Patient Selection for Ovarian Cancer Debulking Surgery

Complete surgical cytoreduction is the most important adverse prognostic factor for survival in ovarian cancer. To achieve this, surgeons often have to perform radical and ultraradical procedures with associated significant postoperative morbidity and mortality. Adverse events are most pronounced in patients with borderline or suboptimal capacity to withstand the stress related to surgery. In frail, elderly, malnourished patients, surgeons face limitations to exercise maximum surgical effort; therefore, alternative treatment strategies are required. Neoadjuvant chemotherapy offers a safe and effective way to enhance recovery after delayed debulking surgery in patients who are not optimal candidates for primary debulking surgery.