In many cases, ovarian cancer treatment involves a combination of cytoreductive surgery and chemotherapy. The goal of surgical treatment is to remove the tumor and any nearby tissues to which the cancer may have spread. However, in addition to a localized tumor, ovarian cancer often involves micrometastases that have spread away from the ovaries to other parts of the body. Because surgery is a local treatment, it cannot address micrometastatic cancer cells. Therefore, a systemic treatment like chemotherapy, which involves the use of powerful drugs that can enter the bloodstream to reach and destroy widespread cancer cells, may be used either before or after cytoreductive surgery, also known as debulking surgery.
The main type of cytoreductive surgery that is performed to address ovarian cancer is called an exploratory laparotomy, or upfront cytoreductive surgery. When performing a laparotomy, a gynecologic oncologist can accurately diagnose and stage a tumor (extent of tumor spread), remove as much cancer as possible from the abdominal and pelvic regions and assess whether additional therapy may be necessary. This complex surgery may involve:
- A total hysterectomy (removal of the uterus)
- A bilateral salpingo-oophorectomy (removal of both ovaries and fallopian tubes)
- An omentectomy (removal of a flap of fatty tissue that covers the bowel in the abdomen)
- Removal of any other cancerous tissue or nearby organ (if required) that is visible within the abdomen
During the procedure, the gynecologic oncologist will also obtain tissue samples from the upper abdomen, collect small amounts of abdominal fluid and remove some nearby lymph nodes by taking a biopsy so that these samples can be examined under a microscope for evidence of cancer to determine the stage of the cancer.
After the completion of cytoreductive surgery, patients are started on systemic chemotherapy that lasts four months followed possibly by maintenance therapy if appropriate. This completes primary treatment of ovarian cancer and subsequently, patients start a surveillance program that generally lasts the next five years. During this time, a patient will typically undergo a physical examination, a CA-125 blood test and if necessary, radiologic imaging. All of these are used to evaluate the effectiveness of treatment and helps keeps the cancer in check. If no signs of cancer are found, a patient is said to be in complete clinical remission.
Our subspecialty-trained and dual board certified/eligible gynecologic oncologists treat patients who are diagnosed with ovarian cancer on a daily basis. As such, they’ve acquired refined skills and extensive experience in performing cytoreductive surgery. As a high-volume cancer center that also treats ovarian cancer patients with a multispecialty team approach, Moffitt helps each individual patient achieve the best possible outcome and quality of life.
Medically reviewed by Mian Shahzad, MD, PhD, gynecologic oncologist.
If you’d like more information about cytoreductive surgery for ovarian cancer treatment, call Moffitt Cancer Center at 1-888-663-3488 or complete a new patient registration form online. You do not need to obtain a referral prior to contacting us.