Mark A. Morgan, MD, professor of obstetrics and gynecology, University of Pennsylvania, director, Gynecology Oncology for University of Pennsylvania Health Systems, discusses bulk reduction surgery prior to chemotherapy in patients with stage III ovarian cancer.

While there are no randomized controlled trials to prove that patients who have all gross tumor removed at the time of initial surgery have an increased survival benefit, Morgan says, there is evidence that suggests this.

Morgan says these patients are then candidates for intraperitoneal chemotherapy, which has shown a survival benefit in three randomized controlled trials. One trial showed a median survival of greater than 5 years.

Because of this, Morgan believes that unless there is a reason not to, patients should be offered initial chemotherapy and debulking surgery.

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Dr. Morgan on Bulk Reduction Surgery in Ovarian Cancer

Mark A. Morgan, MD, professor of obstetrics and gynecology, University of Pennsylvania, director, Gynecology Oncology for University of Pennsylvania Health Systems, discusses the role of robotic surgery in gynecologic cancer.

While robotic surgery is a controversial subject, Morgan says, it is actually just a modification of laparoscopic surgery.

Results of a study by the Gynecologic Oncology Group (GOG), which compared laparoscopic surgery to open surgery in endometrial cancer, showed no difference between the two. Because of these results, it is unlikely that there is a difference in patient survival between robotic surgery and laparoscopic surgery.

However, it has been reported that robotic surgery works better in lymph node dissections and operations on heavier patients compared to laparoscopic surgery, Morgan says.

Morgan says the advent of robotic surgery has increased the use of minimally invasive surgery for women with endometrial or cervical cancer. In the past, Morgan says, the majority of those patients were operated on with a large incision and had to endure long hospital stays. Because most women with endometrial or cervical cancer are obese, they had a more morbid course, Morgan says.

Although robotic surgery is in its infancy, Morgan believes it will play a huge role in both gynecologic oncology surgeries and general surgeries.

Mark A. Morgan, MD

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Dr. Morgan on Bulk Reduction Surgery in Ovarian Cancer

Dr. Morgan on Robotic Surgery in Gynecologic Cancer