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Special Issue
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The impact of secondary cytoreductive surgery on survival in first recurrence of platinum sensitive epithelial ovarian cancer
1Department of Obstetrics and Gynecology, Hospital Miguel Servet, Paseo Isabel la Católica, 1-3, 50009, Zaragoza, Spain
2Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain
3Department of Medical Oncology, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008 Pamplona, Spain
4Department of Surgery, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008 Pamplona, Spain
DOI: 10.31083/j.ejgo.2020.04.8051 Vol.41,Issue 4,August 2020 pp.523-530
Submitted: 22 July 2020 Accepted: 06 August 2020
Published: 15 August 2020
*Corresponding Author(s): Juan Luis Alcázar E-mail: jlalcazar@unav.es
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.
Ovarian cancer; Recurrence; Secondary cytoreductive surgery; Survival; Morbidity
Silvia Ortega, José Angel Mínguez, José Manuel Aramendía,Marta Santisteban,Fernando Martinez-Regueira,Pablo Martí-Cruchaga,Juan Luis Alcázar,Matías Jurado. The impact of secondary cytoreductive surgery on survival in first recurrence of platinum sensitive epithelial ovarian cancer. European Journal of Gynaecological Oncology. 2020. 41(4);523-530.
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