Cancer of the ovary, fallopian tube, and peritoneum: Surgery for recurrent cancer
- Dennis S Chi, MD
Dennis S Chi, MD
- Memorial Sloan-Kettering Cancer Center
- Karin K Shih, MD
Karin K Shih, MD
- Hofstra University School of Medicine
Ovarian cancer is the second most common gynecologic malignancy and the most common cause of gynecologic cancer death in the United States. (See "Epithelial carcinoma of the ovary, fallopian tube, and peritoneum: Epidemiology and risk factors", section on 'Epidemiology'.)
The majority of ovarian cancer patients experience recurrence of disease . The pattern of ovarian cancer recurrence varies from isolated nodal disease, to isolated peritoneal disease, to peritoneal carcinomatosis. Extra-abdominal sites of recurrence are not common with recurrent ovarian cancer.
Most patients with recurrent ovarian cancer are treated with chemotherapy alone. Surgical treatment is reserved for a select group of patients, and currently there are several clinical trials underway to evaluate if secondary cytoreduction improves survival.
Surgery for recurrent ovarian cancer is reviewed here. Medical therapy for recurrent ovarian cancer and initial surgical therapy are discussed separately. (See "Medical treatment for relapsed epithelial ovarian, fallopian tubal, or peritoneal cancer: Platinum-resistant disease" and "Cancer of the ovary, fallopian tube, and peritoneum: Staging and initial surgical management".)
PREOPERATIVE EVALUATION AND PREPARATION
Surveillance of ovarian cancer patients includes physical examination and serum cancer antigen 125 (CA 125), or other tumor markers if initially elevated. Imaging studies are performed as clinically indicated. Recurrence of ovarian cancer most commonly occurs in the peritoneal cavity (abdomen or pelvis), or in the thoracic cavity.
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