title: Comparison of Platinum-based Neoadjuvant Chemotherapy and Primary Debulking Surgery in Patients with Advanced Ovarian Cancer.
abstract: OBJECTIVE
  Ovarian cancer is the sixth common cancer in women in developed countries. In severe cases, the optimal debulking is necessary. In order to increase optimal debulking and reduce preoperative complications, neoadjuvant chemotherapy followed by debulking surgery, and then chemotherapy again is introduced as substitute for primary surgery. In this study, we aim to evaluate perioperative outcome after neoadjuvant chemotherapy with carboplatin/paclyaxol in comparison with primary cytoreduction in patients with advanced ovarian cancer.
  
  
  METHODS
  In this prospective study, 60 patients with advanced ovarian cancer due to the disease severity were assigned into neoadjuvant chemotherapy (n = 30) or control (n = 30) groups. In neoadjuvant chemotherapy group, patients received three cycles of carboplatin (5-6 area under the curve) and paclitaxel (175 mg/m(2)) preoperatively followed by interval surgery. The control group received primary surgery plus adjuvant chemotherapy. Preoperative outcome was compared between groups.
  
  
  RESULTS
  Neoadjuvant group had significantly lower mean levels of CA 125 (p = 0.01) and less severe bleeding (p = 0.03) than control group. There was no significant difference between surgery time, preoperative complications, residual mass less than 1 cm, and hospital stay between groups. There was no mortality during the study.
  
  
  CONCLUSIONS
  Neoadjuvant chemotherapy caused less severe bleeding, but has no effect in decreasing complications after surgery; however, neoadjuvant chemotherapy followed by interval debulking surgery was not superior to primary debulking surgery followed by chemotherapy as a treatment option for patients with advanced ovarian carcinoma in this study.
authors.affiliation: Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, 513866449 Tabriz, Iran.
authors.forename: Manizheh
authors.initials: M
authors.lastname: Sayyah-Melli
authors.affiliation: Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, 513866449 Tabriz, Iran ; Department of General Surgery, Faculty of Medicine, Tabriz University Medical Sciences, Tabriz, Iran ; Department of Hematology and Oncology, Faculty of Medicine, Tabriz University Medical Sciences, Tabriz, Iran.
authors.forename: Gita Kashi
authors.initials: GK
authors.lastname: Zonoozi
authors.affiliation: Department of General Surgery, Faculty of Medicine, Tabriz University Medical Sciences, Tabriz, Iran.
authors.forename: Shahryar
authors.initials: S
authors.lastname: Hashemzadeh
authors.affiliation: Department of Hematology and Oncology, Faculty of Medicine, Tabriz University Medical Sciences, Tabriz, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Esfahani
authors.affiliation: Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, 513866449 Tabriz, Iran.
authors.forename: Elaheh
authors.initials: E
authors.lastname: Ouladehsahebmadarek
authors.affiliation: Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, 513866449 Tabriz, Iran.
authors.forename: Mehry Jafary
authors.initials: MJ
authors.lastname: Shobeiry
authors.affiliation: Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, 513866449 Tabriz, Iran.
authors.forename: Parvin Mostafa
authors.initials: PM
authors.lastname: Garabaghi
authors.affiliation: Department of General Surgery, Faculty of Medicine, Tabriz University Medical Sciences, Tabriz, Iran ; Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, 513866449 Tabriz, Iran.
authors.forename: Azhough
authors.initials: A
authors.lastname: Ramin
keywords: Advanced stage; Neoadjuvant chemotherapy; Ovarian cancer; Primary debulking surgery