. Is there a role for tertiary (TCR) and quaternary (QCR) cytoreduction in recurrent ovarian cancer?Anticancer Res 2015;35:69516956.Google Scholar
Falcone, F, et al. Tertiary cytoreductive surgery in recurrent epithelial ovarian cancer: a multicentre MITO retrospective study. J Gynecol Oncol 2017;147:6672.CrossRefGoogle ScholarPubMed
Manning-Geist, BL, et al. Tertiary cytoreduction for recurrent ovarian carcinoma: an updated and expanded analysis. J Gynecol Oncol 2021;162:345352.CrossRefGoogle ScholarPubMed

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