Relapse: Surgical Considerations and Secondary Cytoreduction

Chapter

Abstract

This chapter focuses on the survival benefit, selection criteria, and morbidity and mortality associated with secondary cytoreduction for recurrent ovarian cancer in the general population and the elderly. The goal of secondary cytoreduction is to improve overall survival by maximizing surgical tumor eradication in patients who demonstrate a complete clinical response to initial platinum-based chemotherapy. Retrospective studies consistently demonstrate a survival benefit associated with maximal secondary cytoreduction. Patient selection criteria should be individualized based on the patient’s life goals, comorbidities and performance status, and availability of adjuvant therapy. Morbidity and mortality rates are comparable to those associated with primary cytoreduction. The role of secondary cytoreduction in the geriatric population is still evolving. In general, elderly are less likely to receive standard treatment for ovarian cancer, but research suggests that secondary cytoreduction can be both safe and feasible and advanced age alone should not be a contraindication to surgery.

Keywords

Secondary cytoreductive surgery Secondary cytoreduction Recurrent epithelial ovarian cancer Relapse Elderly 

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Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  1. 1.Division of Gynecologic Oncology, Department of Obstetrics and GynecologyUniversity of California Irvine, Medical CenterOrangeUSA

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