Advanced cytoreductive surgery: Asia Pacific perspective

Area of Science:

• Oncology
• Surgical Oncology
• Gynaecology

Background:

• Cytoreductive surgery completeness is paramount for survival in advanced ovarian and primary peritoneal carcinoma.
• Current surgical training for Gynaecologic Oncologists often limits the scope of procedures performed.
• A disconnect exists between the surgical requirements for optimal outcomes and existing training paradigms.

Purpose of the Study:

• To advocate for a paradigm shift in Gynaecologic Oncologist surgical training.
• To emphasize the necessity of comprehensive anatomical education and expanded surgical scope.
• To highlight the need for multidisciplinary team-based approaches in advanced cytoreductive surgery.

Main Methods:

• This study is a conceptual analysis and recommendation based on current clinical evidence and surgical practice.
• It reviews the requirements for achieving complete tumor removal (no residual disease).
• It discusses the implications for surgical training curricula and professional development.

Main Results:

• Achieving complete tumor removal requires a broader surgical skill set beyond traditional gynaecological oncology training.
• Enhanced training must include general and upper abdominal procedures.
• A significant shift in mindset and curriculum development is necessary within the specialty and its governing colleges.

Conclusions:

• Future Gynaecologic Oncologist training must evolve to include advanced cytoreductive surgical techniques for improved patient survival.
• The establishment of Advanced Cytoreductive Surgical Units in a multidisciplinary team setting is crucial for safe and effective patient care.
• Successful implementation requires commitment from all stakeholders, including surgeons, hospital administration, and support services.