by Polsdorfer R

Surgery is the main treatment for ovarian cancer in all stages. The goal of surgery is to remove the cancer. It is also to help keep the ovaries working, if possible. The type of surgery depends on the stage of the cancer. Chemotherapy may be done:

  • Before surgery—to shrink the tumor, or
  • After surgery—to kill any remaining cancer cells

Surgery for Early Stage and Advanced Ovarian Cancer

Treatment for ovarian cancer starts with an exploratory laparotomy. An incision is made in the belly wall. It is done to gain access to the pelvic area and abdomen. These procedures may be done during staging.

The extent of surgery depends on how advanced the cancer is. Radical surgery is the best treatment for ovarian cancer. It removes the most tissue. This increases the chance that all the cancer cells will be removed.

Surgery may include one or all of the following:

  • Abdominal hysterectomy —Removal of the uterus.
  • Bilateral salpingo- oopherectomy —Removal of both ovaries and fallopian tubes. It may be advised for women at high risk for ovarian cancer. The ovaries may be removed before cancer is present. This is to prevent ovarian cancer.
  • Omentectomy —Removal of the omentum. The omentum a large apron-like structure. It covers the organs in the abdomen.
  • Debulking —This is done if ovarian cancer has spread into the pelvis or abdomen. As many of the tumors as possible will be removed. It may be done on any organ in the pelvis or abdomen. For example, it may include the colon or bladder. Debulking can be done during a first surgery. Or, it can be done with follow-up surgery.

Lymph nodes and/or other suspicious tissue will be removed. They will be checked in a lab for cancer cells.

Some women with cancer want to have children. If their cancer is in a very early stage, this may be possible. They may be able to have only one ovary and fallopian tube removed. This is an option to discuss with the doctor before treatment.

References

Committee on Gynecologic Practice, Society of Gynecologic Oncology. Committee Opinion No. 716: The role of the obstetrician-gynecologist in the early detection of epithelial ovarian cancer in women at average risk. Obstet Gynecol. 2017;130(3):e146-e149.

Ovarian cancer. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/ovarian-cancer. Accessed March 29, 2022.

Ovarian cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gynecology-and-obstetrics/gynecologic-tumors/ovarian-cancer. Accessed March 29, 2022.

Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq#section/%5F156. Updated Accessed March 29, 2022.

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