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The role of aggressive surgery in the treatment of ovarian cancer
Comment to paper: Aletti
GD et al.: "Aggressive surgical effort and improved survival in
advanced-stage ovarian cancer",
1) What would you say are
the key findings of the study?
Residual disease at the
conclusion of the first surgery independently correlates with overall
surival, regardless of whether radical or extended surgical procedures
were needed.
2) How does this differ
to previous research about the role of aggressive surgery in the
treatment of ovarian cancer?
It is larger than most of
the prior studies and we had the luxury of having a large number of
surgeons operating where there was some individual variation in the
tendency to use radical procedures. We could therefore look at
overall survival by the tendency to use radical procedures and saw a
markedly improved survival. That is a unique comparison of a
more vs. less aggressive approach.
3) What are the
clinical implications of your findings?
If patients can tolerate (medically
speaking) a long operation and it will result in near complete tumor
reduction in ovarian cancer, that should be done. Surgeons
performing these types of operations should evaluate their own practices
and determine there rates of complete and optimal cytoreduction and look
for areas of improvement as we have done.
Comments provided by:
William A. Cliby, M.D.,Mayo Clinic Gynecologic Oncologist
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