Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Clin Adv Hematol Oncol. 2020 Nov;18(11):723-731.
Surgical cytoreduction and platinum/taxane-based chemotherapy are the cornerstones of the management of advanced ovarian cancer; however, the optimal timing and order of these interventions remain a topic of debate. Interpreting the available data, specifically regarding the role of neoadjuvant chemotherapy in the primary setting and surgical cytoreduction in the recurrent setting, requires careful evaluation of surgical quality and patient selection. One tenet that has persisted throughout the historical and modern literature is the prognostic effect of the volume of residual disease after cytoreductive surgery. The goal of debulking surgery has appropriately evolved to that of the complete gross resection of all visible disease, and the repertoire of the gynecologic cancer surgeon has grown to include radical pelvic, upper abdominal, and thoracic procedures. Novel surgical techniques are under investigation, such as minimally invasive cytoreductive procedures and the intraoperative utilization of heated intraperitoneal chemotherapy. Of equal importance is a recent refocusing of attention on patient preferences and the patient's experience during treatment and recovery. In this review article, we examine the literature supporting the role of surgery in the management of advanced ovarian cancer.
手术减瘤术和基于铂类药物/紫杉类药物的化疗是治疗晚期卵巢癌的基石；然而，这些干预措施的最佳时机和顺序仍是一个争论的话题。解读现有数据，特别是关于新辅助化疗在初始治疗中的作用和手术减瘤术在复发治疗中的作用，需要仔细评估手术质量和患者选择。贯穿历史和现代文献的一个原则是肿瘤细胞减灭术后残余肿瘤量的预后作用。肿瘤细胞减灭术的目标已适当演变为完全切除所有可见的疾病，妇科癌症外科医生的技能范围也扩大到包括根治性盆腔、上腹部和胸部手术。新的手术技术正在研究中，例如微创肿瘤细胞减灭术和术中应用腹腔内热化疗。同样重要的是，最近人们重新关注患者的偏好以及患者在治疗和康复过程中的体验。在这篇综述文章中，我们研究了支持手术在治疗晚期卵巢癌中的作用的文献。
