Clinical analysis for the prognostic factors in patients with recurrent epithelial ovarian cancer who underwent secondary cytoreductive surgery

Abstract

Objective：To identify clinical prognostic factor improving survival of recurrent epithelial ovarian cancer (EOC) patients treated with secondary cytoreductive surgery (SCS). Methods：The indications of SCS were as follows; 1) complete response (CR) after primary cytoreductive surgery and adjuvant chemotherapy, 2) disease-free survival (DFS) (≥6 months). Clinical data of 17 patients including age, DFS, peritoneal seeding identified during SCS, the number of recurrent tumors (≥1 cm), serum CA-125 levels and maximal diameter of residual tumor after SCS were reviewed retrospectively between January 1990 and March 2007. Survival analyses were performed using Kaplan-Meier method with log-rank test and univariate Cox’s regression analysis. Results：Mean age of them was 51.7 years. No peritoneal seeding identified during SCS was a prognostic factor improving progression-free survival after SCS (PFS-SCS) (30 vs. 6 months, p＜.01 hazard ratio 0.099, 95% confidence interval 0.011-0.929, p=.043). Furthermore, serum CA-125 level (≤37 U/ml) after SCS was a significant prognostic factors improving overall survival (51 vs. 19 months, p=.033; hazard ratio 0.212, 95% confidence interval 0.045-0.983, p=.045). Conclusion：Serum CA-125 levels with normal value after SCS and no peritoneal seeding may be associated with the improvement of survival in recurrent epithelial ovarian cancer patients treated with SCS.