IMR Press / EJGO / Volume 41 / Issue 4 / DOI: 10.31083/j.ejgo.2020.04.8051
Open Access Original Research
The impact of secondary cytoreductive surgery on survival in first recurrence of platinum sensitive epithelial ovarian cancer
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1 Department of Obstetrics and Gynecology, Hospital Miguel Servet, Paseo Isabel la Católica, 1-3, 50009, Zaragoza, Spain
2 Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain
3 Department of Medical Oncology, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008 Pamplona, Spain
4 Department of Surgery, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008 Pamplona, Spain
Eur. J. Gynaecol. Oncol. 2020, 41(4), 523–530; https://doi.org/10.31083/j.ejgo.2020.04.8051
Submitted: 22 July 2020 | Accepted: 6 August 2020 | Published: 15 August 2020
Abstract

Objective: Analyze the effect on survival of secondary cytoreduction surgery (SCS) in treatment of first recurrence platinum-sensitive epithelial ovarian cancer (REOC). Methods: Retrospective analysis of patients with first REOC who had platinum time-free interval (TFIp) > 6 months and were treated either with SCS followed by chemotherapy or chemotherapy only (CT). Clinical data such as patient’s performance status and number of sites with metastases were specifically assessed. The primary endpoint was overall survival (OS). Results: Seventy-one patients were treated either by SCS (n = 37) or CT (n = 34). Complete resection after SCS was achieved in 89% of patients. After a median follow-up of 51.2 months, median OS, and progression-free survival (PFS) were 68.2 and 21.6 months, respectively, for the whole series of the SCS patients had better survival and disease progression survival than the CT only patients (HR: 0.33, 95%CI: 0.17-0.6; p = 0.001) and (HR: 0.28, 95%CI: 0.15-0.5; p = 0.001), respectively. TFIp < 12 months and multiple metastases were most important prognostic factors for risk of death (HR: 7.7 and 6.2, respectively) and recurrence (HR: 5.8 and 3.8, respectively). Probability to undergo successful SCS is related to oligometastatic disease and no residual disease after first surgery (OR: 30.0 and 5.9, respectively). Conclusions: In women with REOC oligometastatic disease and no residual disease at first surgery are associated with successful SCS. In these patients oligometastatic disease and long platinum TFI are associated with improved probability of survival.

Keywords
Ovarian cancer
recurrence
secondary cytoreductive surgery
Survival
morbidity
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