Researchers at Mayo Clinic Cancer Center reported aggressive surgical removal of as much cancer as possible throughout the abdomen in ovarian cancer patients is the best option for most women.

Results of the study are published in the Obstetrics & Gynecology.

" 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," says William Cliby, at Mayo Clinic and lead investigator of the study. " It helps to define a topic that is often debated within our specialty: the benefit of radical surgery for advanced ovarian cancer patients." Cliby says that data demonstrate many surgeons choose the more cautious route of less surgical intervention, and this results in shorter overall survival.

Cliby and his team of researchers found that aggressive surgery greatly improves survival rates for patients with the most severe disease spread. They also found similar five-year survival rates in most cases for patients undergoing radical and non-radical surgery, indicating to the researchers that aggressive surgery is not a significant risk factor, but instead aids in survival. In those patients with the highest volume of disease ( carcinomatosis ), the researchers found that radical surgery greatly improved the five-year survival rates ( 44 percent versus 17 percent ).

Having a general preference towards maximum surgical intervention, Cliby and colleagues see the results of a survey conducted by the Society of Gynecologic Oncologists in 2001 as troubling, with 45.5 percent of respondents citing lack of evidence for improved survival as a primary rationale against performing aggressive surgical resection in specific cases of advanced ovarian cancer.

Because several other factors are part of the decision to perform surgery, especially more radical surgeries, Cliby's team also looked at risks related to age, preoperative medical condition and operative time. They found that residual disease and radical surgery were the only factors that consistently predicted survival.

The study cohort of 194 women was assembled from patients who underwent primary surgery for stage III C ovarian cancer at Mayo Clinic between 1994 and 1998.

Source: Mayo Clinic, 2006


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