Dr. Salani Discusses Neoadjuvant Chemotherapy Versus Primary Debulking Surgery in Ovarian Cancer

Ritu Salani, MD, gynecologic oncologist, associate professor, Department of Obstetrics and Gynecology, and director, Gynecologic Oncology Fellowship Program, at The Ohio State University Wexner Medical Center, discusses considerations for neoadjuvant chemotherapy versus primary debulking surgery in advanced ovarian cancer.

Several factors should be considered when deciding whether to proceed with neoadjuvant chemotherapy or primary debulking surgery, says Salani. Patient factors are of the utmost importance. If the patient is not fit enough to undergo an extensive surgery, they would not be candidates for primary debulking. If the patient could tolerate the surgery, and their disease is deemed resectable, then surgery is the ideal choice, says Salani.

If the disease is too extensive to resect, or surgery could result in the need for bowel resections or radical operations, neoadjuvant chemotherapy could be an appropriate choice, she adds. Moreover, patients with advanced and large bulky stage IIIC or IV disease could be prime candidates for neoadjuvant chemotherapy, concludes Salani.