A Study Comparing Perioperative Stress Reduction vs. Standard of Care in Ovarian Cancer (PRESERVE)

Inclusion Criteria:

• Advanced (stage II-IV) epithelial ovarian, fallopian tube, or primary peritonealcarcinoma diagnosed on the basis of imaging, CA125, and clinical assessment

• Scheduled to undergo exploratory laparotomy and PDS or IDS

• Scheduled for surgery with at least 10 days of lead time, to allow the participantto take the β-blocker and COX2 inhibitor 7 days preoperatively

• Age ≥18 years

• ASA score of 1 to 3

• Ability to understand the study objectives and procedures, comply with the protocol,and provide informed consent

Exclusion Criteria:

• Chronic treatment with any β-blocker or COX inhibitor

• Contraindication for β-blocker therapy (asthma, second- or third-degreeatrioventricular block, sinus bradycardia, sick sinus syndrome, right-sided heartfailure, pheochromocytoma, peripheral vascular disease)

• Contraindication for COX2 inhibitor therapy (renal failure [creatinine level >1.5mg/dL], significant liver failure [known cirrhosis, bilirubin level >2], activepeptic disease), or current use of oral anticoagulant)

• Contraindication for regional epidural anesthesia

• Chronic autoimmune disease

• Active infection

• Pregnant

• Minimally invasive procedure

• Participation in another clinical trial that interferes with this study