The published studies suggest that for selected women with stage IIIC or IV epithelial ovarian cancer , neoadjuvant chemotherapy and interval cytoreduction are non-inferior to primary cytoreduction and adjuvant chemotherapy with respect to overall and progression-free survival and are associated with less perioperative morbidity and mortality .
PURPOSE To provide guidance to clinicians regarding the use of neoadjuvant chemotherapy and interval cytoreduction among women with stage IIIC or IV epithelial ovarian cancer .
A prospective comparison of integrated FDG-PET/contrast-enhanced CT and contrast-enhanced CT for pretreatment imaging of advanced epithelial ovarian cancer.
OBJECTIVE The use of tumor debulking surgery in the management of epithelial ovarian cancer ( EOC ) , which is often disseminated in the peritoneal cavity at the time of diagnosis , has a significant impact on prognosis . We compared (18)F-fluorodeoxyglucose ( FDG ) positron emission tomography/contrast-enhanced computed tomography ( PET/CT ) to contrast-enhanced CT for the detection of dissemination into the abdominal cavity preventing successful primary debulking surgery . METHODS Forty-one women with EOC underwent preoperative  whole-body low-dose FDG-PET/CT followed by diagnostic high dose contrast-enhanced CT scan , and the results were compared with systematic ally recorded surgical findings as a reference st and ard . Both site-based and patient-based analyses were conducted . RESULTS FDG-PET/CT was superior to conventional CT for the detection of carcinomatosis in subdiaphragmatic peritoneal surfaces ( p=0.020 ) and in the bowel mesentery ( p=0.001 ) . Patient-based analysis of upper abdominal areas requiring extensive surgical procedures showed no significant differences between the two imaging methods . The sensitivity of PET/CT and CT  was poor in certain areas of the peritoneal cavity ( 64 % vs. 27 % in the small bowel mesentery and 65 % vs. 55 % in the right upper abdomen ) . Extra-abdominal disease spread was detected by PET/CT in 32 patients and by CT in 25 patients . CONCLUSIONS PET/CT was not superior to CT for the detection of intra-abdominal disease spread .  Patients with suspected EOC should be referred for upfront radical surgery regardless of the results of preoperative imaging studies . PET/CT is more effective for the detection of extra-abdominal disease than CT , but the clinical significance of this finding is unclear
The published studies suggest that for selected women with stage IIIC or IV epithelial ovarian cancer , neoadjuvant chemotherapy and interval cytoreduction are non-inferior to primary cytoreduction and adjuvant chemotherapy with respect to overall and progression-free survival and are associated with less perioperative morbidity and mortality .
PURPOSE To provide guidance to clinicians regarding the use of neoadjuvant chemotherapy and interval cytoreduction among women with stage IIIC or IV epithelial ovarian cancer .