An international study led by Prof. Dr. Sven Mahner from the LMU Clinic in Munich shows: In advanced ovarian cancer, primary surgery has long-term advantages over interval surgery after chemotherapy. The TRUST study, conducted by the Association of Gynecological Oncology (AGO) as part of the European ENGOT network, compared both approaches in almost 700 patients at qualified cancer centers in Germany, the UK and the USA.

Ovarian cancer is diagnosed in over 7300 women in Germany every year, usually at an advanced stage due to a lack of early detection. The study investigated whether immediate primary surgery or chemotherapy followed by interval surgery provides better results. The decisive factor was the quality of surgery, which enabled complete tumor elimination in three quarters of cases.

In any case, the results show that After primary surgery, patients lived an average of 54 months, after interval surgery 48 months. After five years, around 25 percent of women who underwent primary surgery were relapse-free, compared to only ten percent after interval surgery. If the tumor cannot be completely removed by primary surgery, the study recommends chemotherapy followed by interval surgery, which can still leave 50 percent of women tumor-free.

Quality of life was comparable in both groups, although primary operations took longer and had a higher complication rate (18 percent) than interval operations (12 percent). Why survival after primary surgery is lower in the short term is still being investigated. The study emphasizes the paramount importance of high surgical standards for treatment success.

Original Paper:

TRUST: Trial of radical upfront surgical therapy in advanced ovarian cancer (ENGOT ov33/AGO-OVAR OP7). | Journal of Clinical Oncology

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Gender note. The personal designations used in this text always refer equally to female, male and diverse persons. Double/triple references and gendered designations are avoided in favor of better readability.