{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:22:53Z","timestamp":1790803373848,"version":"4.1.0"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T00:00:00Z","timestamp":1690156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the effect of primary debulking surgery (PDS), NACT followed by interval debulking surgery (NACT-IDS), and chemotherapy alone on the prognosis of FIGO stage IV epithelial ovarian cancer (EOC) with different metastatic patterns.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed 133 cases of FIGO stage IV EOC with pleural effusion (stage IVA), parenchymal metastases (stage IVB), or extra-abdominal lymph node metastases (stage IVB) at our Hospital between January 2014 and July 2021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 133 cases with stage IV disease, 16.5% (n=22) presented with pleural effusion, 46.6% (n=62) with parenchymal metastases, and 36.9% (n=49) with extra-abdominal lymph node metastases. Regardless of the metastatic patterns, the 90.2% (n=120) of cases who underwent PDS\/NACT-IDS exhibited a significantly superior overall survival (OS) compared to the 9.8% cases (n=13) who received chemotherapy alone (32 vs 17 months, <jats:italic>p<\/jats:italic>=0.000). The cohort was further stratified into 58 cases (48.3%) with R0, 41 cases (34.2%) with R1, and 21 cases (17.5%) with R2. The median OS of cases with R0 was significantly better than that of cases with R1\/R2 (74 vs 27 months, <jats:italic>p<\/jats:italic>=0.000). There was no significant difference in median OS between PDS and NACT-IDS (43 vs 31 months, <jats:italic>p<\/jats:italic>=0.676), as well as between FIGO IVA and IVB (35 vs 31 months, <jats:italic>p<\/jats:italic>=0.582). Additionally, the metastatic patterns and the number of neoadjuvant chemotherapy cycles (\u22644 or &amp;gt;4) did not demonstrate any prognostic significance for median OS (<jats:italic>p<\/jats:italic>=0.820 and 33 vs 26 months, <jats:italic>p<\/jats:italic>=0.280, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Regardless of FIGO IVA and IVB stages or metastatic patterns, patients diagnosed with stage IV EOC may benefit from cytoreductive surgery with abdominal R0, compared with chemotherapy alone.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2023.1103357","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T17:37:41Z","timestamp":1690220261000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["A retrospective analysis for investigating the relationship between FIGO stage IVA\/IVB and cytoreductive surgery with prognosis in epithelial 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