Multidisciplinary Surgical Approach for Advanced Ovarian Can
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A study showed that the use of multidisciplinary (MDT) surgical teams resulted in significantly improved rates of complete resection of cancer.

This report by Annals of Surgical Oncology aims to describe changes in complete cytoreduction rates and morbidity after the implementation of a multi-disciplinary surgical team comprising gynecologic oncologists as well as colorectal, hepatobiliary, and upper GI surgeons.

The study used two cohorts. Cohort A was retrospectively and Cohort B was a prospectively collated cohort of patients. A multidisciplinary approach to preoperative medical optimization, intraoperative management, and postoperative care was implemented. The patients in cohort B with the upper abdominal disease were offered primary cytoreduction with or without hyperthermic intraperitoneal chemotherapy (HIPEC). The patients with the upper abdominal disease received neoadjuvant chemotherapy (cohort A).

This study included 146 patients in cohort A and 93 patients in cohort B with stages 3 or 4 ovarian cancer.

--The overall complete macroscopic resection rate (CC0) increased from 58.9 in cohort A to 67.7% in cohort B.

--The rate of primary cytoreductive surgery (CRS) increased from 38 in cohort A to 42% in cohort B.

--The CC0 rate for the patients who underwent primary CRS increased from 49 in cohort A to 77% in cohort B.

--Major morbidity remained stable throughout both study periods.

Conclusively, implementation of a multidisciplinary team intraoperative approach and a meticulous approach to preoperative optimization resulted in significantly improved complete resection rates, particularly for women offered primary CRS.

Source: https://doi.org/10.1245/s10434-020-09494-3
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