When Should Surgical Cytoreduction in Advanced Ovarian Cancer Take Place?

Table 1

RCTs investigating the role of IDS.

Name of Study & year	Rose PG et al. [6] (GOG)	Van der Burg et al. [5] (EORTC)	Redman et al. ${1994}^1$ [7]
N	550 with 448 randomized 226 IDS versus 222 no IDS	425 with 319 randomized 278 evaluated: 138 IDS versus 140 no IDS	86 randomized with 7 ${\text{excluded}}^{*}$37 IDS42 no IDS
FIGO stage	II-IV	IIB-IV	II-IV
Trial characteristics	RD > 1 cm after primary surgery and responding/stable after 3 cycles of Cisplatin/pacitaxelStage IV only pleural effusion	RD > 1 cm & maximum primary debulking not attempted in all cases with high proportion of RD >5 cm Randomization after 3 cycles of CP	Primary surgery and RD > 2 cm 1–4 CP Or 3 PAB followed by $5^{*}$ escalating CP
PFS for IDS versus No IDS	12.5 versus 12.7	18 versus 13
OS for IDS versus No IDS	36.2 versus 35.7	26 versus 20	15 versus 12 months

CP: cisplatin/cyclophosphamide; overall survival in months; PAB: cyclophosphamide/doxorubicine/bleomycin; PSF: progression free survival in months; RD: residual disease.
${}_{}{}^{*}\text{Surgery}$ was non suboptimum.
${}_{}{}^{¹}\text{Randomization}$ begins at the start of the trial.