Introduction/Background Ovarian cancer relapse is a challenge situation, that requires the evaluation of many clinical aspects with a multidisciplinary approach.
A recent randomized trial showed that cytoreductive surgery followed by chemotherapy in women with recurrent ovarian cancer, resulted in longer overall survival than chemotherapy alone.
Methodology The video shows step by step the technique of cytoreduction surgery in a patient with an ovarian cancer tumoral relapse at the level of the hepatic hilum.
The surgery has being performed by General surgeons and Gynecological Oncological surgeons at La Paz University Hospital, Madrid, Spain.
Results 53 years old patient who was diagnosed in February 2022 of endometrioid ovarian carcinoma G2. The patient was proposed for primary cytorreductive surgery. After complete cytorreduction, the final stage of the disease was IIIC stage.
Adjuvant treatment was administered based on a combination chemotherapy with paclitaxel plus carboplatin (6 cycles).
In February 2023 a recurrence was confirmed through PET-CT scan that showed a peritoneal nodule adjacent to hepatic hilium suggestive of tumoral tissue.
A complete cytoreductive surgery was performed:
The first step was the common hepatic artery dissection, followed by the common bile duct dissection as the second step. The third step was the portal vein dissection. After identification and dissection of all the hilium hepatic structures; the resection and removal of the tumoral relapsed was performed.
Conclusion Complete secondary cytoreduction surgery in relapsed ovarian cancer at hepatic hilium is feasible in selected patients with a multidisciplinary approach.
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