Ovarian Cancer Surgery — Heed This LION’s Roar

Most women with ovarian cancer will have metastatic disease at diagnosis, and their symptoms and survival will depend on whether their abdominal tumor can be controlled. Death from ovarian cancer most often occurs from progression of abdominal disease, as a result of either bowel obstruction or the consequences of malnutrition. Removal of all visible disease is the goal of primary cytoreduction and is consistently associated with improved survival in randomized trials. 1 The nonvisible, microscopic tumor that remains is targeted with subsequent chemotherapy. Pelvic and aortic lymph nodes that appear normal frequently harbor microscopic metastases. For several decades, considerable debate has . . .