Dr. Al-Niaimi on the Future Role of Cytoreductive Surgery in Ovarian Cancer

Ahmed N. Al-Niaimi, MD, assistant professor of obstetrics and gynecology, University of Wisconsin School of Medicine and Public Health, discusses the future role for cytoreductive surgery for the treatment of patients with ovarian cancer.

Cytoreductive surgery will continue to play a role in the treatment of patients with ovarian cancer, says Al-Niaimi, but the modality of delivering that surgery will change to become minimally invasive. Minimally invasive surgery will help women recover faster and have less complications, allowing them to move on to chemotherapy and adjuvant therapy—leading to better survival.

In a phase III study of patients with platinum-sensitive recurrent ovarian cancer, the impact of secondary cytoreductive surgery was evaluated. The AGO DESKTOP III/ENGOT ov20 trial randomized patients to second-line chemotherapy alone versus cytoreductive surgery followed by chemotherapy.

Findings showed that complete resection was achieved in 72.5% of operated patients. The median progression-free survival was 19.6 months in the surgical arm versus 14 months without surgery (HR 0.66; 95% CI, 0.52-0.83, P <.001). The median time to the start of first subsequent therapy was 21 vs 13.9 months, respectively (HR, 0.61; 95%CI, 0.48-0.77, P <.001). Overall survival data are not yet mature.