Dr. Wingo on the Evolution of Surgery in Patients With Ovarian Cancer

Shana Wingo, MD, gynecologic oncologist, Arizona Oncology, discusses surgical options for the treatment of patients with newly diagnosed ovarian cancer.

The role of neoadjuvant therapy has shifted the paradigm for physicians, says Wingo. Physicians are used to debulking upfront; however, as data come out in support of neoadjuvant therapy, they feel less apprehensive about bypassing upfront debulking.

Carboplatin and paclitaxel are typically used in the neoadjuvant setting. Physicians determine who is appropriate for upfront surgery versus upfront chemotherapy by evaluating their disease burden and the location of their cancer. There are certain areas where physicians cannot safely operate, or know that a complete resection of the cancer is unlikely. Physicians will also look at a patient's comorbidities. The goal is to get every patient to surgery, Wingo says, but some patients are too ill to have upfront surgery.