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Systematic reviews

Open Access Special Issue

Liver surgery for advanced ovarian cancer: a systematic review of literature

  • Sara Forte1,*,†,
  • Federico Ferrari2,†
  • Gaetano Valenti3
  • Vito Andrea Capozzi4
  • Beatriz Navarro Santana5
  • Guillaume Babin1
  • Frédéric Guyon1

1Department of Surgery, Bergonié Institute Comprehensive Cancer Center, 33000 Bordeaux, France

2Department of Obstetrics and Gynecology, Spedali Civili Brescia, 25123 Brescia, Italy

3Department of Obstetrics and Gynecology, Umberto Primo Hospital, 94100 Enna, Italy

4Department of Gynecology and Obstetrics, University of Parma, 43126 Parma, Italy

5University of Las Palmas de Gran Canaria, 35320 Las Palmas, Spain

DOI: 10.31083/j.ejgo4301015 Vol.43,Issue 1,February 2022 pp.64-72

Submitted: 18 October 2021 Accepted: 24 November 2021

Published: 15 February 2022

(This article belongs to the Special Issue Surgery for Gynecological Cancer: Current Evidences and Perspectives)

*Corresponding Author(s): Sara Forte E-mail:

† These authors contributed equally.


Objective: To analyze the surgical treatment of liver metastases from advanced ovarian cancer (AOC) during either primary or interval debulking surgery (PDS or IDS). Data sources, methods of study selection: A systematic research of the literature was conducted in Scopus, PubMed/MEDLINE, ScienceDirect and the Cochrane Library, including observational prospective, retrospective studies, case series and case reports. Tabulation, integration and results: We collected data regarding study features, characteristics of the patients and of liver metastasis, the type of surgical treatment and postoperative morbidity. The type of liver surgery was described according to the terminology of Brisbane 2000 (TB2000). Ten articles were selected, and 61 patients were included, even though data was not complete for all of them. The weighted average age was 57 years old, and most women underwent PDS (n = 21/32 [66%]). The number of liver metastases was available only for 17 patients including 3 (18%) and 14 (82%) with multiple and single lesions, respectively. Metastasis from peritoneal seeding (peritoneal metastasis) was the most common type of lesion (n = 27/42 [64%]). Only in one study the authors declared the specialty of the surgeon performing the procedures (hepatobiliary). Two studies (n = 15) adopted the TB2000 and reported as follow: 47% wedge resections, 33% segmentectomies, 13% hemi-hepatectomies and 7% right-trisegmentectomy. Clavien-Dindo grade III or greater complications was 13% (n = 2/15). Conclusions: Liver resection is feasible during either PDS or IDS. Single lesion and peritoneal metastasis represent the most common conditions. Wedge liver resection is the most frequent procedure. Prognostic advantage is suggested after liver surgery especially for peritoneal metastasis.


Advanced ovarian cancer; Cytoreductive surgery; Liver metastases resection; Hepatic surgery

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Sara Forte,Federico Ferrari,Gaetano Valenti,Vito Andrea Capozzi,Beatriz Navarro Santana,Guillaume Babin,Frédéric Guyon. Liver surgery for advanced ovarian cancer: a systematic review of literature. European Journal of Gynaecological Oncology. 2022. 43(1);64-72.


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