Key Points

Cytoreductive surgery is one of the cornerstones of therapy for advanced-stage ovarian cancer. Complete tumor removal and microscopic residual disease seem to offer the best survival outcomes.

Secondary cytoreductive surgery should be reserved for patients with prolonged disease-free interval and localized disease.

Second-look surgery does not result in improved survival.

Accurate and complete surgical staging is the foundation of therapy for early-stage ovarian cancer.

Fertility sparing and minimally invasive surgery are often practicable in young women with early-stage ovarian cancer without untoward effects on survival.

Frozen-section analysis is accurate in the diagnosis of ovarian cancer but is less reliable in the diagnosis of borderline ovarian tumors.

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