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ESMO Gynae 2025 | When should clinicians perform surgery after NAC in ovarian cancer?

Christina Fotopoulou, MD, PhD, Imperial College London, London, UK, discusses the timing of interval cytoreductive surgery in advanced epithelial ovarian cancer, highlighting that the traditional belief that operating later than three cycles of neoadjuvant chemotherapy (NAC) leads to worse survival outcomes may be a self-fulfilling prophecy. A prospective randomized study found that operating after six cycles of neoadjuvant chemotherapy did not result in a worse outcome, with no deterioration in overall survival (OS) and progression-free survival (PFS). This suggests that the timing of surgery may depend on the underlying clinical scenario, rather than just the number of cycles of neoadjuvant chemotherapy. This interview took place at 2025 European Society for Medical Oncology (ESMO) Gynaecological Cancers Congress in Vienna, Austria.

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