Primary Debulking Surgery Versus Interval Debulking Surgery in the Management of Advanced-Stage Ovarian Cancer

The improved overall survival rates associated with advanced-stage ovarian cancer primarily reflect the surgeon's capacity to remove all residual disease following either primary debulking surgery (PDS) and chemotherapy or via neoadjuvant chemotherapy and interval debulking surgery (IDS). The aim of this study was to compare the survival rates in ovarian cancer following either PDS or IDS.

We conducted an extensive PubMed search incorporating review articles, retrospective studies, and randomized control trials on the topic of ovarian cancer, with specific terms that included ovarian cancer, PDS, IDS, overall survival, and intraoperative outcomes.

While several investigations have indicated that PDS and IDS confer equivalent survival outcomes, additional results suggested that PDS is associated with improved survival compared to IDS, especially in patients amenable to a gross total resection.

Despite the reportedly similar overall survival outcomes in ovarian cancer, IDS is indicated with elderly or frail patients and in the presence of significant co-morbidities; alternatively, PDS may be preferable in ovarian cancer cases wherein an upfront gross total resection can be readily achieved.