Trends in Primary Treatment and Median Survival Among Women With Advanced-Stage Epithelial Ovarian Cancer in the US From 2004 to 2016.

Three published clinical trials1-3 that randomized women with advanced-stage ovarian cancer to primary cytoreductive surgery before adjuvant chemotherapy or neoadjuvant chemotherapy before interval cytoreductive surgery found no evidence of a progression-free or overall survival advantage for either approach. However, those studies did demonstrate a reduction in surgical morbidity in women assigned to neoadjuvant chemotherapy. Nonetheless, most gynecologic oncologists believe that primary surgical treatment is the preferred approach for advanced ovarian cancer.4 Since the publication of the first of those 3 randomized trials in 2010,1 the use of neoadjuvant chemotherapy for ovarian cancer has increased in the US.5 The objective of this study was to examine and compare time trends in the use of neoadjuvant chemotherapy and the median survival among women with advanced-stage epithelial ovarian cancer in the United States.