499 Prognostic factors in ovarian carcinoma in pathologic complete remission (PCR) at second look surgery (SL)

Abstract

Prognosis of ovarian carcinoma in pCR at SL is still controversial. In a series of 83 patients in pCR at SL, we retrospectively studied several prognostic factors (age, stage, histologic grade, histologic type, initial residual disease after first surgery, time to CA 125 normalization). Median age was 55 years (20–80), there were 5 Stage IC, 17 Stage II, 53 Stage III and 7 Stage IV. All patients underwent an initial maximal debulking surgery followed by 6 platinum based chemotherapy cycles and SL. Consolidation treatment was variable and consisted of intraperitoneal mitoxantrone in 52 pts, intensive chemotherapy in 17 pts or others in 14 pts. Stage (I+II vs III+IV), histologic grade (1+2 vs 3), histologic type (serous vs non-serous) were of no prognostic value for relapse. Age < or > 55 years (Disease Free Survival (DFS) 71% vs 55%), initial tumoral residue < or > 2cm (DFS 85 vs 41%) and time to CA 125 normalization < or > 8 weeks (DFS 80.5% vs 44.4%) are statistically significant for relapse at 2 years (<i>P</i><0.05). The combination of CA 125 normalization < 8 weeks with absence of macroscopic tumoral residue permits to define a group with a very good prognosis, while patients with CA 125 normalization >8 weeks and an initial macroscopic residual tumor display a poorer prognosis (DFS at 2 years 100 vs 47%, <i>P</i><0.05).