Radical Surgery for Advanced Ovarian Cancer

Choosing aggressive surgery for advanced ovarian cancer over a more cautious route improves survival, according to a new study.

In patients with the most severe operable stage of the disease, five-year survival rates were more than four times higher among patients who had radical surgery that those undergoing non-radical procedures, say researchers at the Mayo Clinic (Rochester, MN, USA) in a study published in the January 2006 issue of Obstetrics & Gynecology.

The study included 194 patients undergoing surgery for stage IIIC ovarian cancer. Of these, 144 had carcinomatosis. About half the patients underwent radical surgery, and half underwent non-radical procedures. The researchers assessed five-year disease-specific survival rates and amount of residual disease, comparing results after radical surgery procedures versus less-aggressive procedures.

Overall, five-year disease-specific survival rates were nearly identical in the radical and the non-radical groups. This finding indicates that radical surgery does not have negative impact on survival, the Mayo researchers argued. However, among the 144 patients with carcinomatosis, the survival benefits of aggressive surgery were pronounced. In these patients, the five-year, disease-specific survival rate among the radical surgery group was 38%, compared with 9% in the non-radical surgery group.

"This study provides further evidence that surgery to remove as much tumor as possible at the initial operation is the best option for most patients,” concluded Dr.William Cliby, M.D., and colleagues at the Mayo Clinic. "It helps to define a topic that is often debated within our specialty: the benefit of radical surgery for advanced ovarian cancer patients.




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