Department of Gynecology and Gynecologic Oncology, Dr Horst Schmidt Klinik, Ludwig-Erhard Strasse 100,Wiesbaden, Germany.
Int J Gynecol Cancer. 2009 Dec;19 Suppl 2:S14-7. doi: 10.1111/IGC.0b013e3181bffb3f.
Surgery is a mainstay of therapy in ovarian cancer. Are there any actual changes in the definitions and goals of surgery?
Selective review of the actual literature and results in surgery for primary and recurrent ovarian cancer.
Actual data strongly suggest changing the surgical aim from the so-called optimal debulking (residual disease <1 cm) to complete resection. The standard in patients in whom complete resection might be possible remains to be primary surgery followed by chemotherapy. There might be a subgroup of patients with a poor prognosis who will have only limited benefit of primary surgery, and interval debulking is also possible. Predictive models for suboptimal debulking at primary diagnosis are discussed. The surgical aim in recurrent ovarian cancer is defined as complete resection. Actual multicenter studies investigated prospectively predictive models for complete resection.
Recommendations regarding surgical aim have changed within the recent years. There are still no reliable predictive models for primary surgery of ovarian cancer. The DESKTOP II trial has validated a score of resectability in recurrent ovarian cancer.
手术是卵巢癌治疗的主要手段。手术的定义和目标是否有实际变化？
对原发性和复发性卵巢癌手术的实际文献和结果进行选择性回顾。
实际数据强烈提示将手术目标从所谓的最佳减瘤（残留病变<1cm）改为完全切除。对于可能能够完全切除的患者，标准仍为初始手术加化疗。可能存在一组预后不良的患者，他们从初始手术中获益有限，间隔减瘤也是可能的。对初始诊断时减瘤不彻底的预测模型进行了讨论。复发性卵巢癌的手术目标定义为完全切除。实际的多中心研究前瞻性地研究了完全切除的预测模型。
近年来，关于手术目标的建议已经发生了变化。目前仍没有用于卵巢癌初始手术的可靠预测模型。DESKTOP II 试验验证了复发性卵巢癌可切除性评分。
