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Updated: May 6, 2026
Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
Surgical treatment of advanced ovarian cancer
L David1, Irina Dinu, G Vatachki
1Centrul de Chirurgie Generala si Transplant Hepatic "Dan Setlacec", Institutul Clinic Fundeni, Bucharest, Romania.
Background:
The classical treatment for advanced ovarian cancer (OC) consists of a optimal cytoreductive surgery (when the postoperative residual tumor is under 1 cm.), followed by adjuvant chemotherapy based on platinum or paclitaxel derivatives. The 5-year survival rate in case of advanced OC with secondary peritoneal carcinomatosis (PC) is below 25%. The treatment of PC (interpreted as a local-regional disease and not as a systemic disease) is based on an aggressive surgical act (a full or maximal cytoreduction without residual tumor), followed by local chemotherapy or hypertermic intraperitoneal chemotherapy. This is a retrospective study which reassesses the surgical treatment of advanced OC within the period January 2004 - December 2010 in the Center of General Surgery and Liver Transplantation within Fundeni Institute.
Methods:
In the period January 2004 - December 2010 in the Center of General Surgery and Liver Transplantation within Fundeni Institute were operated 405 patients with advanced ovarian cancer. In 105 patients (25.9%) intraperitoneal chemotherapy with Cisplatin was performed.
Results:
Overal survival was calculated for a subsample of 297 patients, for whom it was possible to properly ensure the follow-up, being of 43 months in the patients with intraperitoneal chemotherapy (p = 0.02) and 37 months in the patients without intraperitoneal chemotherapy.
Conclusions:
The maximal cytoreduction associating IPCH is an aggressive multidisciplinary therapeutic approach in advanced OC, reserved for difficult cases, considered in the past without solution. In properly selected cases, this shows a clear increase in survival rate.
