What types of surgery treat ovarian cancer?

The first step in treating ovarian cancer is surgery to remove as much of the cancerous growth as possible and any tissue to which the cancer has spread.

Often, this involves the removal of one or both ovaries, as well as one or both fallopian tubes (the tubes that connect the ovary to the uterus). The removal of one ovary and fallopian tube is called a unilateral (one side) salpingo-oophorectomy, and the removal of both ovaries and fallopian tubes is called a bilateral (two sides) salpingo-oophorectomy.

Often, the surgeon removes the uterus (hysterectomy) and the omentum (the fatty lining of the abdominal cavity), where this type of cancer tends to spread (omentectomy).

The surgeon will also check your lymph nodes (small organs that fight infection and disease) for signs of disease and may take tissue samples from various places in your abdominal cavity to check for cancer cells.

It is important to take out as much of the tumor as possible, a procedure called "tumor debulking," because it is associated with increased rate of survival.

After surgery for ovarian cancer, your doctor will typically recommend six cycles of chemotherapy administered every three to four weeks, followed by a rest period between cycles.
Barbara A. Goff, MD
Gynecologic Oncology

Surgery is very important for the diagnosis and treatment of ovarian cancer. If you have a suspected ovarian cancer it is very important that you receive treatment from a gynecologic oncologist, a surgeon with special training in the treatment of gynecologic cancers, including ovarian cancer.

If you have a concerning ovarian mass then your surgeon will perform either a laparoscopy (small incisions using a camera) or a laparotomy (large incision) to remove the mass. If it is found to be cancerous at the time of surgery then it is important that a staging operation be performed to remove lymph nodes in the pelvis and the abdomen and removal of the omentum. In women who are found to have spread of the tumor at the time of surgery it is very important to have a surgeon that knows how to remove all of the cancer as the survival rates are much better if the surgeon can remove all of the visible tumor. When patients have advanced ovarian cancer often there needs to be removal of a portion of the small or large intestine, the diaphragm, the rectum, bladder and or spleen. This type of surgery is called radical cytoreduction and it is extremely important, as the cure rates are twice as high for women when the surgeon can remove the entire cancer.

Surgery is usually the primary treatment for ovarian cancer. "Debulking" is the process during surgery to remove as much of the tumor mass as possible. Surgery usually involves removing both ovaries (oophorectomy) and sometimes other reproductive organs, such as the uterus (hysterectomy) and fallopian tubes (salpingectomy), to help prevent the cancer from recurring. It is widely known that the initial surgery and the extent of debulking have a significant effect on survival when an ovarian cancer patient has her initial surgery. The skill, training, and expertise of the surgeon directly affect survival.

Other surgical options are removing the fallopian tubes with the ovaries (salpingo-oophorectomy) or removing the lymph nodes (lymphadenectomy).

Surgical procedures include:
  • Open surgery: An incision a few inches in length is made in the lower abdomen to provide access to the reproductive organs. Hospital stays typically run three to seven days, and patients can resume normal activities after one month or so.
  • Laparoscopy: This minimally invasive procedure can be performed to remove some cancers. It involves only a few very small incisions to allow a viewing scope, camera, and special surgical instruments to be inserted to perform the surgery. Pain and recovery time are greatly reduced with minimally invasive procedures.

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