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Cancers
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Research on Surgical Treatment for Ovarian Cancer
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Research on Surgical Treatment for Ovarian Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 25 October 2025 | Viewed by 4745

Special Issue Editors

Dr. Antonios Apostolos K. Tentes

E-Mail Website
Guest Editor
EUROMEDICA Kyanous Stavros, Viziis 1, 54636 Thessaloniki, Greece
Interests: cancers; surgery
Prof. Dr. Theo Panoskaltsis

E-Mail Website
Guest Editor
Gynecologic Oncology Unit, 1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, 80 Vasilissis Sofias Avenue, 11528 Athens, Greece
Interests: gynecology

Special Issue Information

Dear Colleagues,

The treatment of ovarian cancer is a challenge. Despite cytoreductive surgery (CRS) with standard peritonectomy procedures followed by systemic chemotherapy, the majority of patients develop recurrence. The integration of hyperthermic intraperitoneal chemotherapy (HIPEC) to CRS has shown that survival in secondary and interval cytoreduction is improved with acceptable morbidity and low in-hospital mortality. There is much evidence that HIPEC is beneficial as an upfront treatment. The effect of HIPEC and novel systemic therapy (PARPi) remains to be established.

The main objective of the issue “Research on Surgical Treatment for Ovarian Cancer” is to show that CRS plus HIPEC has revolutionized the treatment of ovarian cancer and will help physicians understand that this modern treatment is successfully performed in specialized centers.

Dr. Antonios Apostolos K. Tentes
Prof. Dr. Theo Panoskaltsis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ovarian cancer
  • surgical
  • cancer treatment

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Published Papers (4 papers)

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Research

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13 pages, 526 KiB  
Article
Incisional Hernia in Cytoreductive Surgery for Advanced-Stage Ovarian Cancer: A Single-Center Retrospective Study
by Marta Míguez Medina, Ana Luzarraga, Sara Catalán, Úrsula Acosta, Alina Hernández-Fleury, Vicente Bebia, Sonia Monreal-Clua, Martina Aida Angeles, Giulio Bonaldo, Antonio Gil-Moreno, Asunción Pérez-Benavente and Jose Luis Sánchez-Iglesias
Cancers 2025, 17(3), 418; https://doi.org/10.3390/cancers17030418 - 27 Jan 2025
Viewed by 946
Abstract
Background/Objectives: An incisional hernia (IH) is a frequent postoperative complication after cytoreductive laparotomic surgery for advanced ovarian cancer (AOC). It occurs in 2–22% of patients in the first two years of follow-up, depending on the series. Although different risk factors have been described [...] Read more.
Background/Objectives: An incisional hernia (IH) is a frequent postoperative complication after cytoreductive laparotomic surgery for advanced ovarian cancer (AOC). It occurs in 2–22% of patients in the first two years of follow-up, depending on the series. Although different risk factors have been described for various types of malignancies and surgeries, few studies have analyzed the risk factors for hernia development in ovarian cancer (OC). However, none have examined the role of enhanced recovery after surgery (ERAS) programs. Methods: We performed a retrospective study that included patients with AOC and primary or interval debulking surgery through a median laparotomic approach. This study was conducted in Vall d’Hebron Hospital, Barcelona, Spain, between January 2015 and December 2022. Univariate and multivariate regression analyses were conducted. Results: Of the 156 patients included, 30 (19.2%) presented with an IH. The patients with IHs were smokers in a higher proportion to non-smokers (53.9% vs. 16.1%, p = 0.003) and more frequently presented with wound dehiscence (34.4% vs. 15.0%, p = 0.026). Patients in whom negative pressure wound therapy was applied had a hernia less frequently than those who had not had it (12.5% vs. 26.7%, p = 0.043). Similarly, the incidence of hernia decreased when patients went through an ERAS protocol (10.1% vs. 28.8%, p = 0.008). In the multivariate analysis, smoking was the only independent risk factor (RR 10.84, CI 2.76–42.64), and applying an ERAS protocol was seen to be the sole protective factor (RR 0.22, CI 0.08–0.61) against the development of an IH. Conclusions: The implementation of ERAS is highly recommended due to its numerous benefits, most notably the reduction in hernia incidence. Additionally, the preoperative identification of current smokers provides an opportunity for smoking cessation and targeted respiratory prehabilitation, both of which further contribute to IH reduction. Full article
(This article belongs to the Special Issue Research on Surgical Treatment for Ovarian Cancer)
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15 pages, 516 KiB  
Article
Prehabilitation—A Simple Approach for Complex Patients: The Results of a Single-Center Study on Prehabilitation in Patients with Ovarian Cancer Before Cytoreductive Surgery
by Marcin Adam Zębalski, Aleksandra Krzywon and Krzysztof Nowosielski
Cancers 2024, 16(23), 4032; https://doi.org/10.3390/cancers16234032 - 1 Dec 2024
Viewed by 979
Abstract
Background/Objectives: Prehabilitation is a low-cost, safe procedure with no side effects, and it may have a positive impact on postoperative outcomes. However, it is not widely implemented. Our study aimed to assess the impact of prehabilitation on postoperative outcomes in patients with [...] Read more.
Background/Objectives: Prehabilitation is a low-cost, safe procedure with no side effects, and it may have a positive impact on postoperative outcomes. However, it is not widely implemented. Our study aimed to assess the impact of prehabilitation on postoperative outcomes in patients with ovarian cancer within the field of gynecological oncology. Methods: We analyzed 110 patients with ovarian cancer who participated in a prehabilitation program before cytoreductive surgery. Based on the results of a 6-min walk test (6MWT), patients were divided into two groups: Group A (patients who improved their 6MWT results) and Group B (patients who did not improve their 6MWT results). Results: Patients in Group A demonstrated better postoperative outcomes. The length of hospital stay was significantly shorter in Group A compared to Group B (median 7 [5, 9] vs. 9 [6, 17], p = 0.032). Group A also had a lower overall number of complications and also fewer complications, as summarized by the Clavien–Dindo classification, compared to Group B. Conclusions: Patient adherence to prehabilitation recommendations was adequate. Prehabilitation was associated with improved postoperative outcomes, including shorter hospital stays and fewer complications. These benefits were more pronounced with higher patient compliance with the prehabilitation program and improvements were recorded in preoperative physical capacity. Full article
(This article belongs to the Special Issue Research on Surgical Treatment for Ovarian Cancer)
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14 pages, 692 KiB  
Article
HIPEC as Up-Front Treatment in Locally Advanced Ovarian Cancer
by Michail Karanikas, Konstantinia Kofina, Dimitrios Kyziridis, Grigorios Trypsianis, Apostolos Kalakonas and Antonios-Apostolos Tentes
Cancers 2024, 16(20), 3500; https://doi.org/10.3390/cancers16203500 - 16 Oct 2024
Viewed by 1286
Abstract
Purpose: The main objective of the study is to evaluate the effect of hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of naïve ovarian cancer women undergoing complete or near-complete cytoreduction by assessing the overall survival, the disease-specific survival, and the disease-free survival. The [...] Read more.
Purpose: The main objective of the study is to evaluate the effect of hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of naïve ovarian cancer women undergoing complete or near-complete cytoreduction by assessing the overall survival, the disease-specific survival, and the disease-free survival. The secondary objective is the identification of prognostic indicators of survival and recurrence of these patients. Patients—Methods: Retrospective study of treatment in naïve women with locally advanced ovarian cancer treated with cytoreductive surgery (CRS) and HIPEC and compared with those who were treated with cytoreduction alone. Clinicopathologic variables were correlated to overall survival, disease-specific survival, and disease-free survival using Kaplan–Meier method, and the multivariate Cox proportional hazards regression models. Results: 5- and 10-year overall survival, disease-specific survival, and disease-free survival rates were significantly higher in patients treated with CRS and HIPEC. These patients were 67% less likely to die from any cause (adjusted hazard ratio, aHR = 0.33, p = 0.001), 75% less likely to die from cancer (aHR = 0.25, p = 0.003), and 46% less likely to develop recurrence (aHR = 0.54, p = 0.041) compared to patients treated with CRS alone. Moreover, the poor performance status (aHR = 2.96, p < 0.001), the serous carcinomas (aHR = 0.14, p = 0.007), and the morbidity (aHR = 6.87, p < 0.001) were identified as independent indicators of poor overall survival. The degree of differentiation (aHR = 8.64, p = 0.003) was identified as the independent indicator of disease-specific survival (aHR = 4.13, p = 0.002), while the extent of peritoneal carcinomatosis (aHR = 2.32, p < 0.001) as the independent indicator of disease-free survival. Conclusions: Treatment in naïve patients with locally advanced ovarian cancer undergoing CRS plus HIPEC appears to have improved overall, disease-specific, and disease-free survival. Full article
(This article belongs to the Special Issue Research on Surgical Treatment for Ovarian Cancer)
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Review

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13 pages, 504 KiB  
Review
Management of Recurrence in Ovarian Cancer—The Role of Surgery and HIPEC with Relevance to BRCA Testing in a PARPi Landscape
by Mathilde Duchon, Raj Naik, Fabrice Lecuru, Gwenaël Ferron, Caroline Cornou, Sabrina Madad Zadeh and Christophe Pomel
Cancers 2025, 17(4), 646; https://doi.org/10.3390/cancers17040646 - 14 Feb 2025
Viewed by 1077
Abstract
Background: The surgical and medical management of recurrent ovarian cancer is complex and requires a personalized approach based on several factors, including the timing of recurrence, the patient’s performance status, previous treatment regimens, and the tumor’s histology and molecular characteristics. Objectives: [...] Read more.
Background: The surgical and medical management of recurrent ovarian cancer is complex and requires a personalized approach based on several factors, including the timing of recurrence, the patient’s performance status, previous treatment regimens, and the tumor’s histology and molecular characteristics. Objectives: Five randomized trials—GOG-0213, DESKTOP III, SOC 1, HORSE, and CHIPOR—have been conducted and shed light on our practice. Results: Both the DESKTOP III and the SOC 1 trials support the benefit of secondary surgery. The GOG-0213 trial, however, did not show an overall survival benefit, confirming that surgery should not be offered to all patients with platinum-sensitive recurrent ovarian cancer and highlighting the importance of strict patient selection using evidence-based selection criteria including the AGO or iMODEL scores. In patients with a negative score, there may be a place for cytoreductive surgery plus HIPEC in BRCA-negative cases following a course of chemotherapy, although current evidence shows no additional benefit for HIPEC when cytoreductive surgery is performed as an adjuvant procedure. Conclusions: Secondary surgery is recommended for platinum-sensitive patients when respecting AGO or iModel criteria. In addition, surgery plus HIPEC can be considered in BRCA-negative patients with an initial negative AGO or iMODEL score who show sufficient response following a course of neoadjuvant chemotherapy to then be considered operable. Full article
(This article belongs to the Special Issue Research on Surgical Treatment for Ovarian Cancer)
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