Neoadjuvant Chemotherapy vs. Primary Surgery for Advanced Ovarian Cancer

Neoadjuvant chemotherapy followed by interval debulking was not inferior to the standard therapy of primary surgery followed by chemotherapy.

Standard therapy for advanced ovarian cancer consists of primary debulking surgery followed by chemotherapy. But some patients present with clinical features (e.g., extensive comorbid conditions, poor performance status, radiologically determined unresectable disease) that can preclude surgical intervention. Neoadjuvant therapy before cytoreductive surgery has been studied; however, a meta-analysis involving 835 patients showed that neoadjuvant chemotherapy was associated with worse prognosis (Gynecol Oncol 2006; 103:1070).

Now, investigators randomized 670 patients with stage IIIC or IV epithelial ovarian, fallopian, or peritoneal cancer to primary debulking surgery followed by platinum-based chemotherapy or to 3 cycles of platinum-based ne…

Reviewing Author

Susana M. Campos, MD, MPH