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Surgery is the primary treatment for all types of ovarian cancer. Surgery is used to:
The type of surgery done depends mainly on the size and stage of the cancer. Other factors may also determine which type of surgery is done, such as the type of ovarian cancer and a woman’s wishes to have children in the future. Several different procedures may be done during surgery to remove as much of the ovarian cancer as possible. Surgical staging will be done along with these procedures. Side effects of surgery depend on the type of surgical procedure.
Ovarian cancer is staged during surgery. Accurate staging of ovarian cancer is very important because the stage will determine the type and length of treatment given after surgery. Some women who appear to have early stage disease (stage I) are assigned a higher stage (stage II or III) after surgical staging.
Surgical staging includes:
A total hysterectomy and bilateral salpingo-oophorectomy (BSO) is the most common surgical procedure used to treat ovarian cancer. This surgery removes the uterus, cervix, both ovaries and both Fallopian tubes.
Ovarian cancer spreads by seeding cancer cells throughout the abdomen and pelvis. Reducing the amount of cancer left behind after surgery improves a woman’s prognosis.
Primary surgical debulking (also called cytoreductive surgery) removes as much of the ovarian tumour as possible during the first surgery to treat ovarian cancer. The goal is to reduce any remaining ovarian tumours to less than 1 cm. Primary surgical debulking may include:
The surgeon may also place a catheter in the abdominal wall so that chemotherapy drugs can be given directly into the abdominal cavity (intraperitoneal or IP chemotherapy).
Interval debulking surgery may be done after 2–4 cycles of chemotherapy, if the ovarian cancer responded to the drugs. It may be offered to women:
A salpingo-oophorectomy removes the ovary and Fallopian tube. Salpingo-oophorectomy may be bilateral (the ovaries and Fallopian tubes on both sides are removed) or unilateral (only one ovary and one Fallopian tube on one side are removed).
A cystectomy is removal of a cyst. This type of surgery may be done in women who have some early stage tumours in one ovary and a cyst in the other ovary and who want to have children in the future.
Some surgical procedures may be done to reduce symptoms and relieve pain from advanced or metastatic ovarian cancer:
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