Introduction/Background Despite the development of new targeted therapies for patients with ovarian cancer, surgery remains a fundamental cornerstone in its treatment, particularly in the management of recurrences. Our objective is to present a highly complex surgical case managed multidisciplinary, from the surgical indication to postoperative care.

Methodology A 61-year-old patient was suspected of ovarian recurrence with 21 months of disease-free survival after completing her first-line treatment of NACT+IDS+Adjuvant chemotherapy (CBDCA AUC 6 + TAXOL 175mg/m2) + iPARP maintenance due to advanced stage high-grade serous ovarian cancer. HRD: BRCA1.

In PET/CT, a 25mm lesion with SUV max 9.87 was observed in segments IV-V of the liver, in contact with the hepatic ilium and cava vein. A second hypermetabolic lesion was identified in segment IV without morphologic translation. Retrocaval lymph node metastasis was also reported. The multidisciplinary tumor board considered the patient for a secondary cytoreduction due to high probabilities of complete cytoreductive surgery. Double hepatic segmentectomy assisted with ICG was performed and recorded by an open approach in 320min with an estimated blood loss of 350ml (Paraaortic cytoreduction was also performed, not recorded).

Results The patient was discharged four days after surgery and Clavien-Dindo II wound seroma was recorded postoperatively. Pathological results confirmed HGSC in both liver resections and para-aortic lymphadenectomy.

Conclusion Recurrences with high surgical risk are common in patients with advanced ovarian cancer. Complete resection may be feasible in some cases, with a benefit in overall survival. Multidisciplinary management is essential in the effort for disease chronification, considering quality of life.

Disclosures No.