PhD defence G.M. (Gatske) Nieuwenhuyzen - de Boer

Below is a brief summary of the dissertation:

In 2021, 1238 Dutch women were diagnosed with ovarian cancer. More than 75% of these women were diagnosed with an advanced stage disease: metastases were found throughout the whole abdominal cavity (FIGO stage III) or even outside the abdominal cavity (FIGO stage IV). In FIGO stage III-IV ovarian cancer, the 1-year survival rate is 74% and the 5-year survival rate is 38%. Of all Dutch women, 1% die of ovarian cancer. This makes ovarian cancer the deadliest gynecologic malignancy in the Netherlands (https://iknl.nl/kankersoorten/eierstokkanker/registratie/).

The survival gain for women with advanced stage ovarian cancer (≥FIGO stage IIB) is mainly found in women in whom complete cytoreductive surgery (CRS) can be achieved. This means that all visible tumor in the abdomen is removed. In recent years, it became increasingly clear that there are large differences in overall survival between those women in whom all disease could be removed and those in whom minimal disease (less than 1 cm) remained after surgery. Therefore, surgical teams are committed to removing all disease in every woman, even from difficult sites and precarious surfaces such as the bowel, the small bowel and the diaphragm.

This thesis first aims to answer the question whether the likelihood of complete cytoreductive surgery (CRS) can be safely increased by using the PlasmaJet as a new surgical device. The second part of this thesis focuses on the predictive value of the tumor marker CA125 and the assessment of the CT scan for achieving a CRS.