Gynaecological oncology: neoadjuvant chemotherapy: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Gynaecological oncology: neoadjuvant chemotherapy

Sample item

A 62-year-old with advanced stage IIIC ovarian cancer and poor performance status has extensive disease in the upper abdomen, and primary cytoreduction is judged unlikely to achieve no residual disease. What approach is appropriate?

AImmediate radiotherapyBObservationCNeoadjuvant platinum-based chemotherapy followed by interval debulking surgeryDHormone therapy

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Neoadjuvant platinum-based chemotherapy followed by interval debulking surgery

Neoadjuvant chemotherapy with carboplatin and paclitaxel, typically three cycles followed by interval cytoreductive surgery and further cycles, is used when optimal primary debulking is unlikely or the patient is unfit. Survival is comparable to primary surgery in such patients with lower perioperative morbidity. Diagnosis is confirmed by biopsy before starting.

Option by option

A. Immediate radiotherapy
Radiotherapy is not the standard therapy.
B. Observation
Observation withholds effective treatment.
C. Neoadjuvant platinum-based chemotherapy followed by interval debulking surgery (correct)
Correct. Interval debulking after neoadjuvant chemotherapy is standard in this setting.
D. Hormone therapy
Hormone therapy is not first-line.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Neoadjuvant platinum-based chemotherapy followed by interval debulking surgery. Neoadjuvant chemotherapy with carboplatin and paclitaxel, typically three cycles followed by interval cytoreductive surgery and further cycles, is used when optimal primary debulking is unlikely or the patient is unfit.

Why is "Immediate radiotherapy" not the answer?

Radiotherapy is not the standard therapy.

Why is "Observation" not the answer?

Observation withholds effective treatment.

Why is "Hormone therapy" not the answer?

Hormone therapy is not first-line.

What concept does this question test?

It tests Gynaecological oncology: neoadjuvant chemotherapy in OBG. Survival is comparable to primary surgery in such patients with lower perioperative morbidity. Diagnosis is confirmed by biopsy before starting.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gynaecological oncology: neoadjuvant chemotherapy?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.