The course for the course of ovarian cancer is set during the first operation. If the tumor can be completely removed so that no tumor remains can be seen with the naked eye, the patients can hope for a favorable outcome. If the remaining tumor cells respond to the platinum-containing chemotherapy and one of the new maintenance therapies, a cure is even possible. The quality of the operation thus directly determines the patient's prognosis and is the most important success factor that the specialized surgeon can directly influence. It is up to you to give the patients a lifetime with their skills.
Obviously, this applies not only to the first operation after the diagnosis, but also to a second operation after the return of platinum-sensitive ovarian cancer and before another chemotherapy. If the tumor can be removed so thoroughly in this situation that it can no longer be seen with the naked eye, the patients live an average of 34.2 months longer than those who do not succeed. However, these women also benefit from the second operation because the survival of all those who have been operated on is increased by an average of 7.7 months compared to those who only received chemotherapy.
These are the results of a multicenter study called Desktop III, which has now been published in the "New England Journal of Medicine" and which had already caused a sensation at the congress of the American Society of Clinical Oncology last year. The study was led by Andreas du Bois and Philipp Harter from the Essen-Mitte Clinics. The time to the occurrence of another relapse was also delayed by the second intervention. In the patients who were operated on again, it took an average of 18.4 months for the ovarian cancer to return, and in the non-operated patients 14 months. 80 centers from twelve countries took part in the study. 206 of the total of 407 patients had been operated on first and then received the second platinum-containing chemotherapy,201 had been treated immediately with chemotherapy. The observation time averaged 69.8 months.
The surgeons' skills stand out
In order to be able to demonstrate the survival benefit from the second operation as clearly as possible, strict inclusion criteria were used that had been developed and tested in two preliminary studies. These criteria suggest which patients are likely to benefit. These are women with a good general condition, whose ovarian cancer was completely removed in the first operation and who had hardly any fluid in their stomach when the decision about the second operation was made. "If these three criteria are met and there is a high probability that the recurrent, platinum-sensitive ovarian cancer can be completely removed in the second operation, the patient should be offered a second operation before the new chemotherapy," says Harter. "The Desktop III study suggeststhat they will live longer and that it will be longer before they have another relapse. "