Here is what what I would say about ovarian cancer surgery at this point in time. Today the concept of ovarian cancer treatment by surgery is tumor debulking. This is the standard of care for most surgeons performing ovarian cancer treatment by surgical operation. "Debulking" is removal of some but not all tumor. Surgeons just remove some ovarian cancer tumor. they expect the systemic chemotherapy to kill the rest of ovarian cancer tumor cells. It is true that chemotherapy in ovarian cancer is quite effective. Dr. Paul Sugarbaker, MD. Chemotherapy in ovarian cancer is more effective than chemotherapy of gastrointestinal cancer. But current treatment standard of surgical debulking of ovarian cancer is bad concept. It is a bad concept. Ovarian cancer patients should have the same meticulous cytoreduction with peritonectomy and visceral resections until there is no visible evidence of disease. Ovarian cancer patients should have a radical resection of all visible cancer. This is what we would have for peritoneal mesothelioma. That is not happening at this point. Radical surgical resection of all ovarian cancer tumor is the first and biggest step in the improved treatment of ovarian cancer. Dr. Paul Sugarbaker, MD. The goal is to bring these surgical oncology principles of peritoneal cavity cancer treatment into treatment of all patients with ovarian cancer. Primary ovarian cancer or recurrent ovarian cancer deserve best surgical treatment. Dr. Anton Titov, MD. аt the moment it is not happening. More patients with ovarian cancer should have better surgical resection of ovarian tumors? Dr. Paul Sugarbaker, MD. Renowned Gastrointestinal Cancer Surgeon. No, no, it is not a current standard of care for ovarian cancer. At this point in time only a small number of ovarian cancer patients have this treatment. It is very meticulous surgery to remove all ovarian cancer tumor spread from peritoneum. Some of ovarian cancer patients are older women. Dr. Paul Sugarbaker, MD. They are not so fit. it is not appropriate to put them through 8 hour long surgical procedure. Cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC). Of course, you have to be selective this ovarian cancer patient to take for radical resection of ovarian cancer. It doesn't pay to do a big ovarian cancer operation on someone. Then have them die after surgery. It is not appropriate to do such an extensive surgery (ovarian cancer cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) that they can never recover a reasonable quality of life. you have to be selective, of course. Dr. Anton Titov, MD. But the first step in improving the results of ovarian cancer treatment is this. Surgeon has to use peritonectomy with visceral resection to remove all visible evidence of ovarian cancer disease. My best recommendation for the treatment of patients with ovarian cancer at this point in time is this. It is the meticulous and complete cytoreductive surgery combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC). Dr. Paul Sugarbaker, MD. Renowned Gastrointestinal Cancer Surgeon.
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