Surgical treatment

Surgery is the main treatment for most ovarian cancer. Basically, it depends on the neoplastic expansion and on what the exact stage is.

• Surgery for early stage ovarian cancer has three main purposes:

1. Diagnostic one: making an accurate histological diagnosis by anatomical pathology confirming of the presence of the tumor itself;
2. Therapeutic one: removing the entire visible neoplasm;
3. Staging the tumor: finding out how widespread the tumor is, taking tissue samples to be examined under the microscope.

During the surgery the tumor is treated through a longitudinal incision in the abdomen so as to favour the exploration of internal abdominal walls. Usually uterus is removed (hysterectomy), along with ovaries and ometum (a layer of peritoneum which sorrounds abdominal organs), while lymph nodes in the pelvis and abdomen are biopsided together with parietal peritoneum (the outer layer of the membrane attached to the abdominal wall and pelvic walls).

• When ovarian cancer is at an advanced stage, having spread outside the pelvis into the abdominal cavity and to other body organs some distance from ovaries (for example bowel, liver, spleen, or diaphragm), together with staging, the first line in treatment and diagnosis is debulking surgery, whose goal is to locate and remove as much of the tumor tissue as possible. International studies on the better prognosis suggest that it is the best option for women. It may require a variety of procedures, depending on the type and stage of ovarian cancer, for example during a laparotomy or a laparoscomy the abdomen is usually opened up for sa surgical removal of one or more organs. But if it would be difficult to remove enough of the cancer, patients may have chemiotherapy first. In this case, a biopsy of the tumor is required to confirm the diagnosis followed by neo adjuvant chemiotherapic which will shrink the tumor so that it is then possible for the surgeon to operate.