Objective To compare the efficacy and safety of neoadjuvant chemotherapy (NACT) combined with interval debulking surgery (IDS) and primary debulking surgery (PDS) in the treatment of advanced ovarian cancer.

Methods From January 2016 to December 2018, 124 patients with epithelial ovarian cancer classified by International Federation of Obstetrics and Gynecology (FIGO) stage ⅢC-Ⅳ in Changhai Hospital of Naval Medical University were retrospectively analyzed. They were divided into two groups: PDS combined chemotherapy group (group P, n=72) and NACT-IDS combined chemotherapy group (group NI, n=52). The general data, perioperative condition, incidence of postoperative complications, complete tumor resection rate and progression-free survival (PFS) were compared between the two groups.

Results The operation time in group NI was significantly shorter than that in group P (P < 0.001). The intraoperative blood loss and blood transfusion volume in group NI were significantly less than those in group P (P < 0.05). The proportion of patients with R0 resection in group NI was significantly higher than that in group P (84.60% vs 25.00%, P < 0.001). The median hospitalization time of patients in group NI and group P was 12 days and 13 days respectively, and there was no significant difference between the two groups (P > 0.05). The incidence of postoperative complications (intestinal obstruction, infection, deep venous thrombosis) in group NI was significantly lower than that in group P (3.85% vs 11.11%). During the follow-up to December 31, 2021, the median PFS of group NI and group P was 12.5 months and 13 months respectively, there was no significant difference between the two groups.

Conclusion NACT-IDS combined with chemotherapy has higher complete tumor resection rate, shorter operation time, less intraoperative blood loss and lower incidence of postoperative complications than PDS combined chemotherapy in patients with advanced ovarian cancer.