Interval debulking surgery for advanced epithelial ovarian cancer

Multiple Cycles of Neoadjuvant Chemotherapy Associated With Poor Survival in Bulky Stage IIIC and IV Ovarian Cancer

“…12 So PDS remains the standard care for advanced EOC, whereas NACT-IDS had been advocated as a management strategy for patients in a worse performance status, with stage IV, or heavy tumor burden. 13,17 Although the results of randomized clinical trial by Vergote et al 9 showed equivalent survivals for NACT-IDS and PDS, many other studies have shown the inferiority of the survival of NACT-IDS compared to PDS.…”

“…10,11 Moreover, there was no conclusive evidence to determine whether NACT would improve or decrease survival rates in patients with advanced EOC. 12,13 In a later study, van Meurs et al 14 and stated that stage IIIC patients with metastatic tumors 45 mm or less benefited more from primary surgery, whereas stage IV patients with metastatic tumors greater than 45 mm benefited more from NACT. In China, to date, there were only 2 published data focused on NACT in patients with ovarian cancer, from which we could not draw confirmative conclusion. 15,16 Given the controversy on NACT's benefits, we performed a single institute, retrospective study on stage IIIC and IV EOC patients with extensive upper abdominal disease to compare multiple cycles of NACT with no more than 1 cycle of NACT.…”

A framework for a personalized surgical approach to ovarian cancer

“…Retrospective meta-analytical data suggested that NACT was associated with a worse outcome compared with primary debulking [14]. Recently, however, the results of two randomized controlled, prospective trials conducted by the European Organization for Research and Treatment of Cancer (EORTC) and the Medical Research Counsel (MRC) Clinical Trials Unit have investigated the potential utility of neoadjuvant chemotherapy as it compares to primary cytoreduction among patients with stage III or IV ovarian cancer [15, 16].…”

Serum CA125 and HE4 levels as predictors for optimal interval surgery and platinum sensitivity after neoadjuvant platinum-based chemotherapy in patients with advanced epithelial ovarian cancer

“…In the advanced stage, many patients have multiple peritoneal locations, making it difficult to completely debulk the tumours in these patients. Based on numerous recent studies, NAC appears to be a valuable option for patients who cannot undergo surgery with optimal cytoreduction performed on them [ 14 , 15 ]. An optimal surgical outcome is one of the most powerful determinants of survival [ 13 ].…”