The optimal timing of surgery in patients with resectable advanced ovarian cancer remains controversial. Should these patients receive the standard radical surgery followed by chemotherapy, or could patients do better with chemotherapy before surgery?

The long-awaited TRUST trial aimed to settle this question, but the results paint a somewhat mixed picture.

Among patients with resectable stage IIIB-IVB ovarian cancer, primary cytoreductive surgery followed by chemotherapy led to a statistically significant 2.4-month median progression-free survival (PFS) benefit over neoadjuvant chemotherapy followed by interval cytoreductive surgery. While the median overall survival was 6 months longer in the upfront surgery group, the difference was not statistically significant. Patients in both grou

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