Meigs to Modern Times: The Evolution of Debulking Surgery in Advanced Ovarian Cancer

摘要

This historical perspective provides context for the development cytoreductive surgery, and its current role in the treatment of advanced ovarian cancer. It discusses the visionary approach of Joe V. Meigs. In his classic1934 textbook "Tumors of the Female Pelvic Organs," Meigs presented a case cohort series of 67 women diagnosed with advanced ovarian cancer at his institution from 1901 to 1923. In an era long before adjuvant chemotherapy, he suggested benefits for maximal debulking, speculated about the benefits of minimally invasive surgery, and reported that the effects of " x-ray" treatment after debulking were mixed. In 1939, he insisted that radical surgery should include, when possible, removal of both of the ovaries, the uterus, the cervix, and peritoneal tumor tissue. Two years before his death, Meigs advocated in 1961 the use of hysterectomy and bilateral salpingooophorectomy except in young patients of childbearing age wishing to conceive.