Tewarie NMSB, van Driel WJ, van Ham M, et al. - It is difficult to balance the benefits and risks when performing cytoreductive surgery (CRS). Researchers herein assessed patients undergoing primary debulking surgery (PDS) or interval debulking (IDS) surgery in the Netherlands for their surgical outcome in terms of short term postoperative morbidity and mortality. For retrospective analysis, they used the Dutch Gynecological Oncology Audit (DGOA). They included a total of 1,027 patients with PDS and 1,355 patients with IDS. Per outcomes, the PDS group had a higher complete cytoreduction rate indicating that the correct patients have been selected; however, there was a higher percentage of complication with re-intervention. As a result, a longer time to start adjuvant chemotherapy was recorded for this group of patients. They identified regional variation for severe complications in the Netherlands. Overall findings emphasize maintaining a balance in aggressiveness of surgery and outcome of the surgical procedure with respect to severe complications.