{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:13:18Z","timestamp":1788415998837,"version":"build-2803163510"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"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>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the impact of the interval between maximal-effort cytoreductive surgery and initiation of adjuvant chemotherapy on progression-free survival (PFS) and overall survival (OS) in women with advanced epithelial ovarian cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted including 145 patients who underwent primary or interval cytoreductive surgery followed by adjuvant chemotherapy at a tertiary gynaecological oncology centre between 2016 and 2021. Time to chemotherapy (TTC) was categorised as \u22646 versus &amp;gt;6 weeks and \u22648 versus &amp;gt;8 weeks. Survival outcomes were assessed using Kaplan\u2013Meier analysis and multivariable Cox proportional hazards regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median age was 60 years, and most patients had FIGO stage IIIC disease (77.2%) and high-grade serous carcinoma (78.0%). Twenty-three patients (15.9%) underwent primary debulking surgery and 122 (84.1%) underwent interval debulking surgery. Complete gross resection (R0) was independently associated with improved overall survival (HR 2.92, 95% CI 1.66\u20135.14; p&amp;lt;0.001) and progression-free survival (HR 2.16, 95% CI 1.33\u20133.52; p=0.002). Initiation of adjuvant chemotherapy more than eight weeks after surgery was independently associated with shorter progression-free survival (HR 1.65, 95% CI 1.12\u20132.45; p=0.013) but was not associated with overall survival. Baseline CA125 &amp;gt;1000 U\/mL independently predicted poorer progression-free survival (HR 1.68, 95% CI 1.11\u20132.56; p=0.016). Mutation status and surgical approach (primary versus interval debulking surgery) were not independently associated with survival following multivariable adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Delayed initiation of adjuvant chemotherapy beyond eight weeks following maximal-effort cytoreductive surgery was independently associated with poorer progression-free survival but not overall survival. Complete gross resection remained the strongest prognostic factor for both survival outcomes. These findings support optimisation of postoperative treatment pathways to minimise avoidable delays in chemotherapy while maintaining safe postoperative recovery. Prospective multicentre studies are warranted to validate these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1856055","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T04:22:29Z","timestamp":1786076549000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Time to adjuvant chemotherapy after cytoreductive surgery and survival outcomes in epithelial ovarian cancer: a retrospective cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Kshitij","family":"Jamdade","sequence":"first","affiliation":[{"name":"Department of Gynaecological Oncology, Nottingham University Hospitals National Health Service (NHS) Trust, City Hospital","place":["Nottingham, United Kingdom"]},{"name":"Department of Gynaecological Oncology, Lancashire Teaching Hospitals National Health Service (NHS) Foundation Trust","place":["Preston, United 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