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Archives of Gynecology and Obstetrics

, Volume 298, Issue 5, pp 873–879 | Cite as

Secondary cytoreduction in ovarian cancer: who really benefits?

  • Maria Teresa Giudice
  • Marco D’Indinosante
  • Serena Cappuccio
  • Valerio Gallotta
  • Anna Fagotti
  • Giovanni Scambia
  • Marco Petrillo
Review

Abstract

Purpose

To identify women affected by recurrent ovarian cancer who benefit from secondary cytoreductive surgery (SCS), analyse their clinical and biological features and investigate the role of minimally invasive surgery (MIS) and hyperthermic intraperitoneal-based chemotherapy (HIPEC) in this subset of patients.

Methods

This narrative review examines the data available from the updated literature. An electronic literature search was conducted in PubMed Medline databases for articles published from 1990 to 2018.

Results

Retrospective studies and preliminary data from the AGO-Desktop III trial show that cytoreductive surgery is associated with improved post-relapse survival in patients with platinum-sensitive relapse, compared to chemotherapy alone. This benefit is more evident in patients treated with complete or optimal primary debulking surgery at referral centres, who did not receive bevacizumab in first-line chemotherapy, and who present a localized pattern of disease. MIS has been proven to be a favourable approach to achieve a complete secondary debulking, reducing peri- and postoperative comorbidities. The application of HIPEC to SCS is associated with an improvement in oncological outcomes by preliminary results.

Conclusions

While waiting for the final results of the ongoing randomized controlled trials, SCS seems feasible and safe in selected patients with recurrent ovarian cancer. Recently, more attention has been focused on the biological features of ovarian tumours, such as BRCA status. Further studies and molecular research should be conducted to identify individualized and targeted therapies in the treatment of ovarian cancer recurrences.

Keywords

Secondary cytoreductive surgery Recurrent ovarian cancer Personalized treatment Biological features Minimally invasive surgery 

Notes

Author contributions

MTG: Protocol/project development, Data collection, Manuscript writing and Manuscript editing. MD’I: Protocol/project development, Data collection, Manuscript writing and Manuscript editing. SC: Protocol/project development, Data collection. VG: Protocol/project development and Manuscript editing. AF: Protocol/project development and Manuscript editing. GS: Protocol/project development, Manuscript writing and Manuscript editing. MP: Protocol/project development, Data collection, Manuscript writing and Manuscript editing. All authors read and approved the final manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Woman and Child HealthIRCCS Fondazione Policlinico Agostino GemelliRomeItaly
  2. 2.Gynecologic and Obstetric Clinic, Department of Clinical and Experimental MedicineUniversity of SassariSassariItaly
  3. 3.School in Biomedical SciencesUniversity of SassariSassariItaly

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