Survival after secondary cytoreduction for recurrent ovarian cancer: which are the prognostic factors?

J Surg Oncol. 2010 Nov 1;102(6):671-5. doi: 10.1002/jso.21686.

Abstract

Objective: Significant controversy exists concerning the factors affecting survival after secondary cytoreduction (SCR) in recurrent ovarian cancer. This study aims to identify factors independently associated with survival after SCR.

Methods: We retrospectively retrieved 39 patients with recurrent ovarian cancer. All patients had been initially treated with primary cytoreduction in our institution and received platinum- and paclitaxel-based chemotherapy postoperatively. Disease-free interval (DFI) had to be longer than 6 months. A variety of clinicopathological factors were recorded. Multivariable Cox regression was performed to examine the associations of parameters with survival.

Results: Median survival was equal to 24 months, the median DFI was 22 months, and complete SCR had been achieved in 19/39 patients (48.7%, 95% CI: 32.4-65.2%). Higher number of recurrence sites, clear-cell histological type, and more advanced FIGO stage were independently associated with shorter survival; longer DFI was associated with longer survival. Noticeably, complete SCR lost its significance at the multivariable model, although it was associated with longer survival at the univariable analysis.

Conclusions: Four factors seem capable of independently modifying survival after SCR: number of recurrence sites, DFI, FIGO stage, and clear cell histology. The two latter factors might reflect aggressive clinicopathological features of the tumor with long-term effect.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Humans
  • Ovarian Neoplasms / mortality*
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / surgery
  • Prognosis
  • Recurrence
  • Reoperation
  • Retrospective Studies
  • Treatment Outcome