Ovarian Cancer Treatment in Istanbul
Ovarian cancer is the most lethal gynecologic malignancy. Istanbul JCI-accredited centers provide state-of-the-art treatment including HIPEC, PARP inhibitors, and bevacizumab.
Treatment
- Primary surgery: Primary debulking surgery (PDS) or interval debulking surgery (IDS) after neoadjuvant chemotherapy. Complete cytoreduction (R0) is the most important prognostic factor
- First-line chemotherapy: Carboplatin+paclitaxel × 6 cycles. Bevacizumab addition for stage III/IV and clear cell histology
- Maintenance after response: BRCA1/2 mutation → olaparib (SOLO-1: 60% reduction in progression risk). HRD positive → niraparib or olaparib
- Recurrent: Platinum-sensitive: carboplatin-based ± bevacizumab ± PARP inhibitor. Platinum-resistant: pegylated liposomal doxorubicin, gemcitabine, topotecan
PARP INHIBITORS — REVOLUTION IN OVARIAN CANCER
For BRCA-mutated ovarian cancer, olaparib maintenance after first-line chemotherapy reduces recurrence risk by 60% (SOLO-1 trial, 2018). All ovarian cancer patients should be tested for BRCA1/2 and HRD.
Cost
Debulking surgery + HIPEC Istanbul: $18,000-35,000 vs $80,000-200,000 USA. Olaparib maintenance (1 year): $15,000-25,000 vs $80,000-150,000 USA.