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Lahousen, M.
Ovarian-Carcinoma - The Way Ahead
ONKOLOGIE. 1994; 17: 134-140. Doi: 10.1159/000218398
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Leading authors Med Uni Graz: Lahousen Manfred
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Abstract:: Ovarian carcinoma has the poorest prognosis of all malignancies of the female genital tract. The majority of patients are diagnosed with advanced disease. Efforts to diagnose the disease in early stages have remained largely fruitless. Modest advances have been made in treatment, particularly in patients with advanced disease. Today the operative treatment of ovarian cancer poses the greatest challenge to the gynecologic surgeon. The impetus that prodded us to fundamentally change our surgical strategy came from chemotherapy. New cytostatic agents (platinum-contaning agents, paclitaxel) offered hope of treating even seemingly inoperable patients. The results achieved by chemotherapy depend largely on the tumor burden after primary surgery. The smaller the residual tumor after primary surgery, the longer the survival rate. Accordingly, tumor masses, wherever they are, should be removed as completely as possible. The surgical pursuit of the routes of spread of ovarian cancer led to the recognition that ovarian cancer regularly spreads to retroperitoneal lymph node groups that previouly received scant attention. The frequency of lymphatic metastasis was unexpectedly high. This immediately led to the issue whether systematic lymphadenectomy should be considered a component of cytoreduction and thus an integral part of primary surgery. Now surgical tumor reduction is generally planned at the beginning of the therapeutic process to optimize the chances for adjuvant chemotherapy. Only a combination of modalities will improve treatment results. Thes efforts have led to 5-year survival rates of 40% in FIGO stage III.
Find related publications in this database (Keywords): Ovarian Cancer; Lymphadenectomy; Adjuvant Chemotherapy; 2nd-Look Laparotomy