A multidisciplinary approach for complete cytoreduction after neoadjuvant chemotherapy in advanced-stage ovarian cancer: a case report
Background. The Portuguese standardized incidence rate of ovarian cancer is 9.5/10,000 women, with 75% of cases diagnosed at an advanced-stage. Presenting an illustrated description of a multidisciplinary surgical approach combining upper and lower abdominal debulking surgery reaching R0 after neoadjuvant chemotherapy in advanced ovarian cancer is the main objective of the presented case.
Case presentation. A 63-year-old patient presented with abdominopelvic pain and suspicious bilateral ovarian lesions. Diagnostic laparoscopy met the criteria for unresectability and tumour biopsy revealed high-grade serous adenocarcinoma of the ovary. A cytoreductive interval surgery was performed after neoadjuvant chemotherapy involving extensive resections of the upper abdomen. R0 was successfully achieved. At the 24-month follow-up, she is free of recurrence.
Conclusions. Maximal debulking is one of the main determinants of survival in advanced-stage ovarian cancer. Meticulous preoperative planning with multidisciplinary surgical coordination is the key to achieving this goal.