Would you recommend surgery or stereotactic radiation therapy for a young woman with high-grade serous ovarian cancer presenting with a pelvic LN oligometastasis following maintenance therapy?
In general, do you tend to favor surgery or radiation for an oligometastatic recurrence of high-grade ovarian cancer that occurs >12 months from platinum-based therapy?
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Like OM, the principle for other cancer favors SBRT as has excellent local control and low morbidity
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I don't know that we know whether one option is better than the other for local management of oligometastatic disease.
We generally discuss these cases in tumor board and consider both local therapy options based on location of tumor, proximity to normal OARs, patient preference, etc.
Sometimes a lymph node medial to say EI vessels in close proximity to a lot of what appears to be immobile small bowel may be better off with surgery.
However, most cases generally are in a location that is less amenable to surgery (say posterolateral to vasculature) OR in a patient with at least one, if not multiple open abdominal surgeries, and some form of radiation is recommended.
If radiation is the path chosen, I think 35-50Gy in 5 is good for locations...
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