ASO Author Reflections: Value of Cytoreduction in Extensive Ovarian Cancer—Does Surgical Effort Still Matter?

Abstract

Surgery for epithelial ovarian cancer has undergone a long journey of evolution over the last decades, starting from a nihilism towards a presumed ‘hopeless’ disease over a transition of cautious speculations about the benefits of cytoreduction, to the advancement of surgical debulking techniques even outside the peritoneal cavity into the mediastinum and chest. The ‘holy grail’ of this journey has been to achieve maximal tumor clearance in an effort to derive the hoped-for therapeutic benefit. Early and continuous adopters of this radical approach have demonstrated a clear survival advantage of their patients’ populations compared with other populations where surgery was of lower effort. These pearls of wisdom and knowledge have been passed through to multiple generations of gynae-oncology surgeons in a constant strive to achieve maximal cytoreduction until, nowadays, the ‘optimal’ postoperative residual disease is accounted to be only microscopic. PRESENT