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Prior to initiation of NACT, a biopsy should be performed, usually of the omental cake, to confirm that a malignancy is present, to identify the site of origin of the tumour and to type and grade the tumour. Histopathologists must be aware of the resultant morphological effects of NACT when examining specimens following interval cytoreduction surgery. Tumour typing and grading, and even the identification of residual neoplasia, are particular challenges. Immunohistochemistry, when used judiciously, can be a useful adjunct in certain scenarios. A pathological assessment of the response to chemotherapy, and the pathological stage should be provided in the pathology report, as these may inform prognosis and subsequent management. We present a comprehensive overview of the relevant clinical and pathological aspects pertaining to NACT for gynaecological malignancies for the practicing surgical pathologist.<\/jats:p>","DOI":"10.1136\/jclinpath-2018-205634","type":"journal-article","created":{"date-parts":[[2019,1,22]],"date-time":"2019-01-22T18:37:53Z","timestamp":1548182273000},"page":"102-111","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Neoadjuvant therapy in gynaecological malignancies: What pathologists need to know"],"prefix":"10.1136","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0806-0924","authenticated-orcid":false,"given":"Aoife J","family":"McCarthy","sequence":"first","affiliation":[{"name":"Department of Anatomical Pathology, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada"},{"name":"Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marjan","family":"Rouzbahman","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada"},{"name":"Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sakinah A","family":"Thiryayi","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada"},{"name":"Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William B","family":"Chapman","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada"},{"name":"Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blaise A","family":"Clarke","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada"},{"name":"Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,1,22]]},"reference":[{"key":"2025121219195194000_72.2.102.1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.68.6907"},{"key":"2025121219195194000_72.2.102.2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2007.053793"},{"key":"2025121219195194000_72.2.102.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0908806"},{"key":"2025121219195194000_72.2.102.4","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/S0140-6736(14)62223-6","article-title":"Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial","volume":"386","author":"Kehoe","year":"2015","journal-title":"The Lancet"},{"key":"2025121219195194000_72.2.102.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2006.08.010"},{"key":"2025121219195194000_72.2.102.6","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djj019"},{"key":"2025121219195194000_72.2.102.7","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000265207.27755.28"},{"key":"2025121219195194000_72.2.102.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2008.11.011"},{"key":"2025121219195194000_72.2.102.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2009.08.025"},{"key":"2025121219195194000_72.2.102.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2015.01.056"},{"key":"2025121219195194000_72.2.102.11","unstructured":"The Canadian Partnership Against Cancer . 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