Résumé
Ovarian carcinoma remains the most lethal gynaecologic malignancy. Half of all high-grade serous ovarian cancers (HGSOCs) have a homologous recombination deficiency (HRD) with regard to the repair of double-strand DNA breaks and are candidate to receive maintenance treatment with PARP inhibitors. While a wealth of literature exists regarding the therapeutic guidance of patients from a medical standpoint, the influence of the HRD status on the surgical outlook has been comparatively limited. In this review, the clinical and biological features of advanced ovarian cancers with BRCA1/2 mutation and/or HRD status are considered with particular reference to their impact on the surgical management and on the medico-surgical sequence. The modification of the surgical indications according to the results of molecular testing in first-line and recurrent settings are discussed.
•HRD-associated EOC exhibit singular clinical and biological characteristics and a better response to systemic treatment.•The results of the molecular testing impact the surgical management of EOC in the first-line and recurrent settings.•Achieving complete resection remains crucial for HRD tumors despite better sensitivity to systemic chemotherapy and PARP inhibitors.•Patients with HRD-tumors seem to benefit most from HIPEC at the time of interval surgery.