Surgery for common epithelial tumors of the ovary.

The objectives of the initial surgical procedure in patients with common epithelial carcinomas of the ovary are determination of the intraabdominal extent of the cancer and the reduction of tumor masses to the smallest residuum before initiating further therapy. Since ovarian cancer is a disease of the entire abdominal cavity, biopsy of selected sites will often detect unsuspected involvement by microscopic foci of metastatic carcinoma. Tumor-reductive surgery resulting in a small tumor residuum before initiating chemotherapy is thought to improve the changes for inducing a complete response. The retroperitoneal operative approach enhances the surgeon's effort to remove tumor bulk. Between July 1, 1972, and September 1, 1978, 104 patients with FIGO Stage III or IV carcinomas of the ovary were treated with melphalan. The conditions of 38 patients were evaluated by second-look laparotomy. This analysis attempts to define tumor-reductive surgery and relates the outcome of the results of the operative procedure to patients treated with melphalan.