Background. Modern methods of treatment of late-stage ovarian cancer (III–IV) are based on the immediate and maximum surgical removal of all manifestations of the tumor process. However, in some cases, surgical treatment has to be performed after neoadjuvant chemotherapy. Differences in the effectiveness of treatment with both approaches are the subject of discussion in oncogynecology. Aim. Analysis of overall survival and progression-free survival in patients with late-stage ovarian cancer (IIIC–IVB) depending on the timing and optimality of cytoreductive surgery. Materials and methods. A retrospective analysis of 467 patients with stage III–IV ovarian cancer who received comprehensive treatment at the Primorsky Regional Oncological Dispensary in the period 2004–2021. Results. Significant advantages in overall survival and progression-free survival were in patients with ovarian cancer of stages IIIC–IVB, who underwent primary cytoreduction (PCR), compared with patients who underwent interval cytoreduction. With suboptimal PCR volume, the overall survival rate is significantly lower than with full or optimal PCR. There is a tendency to better OS and IBD in patients with PCR in full and optimal volume, compared with patients who underwent PCR in full or optimal volume. Neoadjuvant chemotherapy in patients with serous ovarian carcinoma of low-grade IIIC–IVB stages significantly worsens immediate and long-term treatment results. Conclusion. In patients with advanced ovarian cancer, performing primary cytoreduction in full or optimal volume is the main treatment. Neoadjuvant chemotherapy is justified only as a therapy of despair in severe general condition or extreme prevalence of the disease.
Zhurman et al. (Thu,) studied this question.
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