Background
Ovarian cancer is associated with a high mortality, due to the lack of early symptoms and systematic screening. It shows a typical tumor dissemination pattern, with intraperitoneal spread and is often limited to the intraperitoneal space.
Materials and methods
A literature search of PubMed, Medline, and a manual internet search was performed. The most relevant studies regarding the quality of the operation in ovarian cancer were taken into account.
Results
Despite improvements in systemic therapy, the basis of therapeutic management for primary ovarian cancer remains the surgical approach with the goal of maximal cytoreduction, followed by systemic chemotherapy and optional targeted therapy as maintenance therapy. Other approaches such as neoadjuvant chemotherapy and interval surgery have been discussed, but should be limited to patients with special risk profiles according to German key opinion leaders based on the current information. With respect to the current study data available, the gold standard remains primary cytoreductive surgery followed by adjuvant chemotherapy. The outcome of cytoreductive surgery is by far the most important prognostic factor and determines the further course of the patient. Despite this fact, significant differences in the quality of the primary operation exist between hospitals due to the complexity of the operation.
Conclusion
In addition to advances in early diagnosis and systemic therapy, one of the main priorities should be the training of specialised gyneco-oncologists and pelvic surgeons and the treatment of ovarian cancer patients in high volume centers with extensive surgical experience in order to improve the overall patient prognosis.