Dr. Salani on Patient Selection for Primary Debulking Surgery in Ovarian Cancer

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

The first primary endpoint to consider when comparing the outcomes of neoadjuvant chemotherapy and primary debulking surgery is survival outcomes, which have been approximately similar, explains Salani. However, there are a few issues with both treatment modalities that have been challenged in studies, according to Salani.

Individual selection rather than a one-size-fits-all approach is key when choosing to give a patient neoadjuvant chemotherapy or primary debulking surgery, says Salani. The main difference between the options is surgical complications. Primary debulking surgery is often more involved, creating a higher complication rate. If the right patients are chosen, primary debulking surgery can be performed safely, but patients must be considered carefully, concludes Salani.