Ovarian cancer (OC) is the second most common gynecologic malignancy in the United States but it carries the worst prognosis [1]. Epithelial OC comprises the largest subtype, for which the mainstay of treatment is surgical cytoreduction, with chemotherapy recommended to decrease likelihood of recurrence for people with high risk and advanced stage disease [2]. Because approximately three-quarters of all cases are diagnosed after regional or distant spread has occurred [3], the majority of people with OC will require chemotherapy treatment.

Evidence has steadily accrued that having a gynecologic oncologist (GO) as surgeon for OC, compared to both general surgeons and general gynecologists, is associated with improved outcomes. GO surgeons were more likely to perform full surgical staging and lymph node dissection, achieving optimal cytoreduction and increasing the uptake of guideline concordant care [[4], [5], [6], [7], [8]], which has translated into higher rates of survival [[5], [6], [7],[9], [10], [11], [12], [13], [14]].

However, corresponding literature on the role of GOs as chemotherapy providers in OC is less robust. Both GOs and medical oncologists may provide chemotherapy, but current practice patterns and responsibility sharing in chemotherapy provision are unclear. Weeks et al. reported the only recent analysis of survival by chemotherapy provider type, showing that the 5-year mortality did not differ between patients treated by GOs versus other chemotherapy providers, not controlling for surgeon type [15].

With a heterogenous geographic distribution of GOs nationally that underserves rural populations [[15], [16], [17]], better understanding the chemotherapy care landscape may also help direct equitable strategies to combat access disparities. Therefore, we sought to evaluate the impact of different chemotherapy provider specialties on survival in epithelial OC, among patients who underwent surgery with a GO.