Himoto Y, Cybulska P, Shitano F, et al. - Researchers conducted this retrospective study to analyze the impact of the primary treatment approach (primary debulking surgery (PDS) vs neoadjuvant chemotherapy and interval debulking surgery (NACT-IDS)) on the pattern of the first recurrence in patients with completely cytoreduced advanced high-grade serous ovarian carcinoma (HGSOC). The sample consisted of 178 individuals with newly diagnosed stage IIIC–IV HGSOC, complete gross resection during PDS (n = 124) or IDS (n = 54) from January 2008 to March 2013, and baseline and first recurrence contrast-enhanced CT scans. NACT-IDS was linked to more overlapping locations between baseline and first recurrence and fewer recurrences in new anatomic locations vs PDS at univariate and multivariate analyses. At the time of the first recurrence, the distribution of disease differed with the option of primary treatment. Patients who had NACT-IDS experienced recurrence more often in the same locations as the original disease compared with patients treated with PDS.