In stage III ovarian cancer patient with upper abdominal disease < 5cm, management of choice is
Management of Advanced stage diseaseIncludes stage III and IVDebulking surgery versus neoadjuvant chemotherapy followed by Postoperative chemotherapyPrimary cytoreduction surgery is the preferred in1. Retroperitoneal only disease preoperatively 2. Patients with stage IIIC or IV disease with good performance status who have < 5cm upper abdominal disease 3. Patients who are considered ideal for intraperitoneal chemotherapy if optimally reducedNeoadjuvant chemotherapy and interval debulking surgery is preferred in1. Patients with bulky upper abdominal peritoneal disease >5cm in diameter2. Medically unfit for surgeryPostoperative chemotherapySystemic chemotherapy with 6 cycles of carboplatin and paclitaxelPostoperative radiotherapy1. Not effective compared to chemotherapy2. Used clear cell or mucinous carcinomasMAINTENANCE THERAPY1. No role after the complete clinical response 2. Drugs used: 3month or 12month paclitaxel every 28days
Debulking surgery
Mantle cell irradiation
Abdomino-pelvic radiotherapy
Neo-adjuvant chemotherapy
Gynaecological oncology