Comparison of Quality of Life Among Women Treated for Advanced Ovarian Cancer Through Neoadjuvant Chemotherapy Versus Upfront Surgery

Introduction: Ovarian cancer, the eighth most common cancer in women worldwide, often demands intensive treatment in advanced stages (III and IV) using either upfront surgery (primary debulking surgery, PDS) or neoadjuvant chemotherapy (NACT) followed by interval surgery. Although survival outcomes typically drive treatment choices, quality of life (QoL-covering physical, emotional, and psychological aspects-is vital due to the significant burden of both methods. This study examines QoL differences between NACT and PDS in a 32-patient cohort to guide patient-focused care. Objective: To compare the quality of life (QoL) among women with advanced ovarian cancer treated with neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) versus upfront surgery (primary debulking surgery, PDS) followed by chemotherapy. Methods: A comparative analysis was conducted using data from studies totaling 32 patients. Studies were sourced from PubMed and other databases, focusing on patient-reported QoL outcomes, including physical, emotional, and psychological well-being. Descriptive statistics and qualitative synthesis were used to compare QoL metrics between the two treatment groups. Results: Among the 32 patients, NACT improved QoL in 17 patients by reducing tumor burden and enabling less invasive surgery, with reported enhancements in functional status. PDS showed comparable overall QoL in 15 patients but was associated with greater psychological burden, including anxiety and depression, in 10 patients. No significant QoL difference was found between the two approaches in aggregate terms. Conclusion: Both NACT and PDS offer distinct QoL profiles, with NACT potentially benefiting patients unfit for upfront surgery and PDS showing equivalence in overallQoL despite higher emotional toll.Individualized treatment decisions should consider QoL alongside survival outcomes, with further research needed for direct comparisons.