Dr. Fowler on Patient Eligibility for Cytoreductive Surgery in Ovarian Cancer

Jeffrey M. Fowler, MD, professor of gynecologic oncology, The Ohio State University Comprehensive Cancer Center—–James, discusses patient eligibility for cytoreductive surgery in newly diagnosed ovarian cancer.

The first decision makers that physicians make when a patient is referred with advanced-stage ovarian cancer is the age of the patient and whether the age is a critical variable. Technically, there is no an age limit to be able to undergo surgery, but some physicians only conduct surgery upon patients ≤65 years old of age or patients ≤75 years of age. However, it is age combined with what a patient’s performance status is or is not that can also affect the decision. Anesthesia risk score is another important variable, as well as other findings that may give hints of how aggressive physicians have to perform be with surgery.

If a patient is in good health and there is a reasonable opportunity for optimal cytoreductive surgery, the approach is to take that patient for primary cytoreductive surgery. If they have risk factors that would predict higher incidence adverse events or 30-day mortality, thoseare the patients should start with neoadjuvant chemotherapy with the goal of an interval cytoreductive surgery, concludes Fowler.