Ultra-Radical Surgery for Ovarian Cancer

Dr. Janice S. Kwon, MPH, FRCSC,

Because of the long and often complicated hospital stay of these women undergoing ultra-radical surgery for ovarian cancer, Dr. Eisenhauer stressed the importance of an effective multi-disciplinary team in order to provide optimal care to these patients.

Dr. Lloyd Mack, Surgical Oncologist from the Tom Baker Cancer Center in Calgary, discussed his experience in the treatment of colorectal and appendix cancers. These patients have extensive metastatic disease throughout the abdomen and pelvis, similar to women with advanced ovarian cancer. At the Tom Baker Cancer Center, there is considerable experience in offering ultra-radical surgery to these individuals, followed by a specific protocol of chemotherapy.

Of 166 patients, 84% had complete resection (removal) of their tumour, and 85% received the chemotherapy. The 3-year disease-free survival rates were 34% and 48% for colorectal and appendix cancers, respectively, which were significantly higher than those previously reported for these cancers. Patients were living longer with these surgery and chemotherapy results. As well the results have prompted the development of a National Group for further collaboration in this area.

In summary, ultra-radical surgery is possible in order to achieve optimal debulking in advanced ovarian cancer and it has been demonstrated to be effective in metastatic colorectal and appendix cancer. There are barriers to ultra-radical surgery in ovarian cancer, although some of these barriers can be overcome. One alternative to ultra-radical surgery in ovarian cancer is neoadjuvant chemotherapy as initial treatment, followed by surgery at a later date. This treatment practice has been shown to be just as effective as primary surgery in terms of survival outcomes, with fewer complications, and therefore remains a favourable approach in the management of advanced ovarian cancer.

Six years of T-shirts at the Ovarian Cancer Walk of Hope 2011