Ovarian cancer advanced stage లో peritoneal spread ఉంటుంది. Debulking surgery residual disease తగ్గించడానికి. Selected cases లో HIPEC addition survival improve చేస్తుంది. Ovarian cancer often presents with peritoneal spread at advanced stage. Debulking surgery reduces residual disease. HIPEC addition improves survival in selected cases.
Ovarian cancer most cases లో diagnosis అయ్యే time కి advanced stage (Stage III or IV) లో ఉంటుంది. Peritoneal spread almost always present. ఈ reason వల్ల surgical approach peritoneal surface oncology experience అవసరం పడుతుంది.
Primary debulking surgery goal: no visible residual disease (R0). Residual disease volume survival తో directly correlate అవుతుంది. CION Tumor Board లో medical oncology team తో discuss చేసిన తరువాత, neoadjuvant chemotherapy vs upfront surgery decide చేస్తాము.
HIPEC addition regarding, OVHIPEC trial (2018, NEJM) interval cytoreductive surgery కి HIPEC add చేయడం ovarian cancer survival improve చేస్తుందని show చేసింది. నేను suitable cases లో HIPEC consider చేస్తాను.
Most ovarian cancer cases are diagnosed at advanced stage (Stage III or IV) with peritoneal spread almost always present. This is why the surgical approach requires peritoneal surface oncology experience.
The goal of primary debulking surgery is no visible residual disease (R0). Residual disease volume directly correlates with survival. After discussion with the medical oncology team at the CION Tumor Board, we decide between neoadjuvant chemotherapy and upfront surgery.
On the question of HIPEC addition, the OVHIPEC trial (2018, NEJM) showed that adding HIPEC to interval cytoreductive surgery improves survival in ovarian cancer. I consider HIPEC in suitable cases.
Upfront surgery for eligible patients. TAH-BSO with omentectomy and lymphadenectomy. Goal is R0 resection (no visible residual disease).
After neoadjuvant chemotherapy (NACT). For patients not suitable for primary debulking. Combined with HIPEC in selected cases.
OVHIPEC trial showed survival improvement with HIPEC addition at interval surgery. I offer this in eligible cases following Tumor Board discussion.