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Aggressive surgery to remove all cancer cells followed by targeted chemotherapy shows potential to significantly improve ovarian cancer survival.
Recent analysis offered a new model in which women with advanced-stage ovarian cancer should take a more aggressive approach for treatment, including getting surgery before chemotherapy.
The study, published in Nature Reviews Clinical Oncology, argued that a 50% survival rate in women with advanced ovarian cancer is possible compared with the current 20% rate. This could be achieved if physicians were to adopt a standard model-of-care for patients.
In order to achieve positive results, Dr. Steven Narod, senior scientist at Women’s College Research Institute, feels that women should first be treated with an aggressive surgery to remove all cancer cells. Only after surgery should patients move on to targeted chemotherapy in the abdomen, also called intraperitoneal chemotherapy.
The current methods in place for the treatment of advanced stage ovarian cancer calls for chemotherapy prior to surgery, intravenously delivered to the entire body post-operation or surgery that leaves minimal residual disease in the abdomen. This is opposed to the proposed method of removing all visible cancer cells.
In the standard model-of-care for women with ovarian cancer, researchers feels that chemotherapy should be given to patients post-surgery instead of before. This is because chemotherapy can provide false assurance that there is no more cancer cells left in the body.
However, microscopic tumors have the potential to remain in the body after the surgery, which leads to cancer recurrence and mortality.
"For decades, women have been treated with a combination of treatment options, resulting in poor prognosis for most women with advanced-stage ovarian cancer, but there are many survivors as well," Dr. Narod said. "Women need support to endure surgery and the rigors of intraperitoneal chemotherapy, but should be encouraged to do so whenever possible, considering the potential survival benefits. We should offer all women the possibility of a cure.”