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Complications associated with cytoreductive surgery for advanced ovarian cancer: Surgical timing and surmounting obstacles

  • Jill H. Tseng
    Correspondence
    Corresponding author at: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California, Irvine-Medical Center, 333 City Blvd West, Suite 1400, Orange, CA 92868, USA.
    Affiliations
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California, Irvine-Medical Center, Orange, CA, USA
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  • Robert E. Bristow
    Affiliations
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California, Irvine-Medical Center, Orange, CA, USA
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      In 1975, C. Thomas Griffiths introduced the concept of surgical cytoreduction and the inverse relationship between residual tumor volume and survival for the treatment of advanced ovarian cancer [
      • Griffiths C.T.
      Surgical resection of tumor bulk in the primary treatment of ovarian carcinoma.
      ]. In his landmark paper entitled Surgical Resection of Tumor Bulk in the Primary Treatment of Ovarian Carcinoma, Griffiths reported on 102 patients who underwent surgical removal of tumor. Half of the cohort was treated with a hysterectomy and bilateral salpingo-oophorectomy (BSO), while only 6 patients underwent more extensive surgery with a hysterectomy, BSO and removal of 2 metastatic masses greater than 1.5 cm. There were 3 post-operative deaths. Complete tumor resection was achieved in 28% of patients and the median overall survival (OS) was merely18 months. Griffiths concluded that “surgical bulk resection is of little value unless all or nearly all gross tumor is excised.”
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