Surgical resection outcome depends on ovarian cancer type

A new paper shows the survival benefit associated with complete resection in ovarian cancer is histotype-specific: July 2024

Complete removal of all visible cancer during surgery is a key determinant of survival in ovarian cancer patients.

However, much of the evidence supporting this derives from the most common type of ovarian cancer, called ‘high grade serous’ ovarian cancer. Other types of ovarian cancer are now known to be distinct clinical and molecular diseases, and the relative survival benefit of successful surgery in these other types is poorly understood.

Extensive surgical efforts and resources are often needed to achieve so-called ‘complete resection’ of ovarian cancer, and these extensive procedures can be associated with significant treatment-related medical problems in patients.

Knowing which patients benefit most from complete resection is important for prioritising these extensive surgical procedures to those patients for who it will provide the most benefit, and to inform risk-benefit analysis for clinical decision making.

A new study led by the laboratory of Dr Robb Hollis at Edinburgh Cancer Research, part of the Institute of Genetics and Cancer, in collaboration with colleagues at the Edinburgh Royal Infirmary and Institute for Regeneration and Repair, highlights specific groups of ovarian cancer patients for who achieving complete surgical resection is critically important for an improved long-term outcome.

In high grade serous ovarian cancer, complete resection is associated with around a 50% reduction in overall risk for patients. However, the reduction in risk appears to differ substantially in the other less common types.

In a type called ‘low grade serous’ ovarian cancer, the reduction in risk is around 80-85% for patients who are diagnosed with disease that has spread beyond the ovary. Similarly, in two other types – ‘endometrioid’ and ‘clear cell’ ovarian cancer, the reduction in risk is around 60-75%.

This work highlights specific groups of ovarian cancer patients for whom achieving complete surgical resection is critically important for improved long-term outcome. Our findings suggest that extensive surgical efforts are warranted in these patient groups, and that radical surgical approaches should be prioritised for these patients in order to maximise the chances of favourable clinical outcomes.

Links

Article in JNCI Cancer Spectrum: https://doi.org/10.1093/jncics/pkae049

Dr Robert Hollis group website: https://www.ed.ac.uk/cancer-centre/research/hollis-group