Whether or not cytoreduction improves the outlook of ovarian cancer patients is not yet clear from data from Literature. Maybe not the successful procedure itself, but the favourable tumor characteristics of these tumors determine the prognosis. New studies are necessary to define the role of surgery in the overall management of ovarian cancer more precisely. In this article a Dutch study is presented, to answer the question about the influence of attempted cytoreductive surgery prior to, during chemotherapy on survival time and remission rates. All patients are treated with either combination chemotherapy and/or an attempt to cytoreduction prior to or during chemotherapy. With this strategy ethical problems concerning undertreatment are avoided. The study is currently activated but it is too early to draw any conclusions.