Surgical treatment of ovarian cancer
Affiliation and adress for correspondence

Klinika Nowotworów Narządów Płciowych Kobiecych, Centrum Onkologii Instytut im. M. Skłodowskiej-Curie
Correspondence to: Mariusz Bidziński, Klinika Nowotworów Narządów Płciowych Kobiecych, Centrum Onkologii – Instytut im. M. Skłodowskiej-Curie, ul. Roentgena 5, 02-781 Warszawa, e-mail: mbidzinski@coi.waw.pl
Source of financing: Department own sources

GIN ONKOL 2007, 5 (2), p. 61-74
ABSTRACT

The paper presents current algorithms of surgical treatment of patients with ovarian cancer. At early clinical stages (FIGO stage I and II), the basic principle of surgical treatment is radical excision of malignant lesions within the pelvis and meticulous search for metastatic foci of tumour within the mid-abdomen and epigastrium. Therefore, mandatory procedures include omentectomy, multiple sampling of peritoneum (including diaphragmatic lining) and periaortal lymph nodes. In late-stage disease (FIGO stages III and IV), the main task is to remove all metastatic foci, both within the abdominal cavity and retroperitoneal space. In late-stage cases, surgery requires great expertise of both surgical, anesthetic and physiotherapy teams. Required are also precise surgical instruments, including argon bipolar coagulation, a reliable diathermy unit and a kit of self-retaining retractors. Extensive cytoreductive procedures are burdened by an elevated complication rate, therefore in selected cases preoperative (neoadjuvant) chemotherapy is used.

Keywords: chemotherapy, ovarian cancer, cytoreductive surgery, second-look surgery, secondary debulking surgery