Research Spotlight: Chemo Before Surgery Improves Outcomes in Ovarian Cancer

Abdominal Cancers Alliance
Sep 3
2 min read

Mary Kathryn Abel, MD, MAS; Varvara Mazina, MD; Amy J. Bregar, MD; et al.

JAMA Network Open; Published Online: July 25, 2025; 2025;8;(7):e2523434. doi:10.1001/jamanetworkopen.2025.2343

Summary:

A new study looked at women with advanced (stage 3/stage 4) ovarian cancer and found that getting chemotherapy before Cytoreductive surgery (CRS) made treatment safer and reduced the risk of serious complications. The benefits were even greater at hospitals that treat many ovarian cancer patients, where women also lived longer. This shows how important it is to get care at experienced centers and to talk with your doctor about the best timing for treatment.

Key Study Question

Can giving chemotherapy before surgery (called neoadjuvant chemotherapy, or NACT) and being treated at hospitals that perform a high number of ovarian cancer surgeries help women with advanced ovarian cancer live longer and have fewer complications after surgery?

The Big Picture

What was done: Researchers looked at medical records from more than 70,000 women with advanced ovarian cancer treated between 2010 and 2019 at over 1,300 cancer programs across the U.S.
Why it matters: Surgery for advanced ovarian cancer can be very complex and risky, especially at hospitals that don’t perform many Cytoreductive surgery (CRS) procedures. Giving chemotherapy before surgery (NACT) can make the surgery safer, but it wasn’t clear if the benefits of NACT depended on how experienced the hospital was.

What They Found

Fewer deaths after surgery when NACT is used: Women who received chemotherapy before surgery had a much lower risk of dying within 90 days after their operation. The benefit was greatest at hospitals that perform a lot of ovarian cancer surgeries.
- High-volume centers: Risk dropped from 10% to 3%
- Average-volume centers: Risk dropped from 7% to 4%
- Low-volume centers: Risk dropped from 10% to 5%
Longer survival at high-volume hospitals: At hospitals with the most experience, women who had chemotherapy before surgery lived about 4 months longer over five years compared to those who did not.

Why It Matters for Patients and Clinicians

Experience matters: Hospitals that treat more ovarian cancer patients each year had the best outcomes, especially when combined with NACT.
Chemotherapy before surgery can help: It makes surgery safer and can reduce complications, even at hospitals with less experience.
Where you’re treated makes a difference: Choosing both the right treatment approach and the right hospital can improve survival and recovery..

Bottom Line

For women with advanced ovarian cancer, starting with chemotherapy before surgery—especially at a hospital that treats many ovarian cancer patients—can make treatment safer and improve survival. This highlights the importance of asking about both treatment options and hospital experience when planning care.