Diagnosis and Management of Peritoneal Metastases from Ovarian Cancer

Table 1

Indications for surgery in ovarian cancer.

(i) Diagnostic laparotomy or laparoscopy	Exploration performed at any time in the course of ovarian cancer to obtain a histological diagnosis.
	A second-look surgery is performed in patients who are clinically, biochemically, and radiologically free of disease after completion of chemotherapy with the purpose to confirm the response status.
(ii) Staging laparotomy	Surgery performed in patients with clinically early ovarian cancer aiming at the detection of tumor spread.
(iii) Primary cytoreductive surgery	Surgery with the aim of complete resection of all macroscopic tumor in patients with first diagnosis of advanced ovarian cancer before any other treatment (e.g., chemotherapy).
(iv) Secondary surgery/Interval debulking	Surgery performed in patients usually after 3 cycles of chemotherapy, with an attempt to remove any remaining tumor, which has not been eradicated by chemotherapy.
(v) Surgery for progressive ovarian cancer	Surgery with the purpose of removing obviously resistant tumors, which have not responded to chemotherapy and progressed during primary chemotherapy.
(vi) Surgery for recurrent ovarian cancer	Surgery aiming for complete resection for all macroscopic tumor in patients with recurrent ovarian cancer after completion of primary therapy including a subsequent period without any signs of disease.
(vii) Palliative surgery	Surgery performed in patients with symptoms caused by progressive disease or sequelae aiming to relieve symptoms and not towards survival prolongation.