摘要：Objective:The purpose of this study was to evalua.e.differences in morbidity,progression-free interval,and survival in women with advanced epithelial ovarian cancer trea.e. with initial chemotherapy versus initial surgery. Study design:All women with epithelial ovarian cancer who were trea.e. surgically at our hospital between January 1,1995,and January 1,2003,were eligible; the ca.e. of 200 patients met the criteria and underwent retrospective chart review. Results:Ninety-eight patients (49%) had initial chemotherapy,and 102 patients (51%) had initial surgery. Patients who received initial chemotherapy were more likely to ha.e.sta.e.IV disea.e.(initial chemotherapy,27%,vs initial surgery,8%; P = .042) and gra.e.3 disea.e.(initial chemotherapy,73%,vs initial surgery,61%; P = .025). Optimal cytoreduction was achieved more often in patients who received initial chemotherapy (initial chemotherapy,86%,vs initial surgery,54%; P < .001). Only optimal cytoreduction (P = .022),and not treatment choice (P = .089),had an impact on median survival. Conclusion:Initial chemotherapy is a reasonable alternative to initial surgery for the treatment of selected patients with advanced epithelial ovarian cancer.