Ovarian cancer often spreads to surface of the peritoneum (covering of organs inside the abdomen), or surface of bowel or lymph nodes inside the abdomen. Treatment for ovarian cancer typically entails a combination of extensive surgery and chemotherapy.
In this blog, I talk about cytoreductive surgery for ovarian cancer; sharing key insight about what this treatment entails while also shedding light on the meaning of ‘Primary’, ‘Interval’, ‘Delayed’ and ‘Secondary’ when we talk about cytoreduction surgery to help individuals have further understanding about this.
Cytoreductive surgery for ovarian cancer
The primary goal of surgery is to eliminate all visible cancer, which often involves a prolonged cytoreduction procedure lasting 4-6 hours. Patients typically stay in the hospital for 7-10 days, with the initial 48 hours spent in intensive care. The surgery may include the removal of various organs such as the uterus, cervix, ovaries, and fallopian tubes. Additionally, it may involve peritoneal and diaphragmatic surgery, and in some cases, partial bowel removal with the creation of a stoma (in 2% of cases).
Liver and spleen removal might be necessary in certain situations. This complex surgery is performed by a subspecialist, well-trained surgeon and often requires a multidisciplinary approach involving liver or bowel surgeons.
What is Primary cytoreductive surgery?
Primary cytoreduction surgery involves upfront surgical intervention at the time of diagnosis, before any chemotherapy is given. Substantial evidence in literature supports the notion that removing all cancer during the initial surgery enhances life expectancy compared to performing surgery after chemotherapy.
What is Interval cytoreductive surgery?
Interval cytoreduction surgery involves performing surgery after three cycles of chemotherapy, followed by an additional three cycles of chemotherapy.
What is Delayed cytoreductive surgery?
Delayed cytoreduction surgery is when surgery is performed after 6 cycles of chemotherapy. This is followed by two further cycles of chemotherapy.
What is Secondary cytoreduction surgery?
Secondary cytoreduction surgery involves operating on recurrent ovarian cancer. The decision for this surgery is evaluated in a multidisciplinary team meeting, considering factors such as whether complete cytoreduction was achieved when cancer was first diagnosed (the initial cytoreduction success), time since last chemotherapy cycle, the patient's suitability for surgery, disease distribution on CT scan, presence of ascites, and CA125 level.
Find out more
Mr Saurabh Phadnis is a leading consultant specialising in gynaecology, gynaecological oncology, and surgery. His expertise includes performing cytoreduction surgery for advanced-stage ovarian cancer. With conveniently located clinics throughout London, Mr Phadnis delivers highly personalised care to women dealing with concerns and complaints related to gynaecological cancer.
For those in need of surgical intervention, Mr Phadnis ensures patient-centric care, providing exceptional diagnostic, treatment, and supportive services, whiling ensuring comprehensive and individualised care for every patient at each stage of their cancer journey.
