Secondary cytoreductive surgery in recurrent epithelial ovarian cancer: A prognostic analysis with 103 cases

Int J Surg. 2017 Feb:38:61-66. doi: 10.1016/j.ijsu.2016.12.031. Epub 2016 Dec 24.

Abstract

Background: Due to satisfactory cytoreductive surgery combined with platinum-based chemotherapy in epithelial ovarian cancer has improved greatly, however, the relapse rate also high. In current study, we analyzed prognostic factors related to secondary cytoreductive surgery in patients with recurrent epithelial ovarian cancer.

Methods: Clinical and follow-up data from 103 patients with recurrent epithelial ovarian cancer who received secondary cytoreductive surgery and were admitted to our hospital between January 2000 and December 2008 were analyzed.

Results: Median survival after recurrence (RS) after the first relapse for the 103 patients was 36 months, and median overall survival (OS) was 60 months. Patients without visible residual tumors after secondary cytoreductive surgery had longer RS and OS compared to those with residual tumors ≥1 cm. The RS and OS of patients without visible residual tumors after secondary cytoreductive surgery were not significantly different compared to those with residual tumors between 0.1 and 1 cm. Patients with disease free interval (DFI) ≥ 12 months at secondary cytoreductive surgery had longer RS and OS compared to those with DFI < 12 months. Patients with one recurrent lesion had longer RS and OS compared to those with more than one lesion.

Conclusions: Residual tumor at secondary cytoreductive surgery, DFI and number of lesions were independent prognostic factors for secondary cytoreductive surgery in patients with epithelial ovarian cancer. Patients with DFI ≥12 months and a single lesion had better prognosis for achieving satisfactory cytoreduction, especially the absence of visible residual tumors.

Keywords: Recurrent epithelial ovarian cancer; Secondary cytoreductive surgery; Survival after recurrence.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Ovarian Epithelial
  • Chronic Disease
  • Cytoreduction Surgical Procedures* / mortality
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / surgery*
  • Neoplasm, Residual
  • Neoplasms, Glandular and Epithelial / mortality
  • Neoplasms, Glandular and Epithelial / surgery*
  • Ovarian Neoplasms / mortality
  • Ovarian Neoplasms / surgery*
  • Prognosis
  • Reoperation
  • Retrospective Studies
  • Survival Analysis
  • Time Factors