Secondary cytoreduction for patients with recurrent ovarian cancer.

Standard treatment for advanced epithelial cancer includes primary cytoreductive surgery followed by combination chemotherapy. Optimal primary debulking is associated with improved clinical response rates to primary chemotherapy and longer overall survival. Still, at least 60% of advanced-stage ovarian cancer patients who are without clinical evidence of disease after completing primary therapy ultimately develop recurrent disease. Despite significant efforts, standard treatment of patients with recurrent ovarian cancer remains poorly defined. In view of the new refinement in surgical techniques and medical treatments and the extended disease-free interval, physicians and patients face the dilemma of how to handle further management in this subgroup of patients. A clear understanding of the prognostic factors and expectations from the procedure are necessary in order to identify candidates adequately.