Surgical Management of Recurrent Epithelial Ovarian Cancer

Chapter

Abstract

Recurrent ovarian cancer has a propensity for peritoneal spread, and it remains confined to the peritoneal cavity for prolonged periods. An aggressive locoregional therapy comprising of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in addition to systemic chemotherapy has produced promising results in the treatment of this condition for which there is no standard therapy and cure is almost impossible. This treatment has shown an improvement in survival in patients with platinum-resistant recurrent ovarian cancer as well which has an extremely poor prognosis. There is substantial evidence to warrant the use of CRS, but the role of HIPEC needs to be defined further. The results of randomized controlled trials evaluating its benefit are awaited. The extent of disease determined by the peritoneal cancer index (PCI) and complete removal of all visible disease are the two most significant prognostic factors affecting the outcomes of CRS and HIPEC. With the availability of new chemotherapeutic agents and targeted therapies, treatment strategies, which integrate all these treatments to provide maximal gain in survival to patients while preserving the quality of life, are needed.

Keywords

Recurrent ovarian cancer Secondary CRS HIPEC 

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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Department of Surgical OncologyFortis HospitalBangaloreIndia
  2. 2.Department of Surgical OncologyCentre Hospitalier Lyon Sud, Hospices Civils de LyonPierre BéniteFrance
  3. 3.Université Lyon 1, EMR 3738OullinsFrance

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