Kian Behbakht, MD, Professor of Gynecologic Oncology at the University of Colorado School of Medicine, Aurora, said that the study underscored the surgical importance of getting to no visible residual disease in ovarian cancer. 

“Based on today’s data,” said Dr. Behbakht, “it seems as though it’s okay to leave a very small volume of residual disease behind, but it may be even better to get to no residual disease and then do chemotherapy. That may be the next incremental advance in ovarian cancer treatment.” 

If, however, a very small volume of residual disease is unattainable, said Dr. Behbakht, then neoadjuvant chemotherapy should be used “because the data show that survival is improved.”

That being said, Dr. Behbakht expressed concern that because the option of neoadjuvant chemotherapy is available, oncologists may decide that the best way to treat ovarian cancer is to use neoadjuvant chemotherapy for everyone and then attempt debulking.

“These studies really support that initial attempt at debulking,” said Dr. ­Behbakht. “This makes the laparoscopic scoring systems that are out there so very important because, as we have demonstrated over and over again, it’s very difficult to tell who can be debulked and who cannot.” ■

Disclosure: Dr. Behbakht reported no potential conflicts of interest.