Abstract
BackgroundThere is no consensus regarding the secondary cytoreduction surgery (CRS) in recurrent ovarian cancer patients. The present study aims to determine the value of secondary CRS and the eligible subgroup for this procedure.Methods96 platinum-sensitive recurrent ovarian cancer patients were recruited from Jiangsu Institute of Cancer Research between 1992 and 2011. Follow-up was conducted based on the surveillance protocol of MD Anderson Cancer Center. Cox proportional hazards model and log-rank test were used to assess the associations between the survival durations and covariates. Logistic regression analysis was used to explore optimal secondary CRS related factors.ResultsOptimal secondary CRS was associated with time to progression (TTP) and overall survival (OS) in patients (p < 0.01 both). Optimal secondary CRS and asymptomatic recurrent were similarly associated with longer OS (median: 79.2 vs. 53.9 and 76.1 vs. 56.0 months with p = 0.02 and p = 0.04, respectively) and TTP (median: 13.9 vs. 10.5 and 19.3 vs. 9.0 months with p = 0.02 and p = 0.03, respectively) than counterparts. Optimal initial CRS (p = 0.01), asymptomatic recurrent (p = 0.02) and longer progression-free survival duration (p = 0.02) were the independent indicators of optimal secondary CRS.ConclusionsOptimal secondary CRS had survival benefit for platinum-sensitive epithelial ovarian cancer. Asymptomatic recurrent was one of the recruited factors for this procedure.
Highlights
There is no consensus regarding the secondary cytoreduction surgery (CRS) in recurrent ovarian cancer patients
In addition to the potential benefit of secondary CRS, defining the specific population that might best benefit from this surgery is equaled important
Our previous study revealed that rising CA-125 levels optimized the secondary CRS in asymptomatic recurrent Epithelial ovarian cancer (EOC) [12]
Summary
There is no consensus regarding the secondary cytoreduction surgery (CRS) in recurrent ovarian cancer patients. The present study aims to determine the value of secondary CRS and the eligible subgroup for this procedure. The management of recurrent diseases is one of Observational studies have explored that secondary CRS may improve the survival duration of recurrent EOC patients. At least in platinum-sensitive recurrent EOC, the optimal secondary CRS shows a certain positive significance [4,5,6,7,8,9]. Found a patients’ selected model for optimal secondary CRS in recurrent ovarian cancer includes FIGO stage, residual disease after primary surgery, progression-free interval, ECOG performance status, CA125 at recurrence, ascites at recurrence. Other factors predict surgery outcome of secondary CRS includes progression-free survival (PFS) from primary treatment to recurrence, and number of recurrent tumors [13]
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