Palliative surgery for ovarian cancer
INTRODUCTION The majority of patients with advanced ovarian cancer will experience recurrence and ultimately succumb to their disease. Therapies such as secondary cytoreduction and salvage chemotherapeutics may prolong life but are almost never curative. Recurrent ovarian cancer usually presents as intraperitoneal disease, which can result in symptomatic ascites, carcinomatous ileus, or bowel obstruction. Thus, many patients with recurrent disease will experience distressing symptoms of pain, abdominal distention, nausea, vomiting, and dyspnea. The surgeon caring for ovarian cancer patients is likewise faced with difficult decisions regarding potentially palliative procedures that may improve quality of life but which also carry the potential to cause significant morbidity and mortality. This chapter will outline the diagnostic evaluation and surgical management of patients with symptomatic advanced ovarian cancer.