Dr. Karam on Primary Debulking Surgery Versus Neoadjuvant Chemotherapy in Ovarian Cancer

Amer Karam, MD, associate clinical professor, Gynecologic Oncology, Stanford Hospital, director, Robotic Surgery and Outreach, Division of Gynecologic Oncology, Stanford Medicine, discusses primary debulking surgery versus neoadjuvant chemotherapy in the treatment of patients with ovarian cancer.

In the United States and specifically at Stanford Medicine, physicians believe that primary debulking surgery should be the standard of care for eligible patients with advanced ovarian cancer. The goal of the surgery, says Karam, is to achieve microscopic residual disease.

Patients who are too ill, frail, or have extensive disease that prevents them from being eligible to undergo surgery, should be offered neoadjuvant chemotherapy, states Karam. Though there is some debate over the superiority of these approaches, Karam states that every patient who is eligible to undergo primary debulking surgery should be offered the procedure. The ongoing TRUST trial will compare the use of primary debulking surgery to neoadjuvant chemotherapy and help settle the debate of whether primary debulking surgery should be the standard of care for these patients.