Dr. Karam on the Role of Debulking Surgery in Recurrent Ovarian Cancer

Amer Karam, MD, gynecologic oncologist, medical oncologist, obstetrician, and gynecologist (OB-GYN), clinical professor, Obstetrics & Gynecology, Gynecologic Oncology, Stanford Health Care, discusses determining whether to use debulking surgery after recurrence in ovarian cancer.

When patients with ovarian cancer recur, the question of whether another procedure to debulk the cancer would be helpful led to the development several clinical trials, Karam says. Moreover, retrospective examination indicated an advantage for interval or secondary cytoreductive surgery in this patient population, Karam explains. This led to 5 groups developing randomized clinical trials to examine this topic, Karam adds. However, 2 of the earlier clinical trials failed to accrue enough patients, so 3 trials studied the topic, Karam says. These 3 trials include the United States–based GOG-0123 study (NCT00565851), the German-based DESKTOPIII study (NCT01166737), and the Shanghai-based SOC-1 study (NCT01611766), Karem says.

The 3 trials were multi-institutional, Karam continues. The trials randomized patients with recurrent platinum-sensitive ovarian cancer to a secondary cytoreductive surgery followed by chemotherapy or salvage chemotherapy without surgery, Karem concludes.