{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T16:25:08Z","timestamp":1773332708166,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>Stage IVB high\u2010grade serous ovarian cancer (HGSOC) carries a poor prognosis. We aimed to: (1) describe the characteristics and survival of patients treated with primary cytoreductive surgery (PCS), interval cytoreductive surgery (ICS) or chemotherapy alone, (2) investigate the correlation between disease distribution and treatment type, and (3) evaluate the impact of cytoreductive surgery (CS) \u201caggressiveness\u201d and outcome on survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single\u2010center retrospective cohort study of Stage IVB HGSOC patients. Demographics, tumor characteristics, treatment including \u201caggressive\u201d CS (upper abdominal and extraperitoneal procedures), and outcomes were analyzed using descriptive statistics and survival analysis, with nonparametric tests and Cox\u2010proportional hazard models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 110 patients, 24 (22%) underwent PCS, 73 (66%) ICS, and 13 (12%) chemotherapy alone. Median overall survival (OS) was 76.2 (PCS), 36.9 (ICS), and 20.1 months (chemotherapy alone) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014). Supradiaphragmatic lymph\u2010node metastasis differed across groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042). \u201cAggressive\u201d CS was performed in 53.6% of the surgical cohort, with 54.86% no\u2010gross\u2010residual (NGR), 34% optimal \u2264\u20091\u2009cm \u2264 and 11.3% suboptimal\/aborted surgical outcome. Median OS post CS for NGR, optimal \u2264\u20091\u2009cm, and suboptimal was 67.55, 35.26, and 20.97 months, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>OS for Stage IVB HGSOC follows a hierarchical pattern: PCS, ICS, and chemotherapy. Disease distribution guides treatment and residual tumor after CS correlates with survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.70142","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T11:50:09Z","timestamp":1763985009000},"page":"73-80","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Treatment Strategy and Residual Disease as Determinants of Survival in Stage IVB High\u2010Grade Serous Ovarian Cancer: A Retrospective Cohort Study"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0736-1250","authenticated-orcid":false,"given":"Anouk","family":"Benseler","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adina","family":"Tanen","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taymaa","family":"May","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Harvard Medical School, Division of Gynecologic Oncology, Brigham and Women's Hospital Mass General Brigham Boston Massachusetts USA"},{"name":"Department of Surgical Oncology, Division of Gynecologic Oncology Dana Farber Cancer Institute Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Avery","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University Health Network Toronto Ontario Canada"},{"name":"Dalla Lana School of Public Health, Biostatistics Division University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7104-1518","authenticated-orcid":false,"given":"Genevieve","family":"Bouchard\u2010Fortier","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Toronto Toronto Ontario Canada"},{"name":"Division of Gynecology Oncology University Health Network and Sinai Health System Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7022-8308","authenticated-orcid":false,"given":"Marcus Q.","family":"Bernardini","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Toronto Toronto Ontario Canada"},{"name":"Division of Gynecology Oncology University Health Network and Sinai Health System Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liat","family":"Hogen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Toronto Toronto Ontario Canada"},{"name":"Division of Gynecology Oncology University Health Network and Sinai Health System Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"161","article-title":"Carcinoma of the Ovary. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer","volume":"95","author":"Heintz A. 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