Factors Predicting Use of Neoadjuvant Chemotherapy Compared With Primary Debulking Surgery in Advanced Stage Ovarian Cancer-A National Cancer Database Study.

1 Our study showed a trend of increasing use of NACT occurred even before the publication of the first randomized controlled trial of NACT versus PDS (that of Vergote et al 10 ).

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Nonetheless, we did find a decreasing trend in the use of PDS for both stages IIIC and IV patients and an increased rate of NACT, far greater with stage IV disease than stage IIIC, a pattern also noted by Meyer et al. 20 Similar to the study of Thrall et al, 19 we found that in stage IV disease alternatives to primary surgery were increasingly used: CT alone was provided more frequently than NACT, and a significant proportion of patients receive surgery alone or no treatment.

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