Discussant of the abstract on this novel algorithm, Thomas Herzog, MD, Deputy Director of the University of Cincinnati Cancer Institute and Professor of Obstetrics and Gynecology at the UC College of Medicine, called the use of risk-based factors in complex ovarian cancer surgery to successfully triage patients for primary debulking surgery vs neoadjuvant chemotherapy with interval debulking surgery “potentially practice-changing.”

“This is a very important paper, as we continue to refine the primary debulking surgery vs interval debulking surgery choice,” said Dr. Herzog. “Just because we likely can achieve R0 does not mean all patients should proceed with primary debulking surgery. Rather, we need to layer the information from this study into our decision.”

Thomas Herzog, MD

According to Dr. Herzog, this research highlights the importance of resiliency in patient selection—the ability to recover from complications that are invariable with aggressive debulking surgeries. Those with high-risk features are far less likely to recover from a complication than are those who are triaged appropriately, he observed.

Dr. Herzog also underscored the fact that factors used for patient selection have now been validated internally, externally, nationally, and internationally. “The only issue I really have is the applicability of this triage system to non–high-volume centers,” he concluded. 

DISCLOSURE: Dr. Herzog has served in a leadership role for the GOG Partners Board of Directors; and has served as a consultant or advisor to Aravive, AstraZeneca, Caris, Clovis Oncology, Eisai, GSK, Johnson & Johnson, Merck, and Roche/Genentech.