What Should We Expect After a Complete Cytoreduction at the Time of Interval or Primary Debulking Surgery in Advanced XXXX ?

@entity1 @entity43 @entity66 @entity13198 @entity1104
PURPOSE: To compare the impact, in terms of survival, of complete cytoreduction after @entity1104 ( @entity1104 ) and @entity13198 ( @entity13198 ) in @entity1 with advanced @entity43 (International Federation of Gynecology and Obstetrics stages III-IV) by reviewing the recent literature. METHODS: A search of the PubMed database during the last 7  years (2008-2014) was carried out looking for studies specifically showing data on median survival or disease-free survival after complete cytoreduction after either @entity1104 or @entity13198 . RESULTS: We found 24 publications including 14,182 @entity1 with stages III to IV @entity43 . A total of 11871 @entity1 (83.7  %) underwent @entity1104 and 2311 (16.3  %) underwent interval debulking after neoadjuvant chemotherapy. A total of 4684 @entity1 (33  %) were considered completely resected with microscopic @entity66 . After @entity1104 , the weighted average of median overall and progression-free survival was 43 and 17  months, respectively, for the whole group. After @entity13198 , median and progression-free survival were 33 and 14  months. The rate of complete cytoreduction after @entity1104 was inferior to the obtained in @entity1 with @entity13198 (27 vs. 59  %). However, the median survival in @entity1 with complete cytoreduction with primary cytoreduction was 23  months longer than in the group with interval debulking (69 vs. 45  months). CONCLUSIONS: Complete cytoreduction after @entity13198 yields a inferior outcome in terms of median survival than @entity1104 of almost 2  years. Despite the higher rate of complete resection, @entity13198 apparently fails to improve the results obtained by primary debulking.
