{"id":687,"date":"2026-05-07T11:53:00","date_gmt":"2026-05-07T10:53:00","guid":{"rendered":"https:\/\/services.nhslothian.scot\/gynaecology\/?page_id=687"},"modified":"2026-05-07T11:53:48","modified_gmt":"2026-05-07T10:53:48","slug":"interval-cytoreductive-surgery-ics-for-ovarian-cancer","status":"publish","type":"page","link":"https:\/\/services.nhslothian.scot\/gynaecology\/interval-cytoreductive-surgery-ics-for-ovarian-cancer\/","title":{"rendered":"Interval Cytoreductive Surgery (ICS) for ovarian cancer"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Some patients with advanced ovarian cancer are offered interval cytoreductive surgery (ICS) as part of their treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">ICS is surgery performed after a period of chemotherapy, once we have assessed how the cancer has responded. This approach is used when starting treatment with chemotherapy is the safest or most effective option, and surgery is planned at a later stage.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Not all patients are suitable for ICS. The decision is individual and made carefully with you.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Why interval cytoreductive surgery may be recommended<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The main aim of ICS is to safely remove all visible cancer. The amount of cancer left behind after surgery is one of the most important factors influencing outcomes in ovarian cancer.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Studies have consistently shown that:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients with no visible disease remaining after surgery tend to live longer<\/li>\n\n\n\n<li>They also tend to have a longer period before the cancer returns<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">For this reason, surgery is often recommended when it is safe to aim for complete tumour removal. ICS allows chemotherapy and surgery to be combined in a planned, staged way to maximise benefit while maintaining safety.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">When interval cytoreductive surgery is performed ICS is most commonly considered after three cycles of chemotherapy, but in some situations it may be planned later after an in depth team review. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The timing of surgery depends on:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>How the cancer is responding to chemotherapy<\/li>\n\n\n\n<li>What is seen on scans and blood tests<\/li>\n\n\n\n<li>Whether surgery is technically achievable and safe<\/li>\n\n\n\n<li>Your overall health and recovery from chemotherapy<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">There is no fixed number of chemotherapy cycles that applies to everyone. The timing of ICS is discussed within the specialist multidisciplinary team and with you, with the aim of balancing the best chance of complete tumour removal with surgical safety.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What the surgery might involve<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Every operation is different. The exact extent of surgery depends on scan findings, response to chemotherapy, and what is found during the operation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Surgery commonly includes:<\/p>\n\n\n\n<div class=\"wp-block-media-text is-stacked-on-mobile is-image-fill-element has-light-accent-plum-background-color has-background\" style=\"grid-template-columns:41% auto\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"683\" src=\"https:\/\/services.nhslothian.scot\/gynaecology\/wp-content\/uploads\/sites\/106\/2026\/02\/pexels-rdne-6129689-1024x683.jpg\" alt=\"Women in bed looking at nurse\" class=\"wp-image-839 size-full\" style=\"object-position:50% 50%\" srcset=\"https:\/\/services.nhslothian.scot\/gynaecology\/wp-content\/uploads\/sites\/106\/2026\/02\/pexels-rdne-6129689-1024x683.jpg 1024w, https:\/\/services.nhslothian.scot\/gynaecology\/wp-content\/uploads\/sites\/106\/2026\/02\/pexels-rdne-6129689-300x200.jpg 300w, https:\/\/services.nhslothian.scot\/gynaecology\/wp-content\/uploads\/sites\/106\/2026\/02\/pexels-rdne-6129689-768x512.jpg 768w, https:\/\/services.nhslothian.scot\/gynaecology\/wp-content\/uploads\/sites\/106\/2026\/02\/pexels-rdne-6129689-1536x1024.jpg 1536w, https:\/\/services.nhslothian.scot\/gynaecology\/wp-content\/uploads\/sites\/106\/2026\/02\/pexels-rdne-6129689-2048x1365.jpg 2048w, https:\/\/services.nhslothian.scot\/gynaecology\/wp-content\/uploads\/sites\/106\/2026\/02\/pexels-rdne-6129689-1520x1013.jpg 1520w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p class=\"wp-block-paragraph\">Surgery commonly includes:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Removal of the uterus, cervix, ovaries, and fallopian tubes<\/li>\n\n\n\n<li>Removal of the omentum (a fatty layer inside the abdomen)<\/li>\n\n\n\n<li>Removal of areas of the abdominal lining affected by cancer<\/li>\n\n\n\n<li>Removal of lymph nodes if needed<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n<\/div><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">In some cases, more complex surgery is required. This may involve parts of the bowel, diaphragm, spleen, liver, stomach, or pancreas. If part of the bowel is removed, a stoma may be required. This can be temporary or permanent, depending on the situation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This is not a checklist. Only tissues affected by cancer are removed, and decisions during surgery are made carefully and in your best interests.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Benefits and risks<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">ICS is major abdominal surgery. While it can significantly improve survival and, in some cases, lead to long-term remission, it carries risks.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Common risks include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Bleeding or infection<\/li>\n\n\n\n<li>Blood clots in the legs or lungs<\/li>\n\n\n\n<li>Injury to nearby organs such as the bladder or bowel<\/li>\n\n\n\n<li>A longer recovery period<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">More serious complications occur in a minority of patients and may include bowel join leaks, infection within the abdomen, breathing problems, or the need for further surgery. These risks are always weighed carefully against the potential benefits of removing all visible cancer. Your team will discuss this balance openly and honestly with you.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">After interval cytoreductive surgery<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">After surgery, you are usually cared for initially in a high-dependency or closely monitored setting. This is routine for this type of operation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">You may have:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A urinary catheter<\/li>\n\n\n\n<li>Intravenous lines or a central line<\/li>\n\n\n\n<li>Specialist pain relief such as an epidural or spinal<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Most patients remain in hospital for around 7 to 14 days, depending on recovery and the extent of surgery. Recovery takes time, and support from nurses, physiotherapists, dietitians, and your Clinical Nurse Specialist is an important part of this process.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Results and next steps<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Tissue removed during surgery is examined by specialist pathologists. These results take time and are discussed at a multidisciplinary team meeting.<\/p>\n\n\n\n<div class=\"wp-block-media-text has-media-on-the-right is-stacked-on-mobile is-image-fill-element has-light-accent-grey-background-color has-background\"><div class=\"wp-block-media-text__content\">\n<p class=\"wp-block-paragraph\">You will be seen after surgery to:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Review the results<\/li>\n\n\n\n<li>Discuss what they mean for your treatment<\/li>\n\n\n\n<li>Decide whether further chemotherapy or other treatment is recommended<\/li>\n\n\n\n<li>Making your decision<\/li>\n<\/ul>\n<\/div><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"683\" height=\"1024\" src=\"https:\/\/services.nhslothian.scot\/gynaecology\/wp-content\/uploads\/sites\/106\/2026\/02\/pexels-olia-danilevich-5713623-683x1024.jpg\" alt=\"pexels olia danilevich 5713623\" class=\"wp-image-592 size-full\" style=\"object-position:52% 32%\" srcset=\"https:\/\/services.nhslothian.scot\/gynaecology\/wp-content\/uploads\/sites\/106\/2026\/02\/pexels-olia-danilevich-5713623-683x1024.jpg 683w, https:\/\/services.nhslothian.scot\/gynaecology\/wp-content\/uploads\/sites\/106\/2026\/02\/pexels-olia-danilevich-5713623-200x300.jpg 200w, https:\/\/services.nhslothian.scot\/gynaecology\/wp-content\/uploads\/sites\/106\/2026\/02\/pexels-olia-danilevich-5713623-768x1152.jpg 768w, https:\/\/services.nhslothian.scot\/gynaecology\/wp-content\/uploads\/sites\/106\/2026\/02\/pexels-olia-danilevich-5713623-1024x1536.jpg 1024w, https:\/\/services.nhslothian.scot\/gynaecology\/wp-content\/uploads\/sites\/106\/2026\/02\/pexels-olia-danilevich-5713623-1365x2048.jpg 1365w, https:\/\/services.nhslothian.scot\/gynaecology\/wp-content\/uploads\/sites\/106\/2026\/02\/pexels-olia-danilevich-5713623-760x1140.jpg 760w, https:\/\/services.nhslothian.scot\/gynaecology\/wp-content\/uploads\/sites\/106\/2026\/02\/pexels-olia-danilevich-5713623-scaled.jpg 1707w\" sizes=\"auto, (max-width: 683px) 100vw, 683px\" \/><\/figure><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">You will be seen after surgery to:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Review the results<\/li>\n\n\n\n<li>Discuss what they mean for your treatment<\/li>\n\n\n\n<li>Decide whether further chemotherapy or other treatment is recommended<\/li>\n\n\n\n<li>Making your decision<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Whether to proceed with ICS is entirely your choice. You will be supported whichever option you choose.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">We encourage you to:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Take time to think about the information<\/li>\n\n\n\n<li>Write down questions<\/li>\n\n\n\n<li>Discuss concerns with your clinical team or Clinical Nurse Specialist<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Further trusted patient information and support is available via ovarian cancer charities such as <a href=\"https:\/\/www.ovacome.org.uk\/\">Ovacome<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you would like to talk further about interval cytoreductive surgery, please let your team know \u2014 we are very happy to discuss this again with you<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Some patients with advanced ovarian cancer are offered interval cytoreductive surgery (ICS) as part of their treatment. ICS is surgery performed after a period of chemotherapy, once we have assessed how the cancer has responded. This approach is used when starting treatment with chemotherapy is the safest or most effective option, and surgery is planned<\/p>\n","protected":false},"author":354,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-templates\/widewidth.php","meta":{"footnotes":""},"categories":[],"class_list":["post-687","page","type-page","status-publish","hentry"],"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"simonlloyd","author_link":"https:\/\/services.nhslothian.scot\/gynaecology\/author\/simonlloyd\/"},"rttpg_comment":0,"rttpg_category":false,"rttpg_excerpt":"Some patients with advanced ovarian cancer are offered interval cytoreductive surgery (ICS) as part of their treatment. ICS is surgery performed after a period of chemotherapy, once we have assessed how the cancer has responded. This approach is used when starting treatment with chemotherapy is the safest or most effective option, and surgery is planned","_links":{"self":[{"href":"https:\/\/services.nhslothian.scot\/gynaecology\/wp-json\/wp\/v2\/pages\/687","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/services.nhslothian.scot\/gynaecology\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/services.nhslothian.scot\/gynaecology\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/services.nhslothian.scot\/gynaecology\/wp-json\/wp\/v2\/users\/354"}],"replies":[{"embeddable":true,"href":"https:\/\/services.nhslothian.scot\/gynaecology\/wp-json\/wp\/v2\/comments?post=687"}],"version-history":[{"count":8,"href":"https:\/\/services.nhslothian.scot\/gynaecology\/wp-json\/wp\/v2\/pages\/687\/revisions"}],"predecessor-version":[{"id":1154,"href":"https:\/\/services.nhslothian.scot\/gynaecology\/wp-json\/wp\/v2\/pages\/687\/revisions\/1154"}],"wp:attachment":[{"href":"https:\/\/services.nhslothian.scot\/gynaecology\/wp-json\/wp\/v2\/media?parent=687"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/services.nhslothian.scot\/gynaecology\/wp-json\/wp\/v2\/categories?post=687"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}