Update on Surgical Treatment for Ovarian Cancer

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Obstetrics and Gynecology".

Deadline for manuscript submissions: 31 January 2026 | Viewed by 72

Special Issue Editors


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Guest Editor
Gynaecological Oncology Department, Metaxa Cancer Hospital, 18537 Piraeus, Greece
Interests: gynaecological oncology; robotic gynaecology; laparoscopic gynaecology; cancer; endometriosis
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Guest Editor Assistant
Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, 51 Botassi Str., 18537 Piraeus, Greece
Interests: gynaecologic oncology; ovarian cancer

Special Issue Information

Dear Colleagues,

The first recorded surgical removal of an ovarian tumour was performed in 1809 in a patient with a large abdominal mass by Dr. Ephraim McDowell. Remarkably, the patient made a full recovery and lived another 32 years. This groundbreaking procedure is considered the first successful ovariotomy, marking a major milestone in the surgical treatment of ovarian cancer.

Today, surgical resection remains the cornerstone of multidisciplinary treatment for patients with resectable ovarian cancer. Recent advances have significantly transformed this field. These include hyperthermic intraperitoneal chemotherapy (HIPEC), minimally invasive surgery (MIS), fertility-preserving procedures, real-time intraoperative tools, AI-assisted technologies, and machine learning, neoadjuvant chemotherapy (NACT) to reduce the tumour burden preoperatively. There is a growing emphasis on combining these technologies to enhance surgical precision, broaden patient eligibility, improve quality of life, and predict disease recurrence more accurately, with the ultimate goal of achieving long-term survival.

This Special Issue will highlight recent innovations that could reshape current clinical practice and inform future clinical trials, while also introducing multiple new perspectives in relation to ovarian cancer surgery, such as patient-specific 3D modelling and simulation and immunological/neurobiological integration as a polyvagal perspective in stress, recovery, and resilience in ovarian cancer surgery.

Dr. Christos R. Iavazzo
Guest Editor

Dr. Victoria Psomiadou
Guest Editor Assistant

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Keywords

  • ovarian cancer
  • surgical resection
  • ovariotomy
  • HIPEC (hyperthermic intraperitoneal chemotherapy)
  • minimally invasive surgery (MIS)
  • neoadjuvant chemotherapy (NACT)
  • fertility-preserving procedures
  • AI-assisted technologies

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Published Papers (1 paper)

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Research

13 pages, 1262 KiB  
Article
Selective Advantage of NACT in Advanced Ovarian Cancer: A Retrospective Single-Centre Analysis
by Adrienne Szilvia Berczi, Olivér Lampé, Zoárd Tibor Krasznai, Mónika Orosz, Lili Fábián and Rudolf Lampé
Medicina 2025, 61(8), 1493; https://doi.org/10.3390/medicina61081493 - 20 Aug 2025
Abstract
Background and Objectives: Advanced-stage epithelial ovarian cancer (EOC) is associated with poor prognosis, with complete macroscopic cytoreduction representing the strongest modifiable predictor of survival. Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is an alternative to primary debulking surgery (PDS) in patients [...] Read more.
Background and Objectives: Advanced-stage epithelial ovarian cancer (EOC) is associated with poor prognosis, with complete macroscopic cytoreduction representing the strongest modifiable predictor of survival. Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is an alternative to primary debulking surgery (PDS) in patients with high tumor burden. However, its impact on surgical complexity remains debated. This study aimed to compare operative characteristics and survival outcomes between NACT + IDS and PDS using standardized scoring metrics in a real-world oncologic setting. Materials and Methods: We retrospectively analyzed 47 patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIIC-IV high-grade serous EOC treated between January 2018 and August 2022 at a single tertiary center. Twenty-five patients received platinum–taxane-based NACT followed by IDS, and twenty-two underwent upfront PDS with adjuvant chemotherapy. Surgical effort was quantified using the Surgical Complexity Score (SCS), and intra-abdominal tumor burden was assessed via the Peritoneal Cancer Index (PCI). Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan–Meier analysis. Hazard ratios (HRs) with 95% confidence intervals were derived from Cox proportional hazards models. Results: Complete cytoreduction (R0) was achieved in 76% of the NACT + IDS group and 68% of the PDS group. Mean surgical complexity and operative time were significantly lower following NACT (SCS 5.0 vs. 6.2, p = 0.04; 140 vs. 197 min, p = 0.001), without significant differences in blood loss, complication rates, or length of hospital stay. Median PFS was 25 months in the NACT + IDS group versus 21 months in the PDS group, and the difference was not statistically significant. Among patients with R0 resection, survival outcomes were comparable between treatment arms. Conclusions: NACT + IDS was associated with shorter and less complex surgeries in selected patients, but survival outcomes appeared similar when R0 was achieved. Data suggest that selective use of NACT in patients with extensive disease burden or limited general health status may be suitable, while confirming that complete cytoreduction remains the most critical prognostic factor, although these survival comparisons are exploratory given the retrospective design and limited sample size. Full article
(This article belongs to the Special Issue Update on Surgical Treatment for Ovarian Cancer)
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