Evidence map›Paper›PMID 42065038›Full record

SynthesisOncology research2026

Primary Debulking Surgery Versus Neoadjuvant Chemotherapy in Advanced Ovarian Cancer: A Meta-Analysis of All Randomized Clinical Trials with Subgroup Analysis by Patient Profile.

Carlo Ronsini, Giuseppe Cucinella, Maria Cristina Solazzo, Mariano Catello Di Donna, Cono Scaffa, Stefano Cianci, Manuela Ludovisi, Sandro Pignata, Vito Chiantera

Abstract readMeta-Analysis
In one paragraph

Synthesis in Oncology research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Carlo RonsiniUnit of Gynecologic Oncology, National Cancer Institute, IRCCS, Fondazione "G. Pascale", Naples, Italy.
Giuseppe CucinellaUnit of Gynecologic Oncology, National Cancer Institute, IRCCS, Fondazione "G. Pascale", Naples, Italy.
Maria Cristina SolazzoUnit of Gynecologic Oncology, National Cancer Institute, IRCCS, Fondazione "G. Pascale", Naples, Italy.
Mariano Catello Di DonnaUnit of Gynecologic Oncology, National Cancer Institute, IRCCS, Fondazione "G. Pascale", Naples, Italy.
Cono ScaffaUnit of Gynecologic Oncology, National Cancer Institute, IRCCS, Fondazione "G. Pascale", Naples, Italy.
Stefano CianciUnit of Gynecology and Obstetrics, Policlinico "G. Martino", Department of Human Pathology of Adult and Childhood "G. Barresi", University of Messina, Messina, Italy.
Manuela LudovisiDepartment of Life, Health and Environmental Sciences, University of L' Aquila, L' Aquila, Italy.
Sandro PignataMedical Oncology Division B, National Cancer Institute, G Pascale Foundation, Naples, Italy.
Vito ChianteraUnit of Gynecologic Oncology, National Cancer Institute, IRCCS, Fondazione "G. Pascale", Naples, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The optimal sequencing of surgery and chemotherapy in advanced epithelial ovarian cancer remains debated. While primary debulking surgery (PDS) has been considered the standard approach, recent randomized trials have questioned its survival advantage over neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS). The study aimed to systematically evaluate phase III randomized controlled trials comparing PDS and NACT. Methods: Following PRISMA guidelines (PROSPERO ID 1169057), PubMed and Scopus were systematically searched in October 2025 for phase III randomized clinical trials evaluating cytoreductive strategies in ovarian carcinoma. Only full-text English studies reporting overall survival (OS) or disease-free survival (DFS) were included. Risk ratios (RR) with 95% confidence intervals (CI) were calculated. Results: Five phase III trials (EORTC 55971, CHORUS, JCOG0602, SCORPION, TRUST) comprising 2296 patients met the inclusion criteria. PDS (n = 1139) and NACT (n = 1157) showed comparable OS (RR 0.99, 95% CI 0.94-1.03, Conclusions: PDS and NACT provide no significant survival outcomes in advanced ovarian cancer. No clear survival benefit for PDS was observed. Refinement of patient selection, integration of predictive biomarkers, and re-evaluation of PDS in the context of HIPEC and Poly-ADP-Ribose Polymerase (PARP) inhibitor use are warranted to guide individualized treatment strategies.

Indexed as

Carcinoma, Ovarian EpithelialCytoreduction Surgical ProceduresNeoadjuvant TherapyOvarian NeoplasmsChemotherapy, AdjuvantClinical Trials, Phase III as TopicFemaleHumansRandomized Controlled Trials as TopicTreatment OutcomeAdvanced ovarian cancercytoreductive surgeryneoadjuvant chemotherapyprimary cyoreductive surgeryrandomized controlled trials

Identifiers

PMID42065038
PMCPMC13126584

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.