The Role of Surgery in the Treatment of Ovarian Cancer

Most patients with ovarian cancer undergo surgery at some point during the course of their treatment. A primary operation may be undertaken for the purpose of confirming the diagnosis, staging, and debulking. Numerous publications have documented the importance of proper staging in ovarian cancer, which determines the treatment plan — including whether chemotherapy is indicated — and therefore impacts substantially on patient outcomes and survival. Improper staging can lead to underestimation of the extent of the disease and undertreatment. For patients with advanced disease, complete debulking surgery improves survival significantly. If patients are not suitable for primary debulking however, neoadjuvant chemotherapy should be considered. There remains uncertainty surrounding the role and effectiveness of interval debulking surgery as opposed to standard of primary debulking surgery in the course of first-line treatment of advanced ovarian carcinoma. More evidence is needed before a conclusion can be drawn about this issue. Surgery is not limited to primary treatment, but may also be indicated for patients with recurrent ovarian cancer or to provide palliative care and symptom relief for patients who are at the end stages of the disease.