Abstract: Primary treatment is the most crucial survival factor for ovarian carcinoma. Laparotomy comprehensive staging surgery is the standard surgey if clinical stage 1 is considered. Surgical staging procedure should be taken before chemotherapy if an incomplete previous surgery was done. Optimal cytoreductive surgery is suggested to perform in higher level gynecologic oncology center if possible for clinical stage II,III, or IV. Pay more attention to procedures include upper abdominal area. Consider neoadjuvant chemotherapy /primary interval cytoreduction for patients with bulky stage Ⅲ/Ⅳ who are not surgical candidates. Or consider completion surgery after 3-6 cycles followed by postoperative chemotherapy for some selective patients with sub-optimal surgey. Indications for interval cytoreduction need to be definite.

Key words: Ovarian neoplasms, Primary treatment, Staging surgery, Optimal cytoreductive surgery, Interval cytoreductive surgery