[Surgical treatment of ovarian cystadenocarcinoma]

Ovarian cystadenocarcinoma should be dealt with by surgeons well-trained in abdominal and pelvis surgery. The initial laparotomy has a dual purpose: to determine the tumoral stage after detailed evaluation of the lesions, and to remove all or most of the tumoral tissue. This is easy in localized cancers, but difficult, or even impossible, in the majority of stage III cancers. Radical surgery of stage III cancers has not yet been proven to influence the long-term survival. When surgical evaluation and excision have been unsatisfactory at the first laparotomy, another operation through a midline incision is justified before initiating an adjuvant treatment. This "second look" laparotomy is the best way to evaluate a tumoral residue after chemotherapy. In the absence of effective second-line therapy, the operation does not seem to improve the patient's comfort or survival, and it should be reserved to second-line therapeutic trials. Similarly, the surgical treatment of occlusive lesions due to recurrent cancer does not seem to influence the patient's comfort or survival.