{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T16:24:54Z","timestamp":1751646294161,"version":"3.40.5"},"reference-count":39,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T00:00:00Z","timestamp":1670544000000},"content-version":"vor","delay-in-days":38,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82072889","81772787"],"award-info":[{"award-number":["82072889","81772787"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009812","name":"Chinese Society of Clinical Oncology","doi-asserted-by":"publisher","award":["Y\u20102019AZQN\u20100385","Y\u20102019AZZD\u20100359"],"award-info":[{"award-number":["Y\u20102019AZQN\u20100385","Y\u20102019AZZD\u20100359"]}],"id":[{"id":"10.13039\/501100009812","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the impact of the primary treatment sequence (primary debulking surgery, PDS, versus neoadjuvant chemotherapy and interval debulking surgery, NACT\u2010IDS) on post\u2010relapse survival (PRS) and recurrence characteristics of recurrent epithelial ovarian cancer (REOC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Real\u2010world retrospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary hospitals in China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>A total of 853 patients with REOC at International Federation of Gynaecology and Obstetrics stages IIIC\u2013IV from September 2007 to June 2020. Overall, 377 and 476 patients received NACT\u2010IDS and PDS, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Propensity score\u2010based inverse probability of treatment weighting (IPTW) was performed to balance the between\u2010group differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Clinicopathological factors related to PRS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall median PRS was 29.3\u00a0months (95%\u00a0CI 27.0\u201331.5\u00a0months). Multivariate analysis before and after IPTW adjustment showed that NACT\u2010IDS and residual R1\/R2 disease were independent risk factors for PRS (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Patients with diffuse carcinomatosis and platinum\u2010free interval (PFI)\u2009\u2264\u200912\u2009months had a significantly worse PRS (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Logistic regression analysis revealed that NACT\u2010IDS was an independent risk factor for diffuse carcinomatosis (OR\u00a01.36, 95%\u00a0CI 1.01\u20131.82, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.040) and PFI\u2009\u2264\u200912\u2009months (OR\u00a01.59, 95%\u00a0CI 1.08\u20132.35, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.019). In IPTW analysis, NACT\u2010IDS was still significantly associated with diffuse carcinomatosis (OR\u00a01.29, 95%\u00a0CI 1.05\u20131.58, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.015) and PFI\u2009\u2264\u200912\u2009months (OR\u00a01.90, 95%\u00a0CI 1.52\u20132.38, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The primary treatment sequence may affect the PRS of patients with REOC by altering the recurrence pattern and PFI duration.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17329","type":"journal-article","created":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T16:54:30Z","timestamp":1670604870000},"page":"70-78","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Does the primary treatment sequence affect post\u2010relapse survival in recurrent epithelial ovarian cancer? 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