debulking

Tumor removal begins, as with other approaches, by careful debulking.

Symptomatic patients may benefit from surgical debulking of the tumor.

Fractionated radiotherapy may be a better option ideally combined with surgical debulking.

Smaller disease volume prior to any surgical debulking.

Debulking of functional carcinomas may help reduce parathormone production.

So-called optimal debulking removes all tumors bigger than a centimeter in diameter, or 0.39 inches.

Following maximal surgical debulking, three to four courses of cisplatin-containing combination chemotherapy are indicated.

If disease is unresectable, surgical debulking will not improve survival; however, it is occasionally indicated for symptom palliation.

Debulking: In the debulking, or cytoreduction, phase of the procedure the surgeon will remove the visible tumor implants.

Surgery should include total abdominal hysterectomy and bilateral salpingo-oophorectomy with omentectomy and debulking of as much gross tumor as can safely be performed.

The role of surgical debulking for patients with either stage III or stage IVA disease is controversial.

Major cancer centers report that 80 percent of ovarian cancer patients have optimal debulking, but in hospitals that lack expertise the rate may be only 30 percent.

Heroic attempts at surgical debulking, however, are not indicated except for hepatic resection in patients with the carcinoid syndrome (see section on Carcinoid Syndrome).

Curative excision or palliative debulking of a tumor has potential to reduce pain directly, relieve symptoms of obstruction or compression, and improve prognosis, even increasing long-term survival.

When there is residual disease or elevated levels of alpha-fetoprotein or human chorionic gonadotropin after maximal surgical debulking, three or four courses of BEP combination chemotherapy are indicated.

For patients with stage IIIC epithelial ovarian adenocarcinomas who have undergone successful optimal debulking, a recent clinical trial demonstrated that median survival time is significantly longer for patient receiving "'intraperitoneal"' (IP) chemotherapy.

Debulking of the tumor is the next step and must be carefully performed so as to maintain the anterior portions of the capsule in order to prevent injury to cranial nerve VII and/or VIII.

Treatment is usually confined to such surgical intervention as may be necessary to help the child to develop e.g. jaw distraction/bone *rib* grafts, occular dermoid debulking (see below), repairing cleft palate/lip, repairing heart malformations, spinal surgery.