Abstract: As described herein, the inventors have identified gene signatures which permit the identification of patients who will benefit from (e.g. have optimal outcomes) cytoreductive surgery as treatment for ovarian cancer. Accordingly, provided herein are methods of treatment, assays, and systems relating to ovarian cancer and the administration of cytoreductive surgery. In one aspect, the technology described herein relates to a method of treatment comprising, detecting, in a sample obtained from a subject in need of treatment for ovarian cancer, the level of activation of at least one pathway, and administering cytoreductive surgery to the subject if the level of activation is not increased relative to a reference level.