Premium
The role of secondary cytoreductive surgery in the treatment of patients with recurrent epithelial ovarian carcinoma
Author(s) -
Eisenkop Scott M.,
Friedman Richard L.,
Spirtos Nick M.
Publication year - 2000
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(20000101)88:1<144::aid-cncr20>3.0.co;2-x
Subject(s) - medicine , chemotherapy , surgery , cytoreductive surgery , carcinoma , multivariate analysis , cohort , cancer , ovarian cancer
BACKGROUND This study examined the impact of secondary cytoreductive surgery on survival of patients with recurrent epithelial ovarian carcinoma. METHODS One hundred six patients with a disease free interval (DFI) > 6 months after primary treatment underwent secondary cytoreductive surgery. Multivariate analysis determined which variables influenced the cytoreductive outcome and survival. RESULTS Eighty‐seven patients (82.1%) underwent removal of all visible tumor. The median and estimated 5‐year survival for the entire cohort after recurrence was 35.9 months and 28%, respectively. The probability of complete cytoreduction was influenced by the largest size of recurrent tumor (< 10 cm [90.0%] vs. > 10 cm [66.7%]; P = 0.003), use of salvage chemotherapy before secondary surgery (chemotherapy given [64.3%] vs. chemotherapy not given [93.8%]; P = 0.001), and preoperative Gynecologic Oncology Group performance status (0 [100%], 1 [91.4%], 2 [82.4%], and 3 [47.4%]; P = 0.001). Survival was influenced by the DFI after primary treatment (6–12 months [median, 25.0 months] vs. 13–36 months [median, 44.4 months] vs. > 36 months [median, 56.8 months]; P = 0.005), the completeness of cytoreduction (visibly disease free [median, 44.4 months] vs. any residual disease [median, 19.3 months]; P = 0.007), the use of salvage chemotherapy before secondary surgery (chemotherapy given [median, 24.9 months] vs. chemotherapy not given [median, 48.4 months]; P = 0.005), and the largest size of recurrent tumor (< 10 cm [median, 37.3 months] vs. > 10 cm [median, 35.6 months]; P = 0.04]). CONCLUSIONS Complete cytoreduction is possible for the majority of patients with recurrent epithelial ovarian carcinoma and maximizes survival if undertaken before salvage chemotherapy. The authors believe a randomized trial should be initiated to confirm these findings. Cancer 2000;88:144–53. © 2000 American Cancer Society.