BACKGROUND: @entity1 with advanced @entity43 should be treated by radical debulking surgery aiming at complete @entity5 resection. Unfortunately about 70% of the @entity1 present with @entity1442 , when optimal debulking can not be obtained, and therefore these @entity1 gain little benefit from surgery. Neoadjuvant chemotherapy (NACT) has been proposed as a novel therapeutic approach in such cases. In this study, we report our results with primary surgery or neoadjuvant chemotherapy as treatment modalities in the specific indication of operable @entity1 with advanced @entity43 (no medical contraindication to debulking surgery). @entity1 AND METHODS: A total of 59 @entity1 with stage III or @entity43 were evaluated between 1998 and 2003. All @entity1 were submitted to surgical exploration aiming to evaluate @entity5 resectability. Neoadjuvant chemotherapy was given (in 27 @entity1 ) where optimal cytoreduction was not feasible. Conversely primary debulking surgery was performed when we considered that optimal cytoreduction could be achieved by the standard surgery (32 @entity1 ). RESULTS: Optimal cytoreduction was higher in the NACT group (72.2%) than the conventional group (62.4%), though not statistically significant (P = 0.5). More important was the finding that parameters of surgical @entity146 ( @entity190 rates, ICU stay and total hospital stay) were significantly lower in NACT group than the conventional group. The median overall survival time was 28 months in the conventional group and 25 months in NACT group with a P value of 0.5. The median disease free survival was 19 months in the conventional group and 21 months in NACT group (P = 0.4). In multivariate analysis, the pathologic type and degree of debulking were found to affect the disease free survival significantly. Overall survival was not affected by any of the study parameters. CONCLUSION: Primary chemotherapy followed by interval debulking surgery in select group of @entity1 doesn't appear to worsen the prognosis, but it permits a less aggressive surgery to be performed.

Neoadjuvant chemotherapy versus primary surgery in advanced XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PATIENTS'] @entity43 :: ('MESH:D010051', 'Disease') :: ['ovarian carcinoma', 'IV epithelial ovarian carcinomas', 'ovarian cancer'] @entity146 :: ('MESH:D001523', 'Disease') :: ['aggressiveness'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity1442 :: ('MESH:D020178', 'Disease') :: ['advanced disease']
@entity43 :: (MESH:D010051,Disease) :: ['ovarian carcinoma']
