To investigate the optimal time of debulkingin Stage Ⅱto stage Ⅳ epithelial ovarian carcinoma,considering corresponding advantages of both surgeryand chemotherapy. Methods From January 1989 to December 1996,ninety-five stage Ⅱ to stage Ⅳ ovarian cancer patientswere treated under two different regimens. Group A-76 cases (2 cases in Ⅱ a stage, 4 cases in Ⅱ b stage,6 cases in Ⅱ c stage, 58 cases in Ⅲ c Stage and 7cases in Ⅳ stage) was managed according to atraditional surgery-chemotherapy regimen; and groupB-19 cases (17 cases in Ⅲ c stage and 2 cases in Ⅳstage) was managed with a chemotherapy-surgery-chemotherapy regimen. Results The optimal debulking rate (no macroscopicresidual or residual < 2 cm) in group A was significantlylower than in group B, being 32.9% (25/76) and68.4% (13/19), respectively (P < 0.001 ). Theavenge survival time of those with a residual focus>2 cm was shorter than those with a residual focus< 2 cm, in both groups. Sixteen out of the 51 patientswith a residual focus > 2 cm had a second debulkingoperation, among whom 7 had preoperativechemotherapy. All of these 7 patients had either noresiduals or residual < 2 cm. In 9 cases withoutpreoperative chemotherapy, the residuals were all> 2 cm. The average survival time among these twogroups were significantly different (P < 0. 01 ). Conclusion (1 ) For those patients in whom optimaldebulking was clinically assessed to be possible, timelyoperation is mandatory. (2) For those inoperableadvanced cases, chemotherapy- surgery- chemotherapyregimen is recommended. (3) For those with residuals>2 cm and were assessed to be difficult to eradicateduring second-look operation, multi-routechemotherapy (intro-arterial, intraperitoneal, andsystematic) should be given before going on thesecond debulking operation. Positive attitude andproper regimen would offer better results. (4) Amulticenter prospective study would give more decisiveconclusion. To investigate the optimal time of debulkingin Stage II to stage IV epithelial ovarian carcinoma, considering corresponding advantages of both surgery and chemotherapy. Methods From January 1989 to December 1996, ninety-five stage II to stage IV ovarian cancer patients were treated under two different regimens. Group A -76 cases (2 cases in Ⅱ a stage, 4 cases in Ⅱ b stage, 6 cases in Ⅱ c stage, 58 cases in Ⅲ c Stage and 7 cases in Ⅳ stage) was managed according to atraditional surgery-chemotherapy regimen; and groupB- 19 cases (17 cases in Ⅲ c stage and 2 cases in Ⅳ stage) were managed with a chemotherapy-surgery-chemotherapy regimen. Results The optimal debulking rate (no macroscopic residual or residual <2 cm) in group A was significantly lower than in group B, Theavenge survival time of those with a residual focus> 2 cm was shorter than those with a residual focus <2 cm (25/76) and68.4% (13/19), respectively (P <0.001) , in both groups. Sixtee n out of the 51 patients with a residual focus> 2 cm had a second debulkingoperation, among whom 7 had preoperative chemotherapy. All of these 7 patients had either noresiduals or residual <2 cm. In 9 cases withoutpreoperative chemotherapy, the residuals were all> 2 cm The average survival time among these twogroups were significantly different (P <0.01). Conclusion (1) For those patients in whom optimaldebulking clinically assessed to be possible, timelyoperation is mandatory. (2) For those inoperableadvanced cases, (3) For those with residuals> 2 cm and were assessed to be difficult to eradicateduring second-look operation, multi-route chemotherapy (intro-arterial, intraperitoneal, and systems) should be given before going on thesecond Positive attitude and pro regimen would offer better results. (4) Amulticenter prospective study would give more decisiveconclusion.