Ovarian cancer is a kind of malignant tumor with high malignancy degree, which has become a major killer threatening women’s health. Since there is no better means to help us diagnose ovarian cancer at an early stage, most ovarian cancers are already at an advanced stage when detected, which makes the treatment of ovarian cancer still in a relatively passive state. For an ovarian cancer patient, timely detection and diagnosis may be the first step to “save life”, but it is far from enough – after the detection of ovarian cancer “enemy”, systematic and standardized treatment is the real goal. Systematic and standardized treatment is the only guarantee to extend the “lifeline”. In this battlefield with ovarian cancer, the initial treatment is like the first round of attack on the enemy. On the contrary, it will make the “annihilation war” which can be won become a long-term “tug-of-war” with the spreading tumor cells. Therefore, the initial treatment of ovarian cancer is especially important, and may even be the most important step in all treatments. The first step in the treatment of ovarian cancer is to determine the stage, because the subsequent treatment requires different treatment plans according to the different stages. Surgery is often not only the best means to confirm the diagnosis, but also the only way to accurately determine the stage, which we call “surgical pathological staging”. Therefore, surgery is the most important part of the initial treatment. The goal of treatment for early stage ovarian cancer (stage I and II) should be cure. Except in rare cases where objective circumstances do not allow, surgical treatment should definitely be the first choice and should include abdominal irrigation or ascites after opening, comprehensive exploration of the pelvic and abdominal cavities, biopsy or cytological examination of multiple points of the peritoneum or suspicious lesions, as well as total hysterectomy, double adnexa, greater omentum, appendectomy, and resection of pelvic lymph nodes and para-abdominal aortic lymph nodes. These procedures are collectively referred to as full staging surgery for ovarian cancer. Some very early stage young patients can also undergo full staging surgery to preserve fertility, i.e., preservation of the uterus and healthy adnexa, and the rest as above. Since the scope of surgery is not sufficient to obtain the most comprehensive pathological diagnosis, accurate staging is not possible. Therefore, we emphasize that the earlier the stage, the larger the scope of surgery must be. It is worth noting that our country is vast and the medical level is not uniformly developed. If ovarian cancer is found by chance intraoperatively in a hospital without corresponding surgical techniques, the lesion should be removed as much as possible or only a biopsy should be taken, and then transferred to a hospital with surgical techniques for open re-staging surgery as soon as possible in order to obtain accurate surgical pathological staging. After surgery, patients should be classified into high, intermediate and low risk types according to the results of surgical pathological staging and histopathological type and grading, and according to this risk grading, 3-6 courses of observation or chemotherapy should be selected. Currently, in general, the preferred chemotherapy regimen should be paclitaxel + carboplatin. In advanced ovarian cancer (stages III and IV), the aim of treatment is to prolong survival or even cure as much as possible. Surgery should be the first choice of treatment as far as possible. Some patients who are evaluated to be difficult to achieve satisfactory tumor cytoreduction (residual lesion 70 years old) can be considered to be treated with neoadjuvant chemotherapy (paclitaxel + carboplatin, usually 1-3 courses) to shrink the lesion before surgery. Ovarian cancer is highly malignant and prone to metastasis and recurrence. During the initial treatment, all visible lesions should be removed as much as possible, preferably to achieve no visual residue, or to strive for residual lesions less than 1 cm, which is called satisfactory tumor cell reduction. The more satisfactory the initial surgical treatment, the better the prognosis will be, and the more useful the subsequent chemotherapy or biologic therapy will be. Therefore, surgery is more difficult for patients with advanced disease. Sometimes, in addition to removal of the whole uterus and bilateral adnexa and the greater omentum and appendix, it may be necessary to remove part of the intestinal canal, bladder, ureter, and even part of the liver, part of the pancreas, spleen, and other organs. For patients who are not satisfied with the initial surgery, intermittent tumor cytoreduction can be performed selectively after 3 courses of chemotherapy, and if the tumor can be removed, it can also achieve better treatment results. If surgery is our “commando”, then post-operative chemotherapy is the strong “backup”. Only reasonable and systematic chemotherapy with sufficient amount and course can “wipe out” the remaining tumor cells. Only reasonable and systematic chemotherapy with sufficient amount and course can “destroy” the remaining tumor cells and achieve satisfactory curative effect. In other words, only satisfactory surgery combined with standardized chemotherapy can most effectively slow down or even stop the recurrence and progression of tumor. The preferred chemotherapy regimen is the same as that for early-stage ovarian cancer, however, for patients with satisfactory tumor cell reduction, it can be considered in combination with intraperitoneal chemotherapy, which is generally considered to be more effective than intravenous chemotherapy alone. As for the number of courses of chemotherapy, 6-8 courses of chemotherapy can be done according to specific conditions. Because the scope and difficulty of ovarian cancer surgery are large and there are many complications, it requires the joint efforts of gynecologic oncologists, gastrointestinal surgeons, urologic surgeons, hepatobiliary surgeons, vascular surgeons, anesthesiologists and ICU doctors, and sometimes it also requires the cooperation of internal medicine doctors. Therefore, it is recommended that patients should consult a hospital with a professional team when they discover suspected ovarian cancer, so that they can systematically evaluate the disease and formulate the best individualized treatment plan to fight the crucial “first battle” and “fight ruthlessly, accurately and steadily” against ovarian cancer. “We should fight a beautiful war of annihilation against ovarian cancer!