Dr. Boisen on Neoadjuvant Chemotherapy Versus Upfront Surgery in Ovarian Cancer

Michelle M. Boisen, MD, assistant professor, Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh Medical Center, discusses the selection of neoadjuvant chemotherapy versus upfront surgery for women with newly diagnosed ovarian cancer.

In the past decade, data from randomized trials comparing upfront surgical resection with neoadjuvant chemotherapy have shown a lower mortality rate in patients who undergo neoadjuvant chemotherapy prior to surgery, says Boisen.

However, additional investigation is needed to determine the relative impact of neoadjuvant chemotherapy versus surgery on a patient’s long-term prognosis.

Prospective studies suggest that outcomes with neoadjuvant chemotherapy and upfront surgical resection are similar; however, the extent of the surgery performed in clinical trials has not been standardized, says Boisen.

In practice, surgery should be pursued for fit patients with newly diagnosed disease who are able to undergo an optimal debulking surgery, concludes Boisen.