Abstract
5004 Background: The role of cytoreductive surgery (CS) in recurrent ovarian cancer (ROC) has not been clearly defined. Patient selection for CS remains arbitrarily and depends more on center’s preference than on established selection criteria. Methods: The AGO performed a retrospective study evaluating criteria for CS in ROC. 25 institutions documented their pts with CS for invasive epithelial ROC performed 2000–2003. Results: 268 pts were included, mean age was 59.5 years (23–83) and 108 pts (40.4%) had a treatment-free-interval of 12 months or less. 146 pts (55%) received platinum-based chemotherapy following surgery. Complete tumor removal was achieved in 133 pts (50%). Complete resection was associated with significantly longer survival compared to CS leaving any residuals (median 45.2 vs 19.7 months; HR 3.71 (95% CI 2.27–6.05); p< 0.0001). Variables associated with a higher probability for complete resection in multivariate analysis were good performance status (ECOG 0 vs >0; OR 2.56 (95%CI 1.49–4.42); p< 0.001), no ascites (< vs > 500ml; OR 4.26 (1.62–11.24); p<0.003), no residuals after 1st surgery (0 vs >0 mm; OR 2.09 (1.20–3.64); p=0.009) and no evidence for peritoneal carcinosis in pre-OP diagnostics (yes vs no; OR 2.67 (1.34–5.32); p=0.005). A complete resection was possible in 81% if these 4 variables were present. Prognostic factors in multivariate analysis for survival after a secondary cytoreductive surgery were complete surgical resection at recurrence (0 vs > 0 mm; OR 2.86 (1.66–4.93); p<0.001), post-OP platinum chemotherapy (yes vs no; OR 1.83 (1.16–2.88); p=0.009) and no ascites (< vs > 500 ml; OR 2.09 (1.18–3.71);p=0.012). Conclusions: Only patients with complete resection seems to benefit from radical surgery. The presence of the 4 variables as shown above helped to predict surgical outcome. Based on these data the AGO will evaluate this new panel of selection criteria in a prospective multi-institutional study. No significant financial relationships to disclose.
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