Place de la chirurgie dans la prise en charge des récidives de cancers épithéliaux de l'ovaire

Recurrent ovarian cancer is unfortunately a very common situation. Surgery in these patients should be combined with the new available chemotherapy agents and targeted therapies. The management of these patients has changed considerably in recent years. In addition, these new therapeutic modalities raise the question of the best follow-up for these patients. In case of peritoneal recurrence, secondary cytoreductive surgery is to be discussed in patients with resectable peritoneal recurrence. To select patients who could benefit from this surgery, general condition of the patient, time from the end of treatment and initial surgery (potential morbidity) are to be taken into account. If surgery is performed, it must be macroscopically complete. Two major phase III trials (DESKTOP III and CHIPOR) are in progress to define the impact of surgery and CHIP. Exclusive lymph node recurrences, less frequent, are of better prognosis and are treated by secondary surgery and chemotherapy, or repeated surgery if the recurrence is still isolated.