Background

Ovarian cancer has high mortality among gynecologic malignancies.

Optimal timing between cytoreductive surgery and chemotherapy remains unclear. This study examines how timing impacts overall survival (OS) and progression-free survival (PFS).

Objective

To assess how delays in initiating adjuvant chemotherapy after cytoreductive surgery affect OS and PFS in ovarian cancer patients.

Methods

Design: Retrospective cohort study (2016–2021)

Sample: 149 patients

Groups: ≤6 weeks vs >6 weeks, ≤8 weeks vs >8 weeks

Analysis: Kaplan-Meier & Cox regression

Endpoints: OS (primary), PFS (secondary) 

Results

Median age: 59 years;

Advanced disease: 92%; High grade serous carcinoma: 70%

Surgeries: IDS (120), PDS (29), R0 (82.6%)

Extensive surgeries: Splenectomy (51), Bowel (48), Liver (16), Bladder (13), Pancreatectomy (17)

Complications: 14 intraoperative; diaphragmatic injury most common

Findings:-

No significant OS/PFS difference ≤6 vs >6 weeks (p=0.42, p=0.71)-

Significant PFS improvement in ≤8 vs >8 weeks (p=0.022) 

Conclusion

Starting chemotherapy within 8 weeks post-surgery improves PFS. No strong OS effect, but trend favors early treatment.

Recommendation: Avoid delays >8 weeks.

  Takeaways ✓Initiate chemo within 8 weeks ✓Avoid >8-week delay ✓Supports streamlined recovery ✓Needs prospective validatio