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Treatment of choice is total abdominal hysterectomy and bilateral salpingo-oophorectomy with omentectomy.

After surgical debulking of tumor and a thorough evaluation of residual tumor, chemotherapy is the treatment of choice for maintaining a long disease-free interval.

After completion of chemotherapy (usually about 12 months after diagnosis) patients should undergo a second-look laparotomy to evaluate response to therapy. Intraperitoneal chemotherapy may be administered for microscopic tumor or small residual tumor bulk, or the patient may undergo whole-abdomen radiation.

Key word

Debulking--surgical removal of as much macroscopic ovarian tumor as possible in the pelvis and abdomen.

The principle behind debulking is to reduce the size of the largest residual tumor to less than 2.0 cm in greatest dimension so that the patient's total tumor mass is minimal. The effectiveness of postoperative adjuvant radiation and chemotherapy is increased when the tumor burden is smallest. Also called: tumor reduction surgery, cytoreductive surgery. Excludes: omentectomy alone, multiple lymph node samplings and biopsies of suspicious areas for staging purposes.

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