Primary surgery for ovarian cancer.

AIM: Review studies on survival outcomes for all survival treatment methods of primary ovarian cancer. METHODS: This presentation is based on systematic literature search in Pubmed, Medline, Cochrane and Internet addresses for treatment protocols. RESULTS: Major controversies still exist on what constitutes optimal surgical staging in a patient with early-stage ovarian cancer and what is optimal surgical management for high-risk patients. Several large retrospective studies consistently identify the size of the largest residual disease after primary cytoreductive surgery as an independent determinant of prognosis, but the size limit of residual disease that needs to be fulfilled for cytoreduction to have effect on survival is not identified. The effect of neoadjuvant chemotherapy in advanced ovarian cancer is uncertain. A large prospective randomized study is initiated for assessing the role of neoadjuvant chemotherapy. The survival rate is better for patients treated at teaching hospitals compared with non-teaching hospitals. CONCLUSION: This systematic review demonstrates the need for more studies on survival outcomes for all surgical treatment methods of primary ovarian cancer assessed in this report.