Ahmed N. Al-Niaimi, MD, assistant professor of obstetrics and gynecology, University of Wisconsin School of Medicine and Public Health, discusses cytoreductive surgery in ovarian cancer.

Reaching optimal cytoreduction is complicated, so collaboration is key reaching that goal, says Al-Niaimi. It is important to achieve cytoreduction in a systematic way, Al-Niaimi explains, as optimal cytoreduction provides the opportunity for a higher survival and cure rate for these patients. This is particularly true when ovarian cancer spreads to the liver, gallbladder, and porta hepatis, Al-Niaimi says. Achieving an optimal cytoreduction in this case with diaphragm surgery is challenging, but can offer a great benefit.

Results from the phase III AGO DESKTOP III/ENGOT ov20 trial, which randomized patients to second-line chemotherapy alone versus cytoreductive surgery followed by chemotherapy, showed that complete resection was achieved in 72.5% of patients who underwent surgery. The median progression-free survival for the surgical arm was 19.6 months compared with 14 months for patients who did not undergo surgery.

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Ahmed N. Al-Niaimi, MD, assistant professor of obstetrics and gynecology, University of Wisconsin School of Medicine and Public Health, discusses cytoreductive surgery in ovarian cancer.
 

Dr. Al-Niaimi Discusses Cytoreductive Surgery in Ovarian Cancer

Ahmed N. Al-Niaimi, MD, assistant professor of obstetrics and gynecology, University of Wisconsin School of Medicine and Public Health, discusses the future role for cytoreductive surgery for the treatment of patients with ovarian cancer.

Cytoreductive surgery will continue to play a role in the treatment of patients with ovarian cancer, says Al-Niaimi, but the modality of delivering that surgery will change to become minimally invasive. Minimally invasive surgery will help women recover faster and have less complications, allowing them to move on to chemotherapy and adjuvant therapy—leading to better survival.

In a phase III study of patients with platinum-sensitive recurrent ovarian cancer, the impact of secondary cytoreductive surgery was evaluated. The AGO DESKTOP III/ENGOT ov20 trial randomized patients to second-line chemotherapy alone versus cytoreductive surgery followed by chemotherapy.

Findings showed that complete resection was achieved in 72.5% of operated patients. The median progression-free survival was 19.6 months in the surgical arm versus 14 months without surgery (HR 0.66; 95% CI, 0.52-0.83, 

<.001). The median time to the start of first subsequent therapy was 21 vs 13.9 months, respectively (HR, 0.61; 95%CI, 0.48-0.77,

 <.001). Overall survival data are not yet mature.

Ahmed N. Al-Niaimi, MD

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Dr. Al-Niaimi Discusses Cytoreductive Surgery in Ovarian Cancer

Dr. Al-Niaimi on the Future Role of Cytoreductive Surgery in Ovarian Cancer