Secondary cytoreduction--thoughts on the "pro" side

The advantages of secondary cytoreduction in the treatment of women with ovarian carcinoma include improved survival and potential improvement in quality of life. To summarize the literature on this topic, patients can be grouped into four distinct clinical settings. Debulking at the time of second-look laparotomy, interval debulking following three to four courses of chemotherapy, and debulking at the time of recurrence following a disease-free interval are scenarios which offer clinical advantages to women with ovarian carcinoma. However, there is little or no evidence to support a survival or quality of life advantage for women who undergo secondary debulking despite progressive disease on primary platin-based chemotherapy. Data on the pro side of the secondary tumor debulking debate are summarized here.