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Chemotherapy or Surgery?

Posts: 4
Joined: Aug 2012

My mother has stage III/IV ovarian cancer that has spread to the omentum, few lymph nodes, and the spleen. She already had 2 cycles of chemo Taxol/Carbo, now she has the option of proceeding with surgery or wait till she completes her 3rd cycle of chemo. Is there an advantage of having surgery sooner or is it better to complete all 3 cycles of chemo before surgery? Thank you in advance.

Glad to be done's picture
Glad to be done
Posts: 569
Joined: Jul 2012

I am not really sure... I had surgery first then chemo.

Tethys41's picture
Posts: 1229
Joined: Sep 2010

When I was diagnosed, my doctor was on the fence about whether to start with surgery or chemo. He prefers to do surgery first, but sometimes the cancer has spread so much that the idea is to have the chemo reduce the tumor load so that the results of the surgery will be better. Does her doctor think he can perform an optimal debulking at this point, or would an addtional dose of chemo probably increase the chances of a better surgical result?

lovesanimals's picture
Posts: 1364
Joined: Sep 2011

As a stage 2b survivor, my situation was different; I had debulking surgery first, then six rounds of carbo/taxol chemo.

Praying for the best possible outcome for your mom.


Posts: 4
Joined: Aug 2012

Thank you, Kelly. Wish you the best.

Posts: 4
Joined: Aug 2012

Thank you for the comment. From our first meeting with the surgeon, he said there is little difference if my mom has surgery first or surgery after her 3rd chemo cycle. She had another CT scan yesterday, we will meet with the surgeon again tomorrow to go over the results. You asked a very good question, I think we will ask him this question tomorrow. Thank you very much. Wish you the best, Tethys41.

Alexandra's picture
Posts: 1311
Joined: Jul 2012

Primary chemotherapy followed by interval debulking surgery in select group of patients doesn't appear to worsen the prognosis, but it permits a less aggressive surgery to be performed.

There was no difference in progression-free or overall survival and in the rate of optimal cytoreductive surgery between the neoadjuvant and adjuvant chemotherapy groups despite the fact that patients receiving neoadjuvant chemotherapy had a more extensive disease. (http://www.biomedcentral.com/1471-2407/6/153)

Neoadjuvant chemotherapy is associated with less peri-operative morbidity, less need for further aggressive surgery, and similar survival. Additionally, in patients with extra-abdominal disease, neoadjuvant chemotherapy is associated with an improved progression-free survival and overall survival.

Neoadjuvant chemotherapy with interval debulking surgery for stage IV ovarian cancer resulted in higher rates of complete resection to no residual disease, less morbidity, and equivalent overall survival compared to primary debulking surgery followed by chemotherapy. (http://www.ncbi.nlm.nih.gov/pubmed/21994038)

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