Abstract
Objective
This study aimed to evaluate the impact of the secondary cytoreductive surgery on
survival parameters in women with platinum-sensitive recurrent ovarian cancer who
undergone secondary cytoreduction following chemotherapy compared to women who recieved
chemotherapy alone.
Study Design
In a retrospective study, data were rewieved from women who were diagnosed and treated
with ovarian cancer and its primary platinum-sensitive recurrence at the University
Hospital Brno in the Czech Republic between November 2009 and March 2016. Out of the
total number of 62 patients with recurrence, 30 women underwent cytoreductive surgery
plus chemotherapy and 32 were treated with chemotherapy alone. The good performance
status expressed by ECOG score 0–1, the single site of recurrence regardless of platinum-free
interval or multiple sites of recurrence but no carcinomatosis and platinum-free interval
>12 months, and no or small-volume ascites (<500 ml) were considered inclusion criteria
for cytoreductive surgery. Women not meeting these criteria were treated by chemotherapy
alone. Descriptive statistics, Kaplan-Meier survival curves and Log-Rank test were
used for statistical estimations.
Results
The analysis confirmed more favorable prognosis in patient group treated with a combination
secondary cytoreduction and chemotherapy. Mean disease-free survival (DFS) was 49.8
months (95% CI; 33.2–66.3) and mean overall survival (OS) stood at 54.0 months (95%
CI; 39.4–68.6) in this patient cohort, while in patient group treated with chemotherapy
alone it was found that mean DFS was 16.6 months (95% CI; 7.4–25.8) and mean OS stood
at 26.2 months (95% CI; 16.6–35.8). When testing the difference between survival curves,
statistically significant differences were observed in both DFS (p = 0.010) and OS
(p = 0.007) rates between two treatment groups. Age < 60 years at the time of recurrence and zero macroscopic residual disease after secondary
cytoreduction were identified as favorable prognostic factors for both DFS and OS
in a multivariate analysis.
Conclusion
Secondary cytoreductive surgery is acceptable as a viable treatment option for highly
selected women with ovarian cancer recurrence. Complete resection is considered ultimate
goal of secondary cytoreduction on condition that the balance between maximal survival
gain and minimal operative morbidity will be kept.
Keywords
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Article info
Publication history
Published online: June 20, 2018
Accepted:
June 14,
2018
Received:
March 29,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
