How do you approach adjuvant therapy for patients with advanced ovarian cancer who undergo interval debulking surgery following six cycles of neoadjuvant chemotherapy?

If viable tumor at the time of surgery and patient has acceptable performance status then I would treat 2-3 more cycles of chemo followed by maintenance therapy. However, if no viable tumor at the time of surgery then I would forego IV chemotherapy and start maintenance postoperatively depending on ...

I avoid administering 6 courses of neoadjuvant chemotherapy. I aim to only give 3-4 courses and then do the operation if the patient has responded. In my experience, giving 6 courses or more interferes with tumor biology and the tumor may develop chemoresistant cells.