Debulking (cytoreductive surgery)
Surgery that removes as much tumour as possible when it cannot all be removed cleanly; leaving nothing visible behind is what matters.
Central to ovarian cancer, where survival tracks the residual disease after surgery: complete cytoreduction (no visible tumour) is the goal. Primary debulking is done first if feasible; otherwise three cycles of carboplatin-paclitaxel are followed by interval debulking (EORTC 55971, CHORUS). Secondary cytoreduction at platinum-sensitive relapse helps selected patients (DESKTOP III) but not unselected ones (GOG-0213). Cytoreductive surgery plus HIPEC is used for peritoneal disease from appendix, colorectal and ovarian cancers, and cytoreductive nephrectomy in kidney cancer.
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