A multidisciplinary approach for complete cytoreduction after neoadjuvant chemotherapy in advanced-stage ovarian cancer: a case report

Abstract

Background. The Portuguese standardized incidence rate of ovarian cancer is 9.5/10,000 women, with 75% of cases diagnosed at an advanced-stage. Present-ing 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 adenocarcino-ma of the ovary. A cytoreductive interval surgery was performed after neoadju-vant 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 multidis-ciplinary surgical coordination is the key to achieving this goal.