Primary Debulking Surgery (PDS) is Preferable to Interval Debulking Surgery (IDS) in Advanced Ovarian Cancer when High Complete Cytoreduction Rates (R0) are Achieved: a retrospective cohort study

Objective: To compare the survival rates in advanced ovarian cancer patients undergoing Primary Debulking Surgery (PDS) and Interval Debulking Surgery (IDS). Moreover, to compare the different radical procedures performed and perioperative morbidities in advanced ovarian cancer patients in both PDS and IDS groups. Design: Retrospective cohort study. Setting: University Hospitals of Leicester (UHL). Population: 102 advanced ovarian cancer patients. Methods: From the UHL register, we identified 102 advanced ovarian cancer patients that underwent cytoreductive surgery from January 1, 2015-January 1-2020. The demographic criteria, radical procedures, perioperative morbidities and survival rates were analysed and compared. Main outcome measures: 1-year, 5-year overall survival, 1-year and 5-year progression free. Results: The 1-year and 5-year overall survival rates in FIGO stage 3c advanced ovarian cancer patients were significantly higher in the PDS group (92.3% and 38.6%) in contrast to IDS patients (91.2% and 67.5%). The 1-year and 5-year progression free survival rates of stage 3c and 4 were significantly higher in patients who underwent PDS (77.8% and 26.9%) in comparison to patients who underwent IDS (61.4%, and 13.2%). Surgical complexity was higher in PDS patients; however, the perioperative morbidities were acceptable. Conclusions: PDS was associated with higher survival rates than IDS in advanced ovarian cancer patients when high complete cytoreductive rates are achieved despite being associated with higher surgical complexity. Advanced ovarian cancer patients should be offered PDS instead of NACT if fit for surgery. Funding: None Tweetable Abstract: PDS should be offered to advanced ovarian cancer patients if fit for surgery.