Dr. Barber on Chemotherapy Versus Surgery for Ovarian Cancer

Emma Barber, MD, UNC Department of Obstetrics and Gynecology, UNC School of Medicine, UNC Lineberger Comprehensive Cancer Center, discusses neoadjuvant chemotherapy versus surgery for patients with ovarian cancer.

Physicians tend to think of neoadjuvant chemotherapy as reserved for people who are not going to do well with surgery, cannot have a resection, and have no gross residual disease when the tumor is removed, state Barber.

In European randomized trials, the 2 approaches are surgery first, followed by chemotherapy, or chemotherapy first, followed by surgery, which have been shown to be equivalent. But in some patients with stage IIIC disease, even in those trials with patients with a smaller burden of disease, upfront surgery improves their survival. Even in that population, surgery first is going to be associated with more short-term morbidity.