Surgery 1st, then chemo benefits certain ovarian cancer patients, research suggests

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For patients with high-grade serous ovarian cancer, an aggressive form of the disease, surgery to remove the tumor before starting chemotherapy should lead to better outcomes than the reverse, according to research published June 14 in Proceedings of the National Academy of Sciences.

Researchers from NYU Langone's Perlmutter Cancer Center in New York City and Dana-Farber Cancer Institute in Boston led the study, which involved the use of a mathematical model to compare treatment outcomes between patients with the ovarian cancer who received two different treatment options: Primary debulking surgery or neoadjuvant chemotherapy. 

In the first approach, patients undergo tumor removal with chemotherapy added after. In the other option, neoadjuvant chemotherapy, patients first receive a few cycles of chemo to shrink the tumor before surgery. 

Primary debulking surgery was tied to superior outcomes because it offers the best chance of removing treatment-resistant cancer cells, the findings showed. 

"Our model, combined with earlier clinical data, suggests that for patients who can undergo complete debulking, surgery offers the best chance of long-term survival or even cure," said Benjamin Neel, MD, PhD, co-senior author of the study and director of the Perlmutter Cancer Center.

The findings also indicate a shorter period of initial chemotherapy may be more beneficial than the current recommended interval for patients who are unable to undergo debunking surgery.

The best order of treatment for patients with high-grade serous ovarian cancer has long been controversial, which prompted the study, researchers said. 

To view the full study, click here.

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