PT - JOURNAL ARTICLE AU - Lu, F. Kayikçiog AU - Köse, M. F. AU - Boran, N. AU - Çalişkan, E. AU - Tulunay, G. TI - Neoadjuvant chemotherapy or primary surgery in advanced epithelial ovarian carcinoma AID - 10.1136/ijgc-00009577-200111000-00007 DP - 2001 Nov 01 TA - International Journal of Gynecologic Cancer PG - 466--470 VI - 11 IP - 6 4099 - http://ijgc.bmj.com/content/11/6/466.short 4100 - http://ijgc.bmj.com/content/11/6/466.full SO - Int J Gynecol Cancer2001 Nov 01; 11 AB - Neoadjuvant chemotherapy has been proposed as an alternative approach to conventional surgery as initial management of bulky ovarian cancer, with the goal of performing adequate debulking in the interval surgery. Two hundred five consecutive patients with advanced ovarian cancer were divided into two groups. Neoadjuvant chemotherapy followed by interval surgery was performed in 45 of 205 patients. The remaining 158 patients received primary surgery plus adjuvant chemotherapy. Optimal cytoreductive surgery rates were significantly higher in the neoadjuvant CT group (P< 0.001). In multivariate analysis, only residual tumor diameter and appendix involvement were found to affect total survival significantly in both groups. Five-year survival and median survival were not statistically different when all patients treated conventionally were compared with all patients treated with neoadjuvant chemotherapy. Primary chemotherapy followed by interval debulking surgery in a selected group of patients does not appear to worsen prognosis, but it permits less aggressive surgery and improves patients' quality of life.