Christina Fotopoulou, MD, Imperial College London, London, United Kingdom, discusses the complexities of surgery for stage IV ovarian cancer patients at the ESMO Gynaecological Cancers Congress 2024 in Florence, Italy. She highlights that not all stage IV patients are the same, with some having extensive extra-abdominal disease and distant metastases making them inoperable, while others benefit from adjuvant chemotherapy before surgery. Improved imaging now identifies more patients with sub-centimeter PET-positive lymph nodes, raising questions about their significance and the necessity of preoperative PET-CT scans. Prof. Fotopoulou emphasizes the importance of macroscopic tumor clearance and the role of systemic chemotherapy. She also presents guidelines for determining inoperability to avoid unnecessary surgeries, stressing that specialized teams with adequate expertise and infrastructure should manage these patients. This interview took place at the ESMO Gynaecological Cancers Congress 2024 in Florence, Italy.
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