Gynecol Oncol Research Articles

Germline and Somatic Testing for Ovarian Cancer: An SGO Clinical Practice Statement

(Abstracted from Gynecol Oncol 2024;181:170–178 Identification of germline and somatic pathogenic variants as well as homologous recombination deficiency (HRD) can contribute to the prediction of treatment response, prognostic outcome, and suitability for targeted agents. Germline genetic testing can also serve to inform risk for other malignancies and prompt risk management for at-risk relatives.

Disparities in Brachytherapy Utilization in Cervical Cancer in the United States: A Comprehensive Literature Review

(Abstracted from Gynecol Oncol 2024;179:79–84) Advanced cervical cancer is commonly treated with concurrent chemotherapy and external beam radiation therapy (RT), followed by brachytherapy (BT) boost. Brachytherapy allows dose escalation to the central disease while limiting the dose to normal surrounding organs including the bladder, rectum, and small bowel and sigmoid colon.

Building Knowledge Using a Novel Web-Based Intervention to Promote HPV Vaccination in a Diverse, Low-Income Population

(Abstracted from Gynecol Oncol 2024;181:102–109) Significant racial and socioeconomic disparities exist in the incidence, morbidity, and mortality from cervical cancer within the United States and worldwide. Greater than 90% of cervical cancer cases are attributable to human papillomavirus (HPV), and evidence suggests an approximately 90% reduction in cervical cancer incidence among HPV-vaccinated individuals.

Baseline value and longitudinal kinetics of circulating nucleosomes during neo-adjuvant chemotherapy in newly diagnosed ovarian cancer: Results from the randomized phase II trial CHIVA (GINECO).

e15029 Background: Nucleosomes (DNA wound around histone proteins) were reported as potential cancer biomarkers (1). The links between circulating nucleosomes and clinical endpoints in advanced ovarian cancer (OC) patients treated with neo-adjuvant chemotherapy (NACT) +/- interval debulking surgery (IDS) were retrospectively assessed in the randomized phase II CHIVA trial (2). Methods: The diagnostic concentration and the longitudinal kinetics of 2 nucleosomes (H3K27 and H3K36, log-scale) were investigated at baseline, during NACT, after IDS, and at progression. The baseline titer measured with Nu.Q prototype immunoassays (H3K27Me3, H3K36Me3 (Belgian Volition SRL, Belgium)) was compared to those of a cohort of 201 cancer-free subjects. Their prognostic values regarding the probability of obtaining a complete IDS and progression-free survival (PFS) were assessed with respect to the modeled CA-125 KELIM (3), classical clinical covariates and treatment arms. The maximum selected rank statistics was used to determine the optimal cut-off at different disease management times. Results: H3K27 and H3K36 nucleosome concentrations were available for 148/188 patients. H3K36 and H3K27 baseline concentrations were correlated and significantly higher in OC patients compared to cancer-free subjects (H3K36, 2.8 vs 2.4 ng/mL, P<0.0001; H3K27, 3.2 vs 2.1, P<0.0001), without difference according to BRCA status. The baseline titer of H3K36 was an independent predictor of the completeness of IDS (OR=0.33; 95% CI=0.13-0.71, p=0.009). The baseline concentration of H3K27 was independently associated with PFS (< or ≥3.8 ng/mL, HR=1.84, 95%CI=1.11-3.02, p=0.016), complementary to the CA-125 KELIM. Both nucleosome longitudinal kinetics showed a decrease during NACT, but there was no significant statistical association between their kinetics and radiological response rate, completeness of IDS or PFS. Conclusions: Baseline values of H3K36 and H3K27 could represent a non-invasive method for detecting OC, with potential relevant prognostic value of initial titers in newly diagnosed OC patients. 1. McAnena, Cancers 2017. 2. Ferron, Gynecol Oncol 2023. 3. You, CCR 2020.

Effectiveness and Safety of REBACIN as a Non-invasive Intervention for Persistent High-Risk Human Papillomavirus Infection: A Real-World Prospective Multicenter Cohort Study

(Abstracted from Gynecol Oncol 2023;178:8–13) High-risk human papillomavirus (hrHPV) infection is an essential factor in the development of cervical cancer, making timely treatment of this infection important. The number of individuals with persistent hrHPV in the gynecological outpatient setting remains high, and no effective hrHPV drug has been brought to market.

Association of Body Mass Index With Early Age at Diagnosis of Endometrial Intraepithelial Neoplasia

(Abstracted from Gynecol Oncol 2023;175:15–19) The development of endometrial intraepithelial neoplasia (EIN), a precursor lesion to endometrioid endometrial cancer, is related to prolonged and unopposed excess estrogen stimulation in the endometrium. The 2 conditions are frequently diagnosed concurrently.

GLORIOSA: A randomized, open-label, phase 3 study of mirvetuximab soravtansine with bevacizumab vs. bevacizumab as maintenance in platinum-sensitive ovarian, fallopian tube, or primary peritoneal cancer.

TPS5622 Background: Elevated folate receptor-alpha (FRα) expression is a characteristic of epithelial ovarian cancer (EOC), thereby providing a rational target for antibody drug conjugate (ADC) development in ovarian cancer. Mirvetuximab soravtansine (MIRV) is an ADC comprising a FRα-binding antibody, cleavable linker, and the maytansinoid DM4, a potent tubulin-targeting agent that has received accelerated approval for patients with FRα positive platinum resistant ovarian cancer. MIRV in combination with BEV has demonstrated clinically meaningful activity, along with acceptable tolerability, in patients with FRα expressing ovarian cancer.1 Methods: GLORIOSA is a randomized, open-label, phase 3 study designed to evaluate the efficacy of in combination with bevacizumab compared with bevacizumab alone as maintenance for patients with FRα-positive recurrent platinum-sensitive epithelial ovarian, fallopian tube, or peritoneal cancers who have not progressed after second line platinum-based chemotherapy plus bevacizumab (which may be given on protocol for patients with high FRα tumor expression). Confirmation of high FRα positivity by immunohistochemistry using the Ventana FOLR1 CDx Assay (high expression; ≥ 75% of viable tumor cells staining at 2+ intensity) and 1 prior line of therapy is required for inclusion. GLORIOSA is designed to randomize 418 patients, 1:1 receiving intravenous MIRV at a dose of 6 mg/kg adjusted ideal body weight plus bevacizumab 15mg/kg every 3 weeks or receiving bevacizumab 15mg/kg every 3 weeks until disease progression or unacceptable toxicity. Radiological assessments will be conducted every 9 weeks (± 2 weeks) for 72 weeks, and subsequently every 18 weeks (± 3 weeks) until progressive disease (PD), death, the start of new anticancer therapy, or withdrawal of consent from the study (whichever occurs first). The primary efficacy endpoint is progression-free survival by investigator and will also be assessed as a sensitivity analysis. The secondary endpoints include objective response rate, quality of life, overall survival, and safety and tolerability. GLORIOSA is a global study that opened for enrollment in December 2022. Reference: 1. Gilbert L, Oaknin A, Matulonis UA, et al. Safety and efficacy of mirvetuximab soravtansine, a folate receptor alpha (FRα)-targeting antibody-drug conjugate (ADC), in combination with bevacizumab in patients with platinum-resistant ovarian cancer. Gynecol Oncol. 2023; 170: 241–247 Clinical trial information: NCT05445778 .

O-RADS US Risk Stratification and Management System: Case-based Learning Approach for Daily Practice

HomeRadioGraphicsVol. 43, No. 3 PreviousNext UltrasoundRadioGraphics FundamentalsO-RADS US Risk Stratification and Management System: Case-based Learning Approach for Daily PracticeKalesha Hack, Lori Strachowski, Rochelle F. Andreotti, Hournaz Ghandehari, Priyanka Jha, Christopher Lim, Chirag Patel, Phyllis Glanc Kalesha Hack, Lori Strachowski, Rochelle F. Andreotti, Hournaz Ghandehari, Priyanka Jha, Christopher Lim, Chirag Patel, Phyllis Glanc Author AffiliationsFrom the Department of Medical Imaging, University of Toronto, Sunnybrook Health Sciences Centre, MG160, 2075 Bayview Ave, Toronto, ON, Canada M4N 3M5 (K.H., H.G., C.L., C.P., P.G.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (L.S., P.J.); and Department of Radiology, Vanderbilt University, Nashville, Tenn (R.F.A.).Address correspondence to P.G. (email: [email protected]).Kalesha HackLori StrachowskiRochelle F. AndreottiHournaz GhandehariPriyanka JhaChristopher LimChirag PatelPhyllis Glanc Published Online:Feb 23 2023https://doi.org/10.1148/rg.220079MoreSectionsFull textPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In AbstractUnderstanding the O-RADS US lexicon and how to apply it accurately can improve care in daily practice by decreasing unnecessary follow-up and surgery and promoting rapid referral to a gynecologic oncologist.Suggested ReadingsAndreotti RF, Timmerman D, Benacerraf BR, et al. Ovarian-Adnexal Reporting Lexicon for Ultrasound: A White Paper of the ACR Ovarian-Adnexal Reporting and Data System Committee. J Am Coll Radiol 2018;15(10):1415–1429 [Published correction appears in J Am Coll Radiol 2019;16(3):403–406.]. Crossref, Medline, Google ScholarAndreotti RF, Timmerman D, Strachowski LM, et al. O-RADS US risk stratification and management system: a consensus guideline from the ACR Ovarian-Adnexal Reporting and Data System Committee. Radiology 2020;294(1):168–185. Link, Google ScholarBasha MAA, Metwally MI, Gamil SA, et al. Comparison of O-RADS, GI-RADS, and IOTA simple rules regarding malignancy rate, validity, and reliability for diagnosis of adnexal masses. Eur Radiol 2021;31(2):674–684. Crossref, Medline, Google ScholarCao L, Wei M, Liu Y, et al. Validation of American College of Radiology Ovarian-Adnexal Reporting and Data System Ultrasound (O-RADS US): Analysis on 1054 adnexal masses. Gynecol Oncol 2021;162(1):107–112. Crossref, Medline, Google ScholarGiede KC, Kieser K, Dodge J, Rosen B. Who should operate on patients with ovarian cancer? An evidence-based review. Gynecol Oncol 2005;99(2):447–461. Crossref, Medline, Google ScholarGlanc P, Benacerraf B, Bourne T, et al. First international consensus report on adnexal masses: management recommendations. J Ultrasound Med 2017;36(5):849–863. Crossref, Medline, Google ScholarHack K, Gandhi N, Kahn D, Glanc P. OC03.05: External validation O-RADS ultrasound risk stratification and management system. Ultrasound Obstet Gynecol 2021;58(S1):8–9. Crossref, Google ScholarHack K, Glanc P. The Abnormal Ovary: Evolving Concepts in Diagnosis and Management. Obstet Gynecol Clin North Am 2019;46(4):607–624. Crossref, Medline, Google ScholarLevine D, Patel MD, Suh-Burgmann EJ, et al. Simple adnexal cysts: SRU consensus conference update on follow-up and reporting. Radiology 2019;293(2):359–371. Link, Google ScholarPi Y, Wilson MP, Katlariwala P, et al. Diagnostic accuracy and inter-observer reliability of the O-RADS scoring system among staff radiologists in a North American academic clinical setting. Abdom Radiol (NY) 2021;46(10):4967–4973. Crossref, Medline, Google ScholarSadowski, EA, et al. O-RADS MRI Risk Stratification System: Guide for Assessing Adnexal Lesions from the ACR O-RADS Committee. Radiology 2022;303:35–47. Link, Google ScholarStrachowski LM, Jha P, Chawla TP, et al. O-RADS for Ultrasound: A User's Guide, From the AJR Special Series on Radiology Reporting and Data Systems. AJR Am J Roentgenol 2021;216(5):1150–1165. Crossref, Medline, Google ScholarTimmerman D. Lack of standardization in gynecological ultrasonography. Ultrasound Obstet Gynecol 2000;16(5):395–398. Crossref, Medline, Google ScholarArticle HistoryReceived: Apr 8 2022Revision requested: May 16 2022Revision received: June 3 2022Accepted: June 8 2022Published online: Feb 23 2023 FiguresReferencesRelatedDetailsAccompanying This ArticleO-RADS US Risk Stratification and Management System: Case-based Learning Approach for Daily PracticeFeb 23 2023Default Digital Object SeriesRecommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 43, No. 3 Slide PresentationAbbreviations Abbreviations: O-RADS Ovarian-Adnexal Reporting and Data System Metrics Altmetric Score PDF download

32O 5-year (y) overall survival (OS) with maintenance olaparib (ola) plus bevacizumab (bev) by clinical risk in patients (pts) with newly diagnosed advanced ovarian cancer (AOC) in the phase III PAOLA-1/ENGOT-ov25 trial

In the PAOLA-1/ENGOT-ov25 trial, adding maintenance ola to bev improved progression-free survival in homologous recombination deficiency-positive (HRD+; tumour BRCA1/2 mutation [tBRCAm] and/or genomic instability) pts with newly diagnosed AOC at higher and lower risk of progression by disease stage and surgical status. Greatest benefits were seen in lower-risk pts (Harter et al. Gynecol Oncol 2022). Here, we analysed 5-y OS according to clinical risk and HRD status. Pts in response after first-line platinum-based chemotherapy + bev were randomized 2:1 to ola (300 mg bid; up to 24 months [mo]) + bev (15 mg/kg q3w; up to 15 mo) or placebo [pbo] + bev. This post hoc exploratory analysis evaluated OS in pts classified as higher risk (stage III with upfront surgery and residual disease or neoadjuvant chemotherapy; stage IV) or lower risk (stage III with upfront surgery and no residual disease), and by HRD status. 537 pts were randomized to ola + bev and 269 to pbo + bev (median OS follow-up 61.7 and 61.9 mo, respectively). Of 806 randomized pts, 595 (74%) were classified as higher risk and 211 (26%) as lower risk. At final data cutoff (22 March 2022), OS events had occurred in 377 higher-risk pts (data maturity 63%) and 69 lower-risk pts (data maturity 33%). OS was prolonged with ola + bev in higher- and lower-risk pts with a tBRCAm or who were HRD+. No OS benefit was seen in HRD− pts in any clinical risk subgroup. Subsequent PARP inhibitor therapy was received by 19.5% and 19.6% of ola + bev pts, and 45.9% and 45.2% of pbo + bev pts, in higher- and lower-risk groups, respectively.Table: 32OHRD statusHigher risk (n=595)Lower risk (n=211)No. of events/no. of pts (%)5-y OS rate† (%)No. of events/no. of pts (%)5-y OS rate† (%)Ola + bevPbo + bevOla + bevPbo + bevOla + bevPbo + bevOla + bevPbo + bevFull analysis set249/399 (62)128/196 (65)38.535.339/138 (28)30/73 (41)72.758.3HRD+*82/177 (46)53/89 (60)55.242.211/78 (14)16/43 (37)88.361.3tBRCAm43/109 (39)29/55 (53)65.248.35/48 (10)8/25 (32)91.466.1HRD−116/144 (81)46/62 (74)18.226.324/48 (50)12/23 (52)48.048.5HRD status by Myriad MyChoice HRD Plus assay; tBRCAm status by central labs.*HRD+ defined as a tBRCAm and/or genomic instability score of ≥42 on the Myriad MyChoice HRD Plus assay; †Kaplan–Meier estimates. Open table in a new tab HRD status by Myriad MyChoice HRD Plus assay; tBRCAm status by central labs. *HRD+ defined as a tBRCAm and/or genomic instability score of ≥42 on the Myriad MyChoice HRD Plus assay; †Kaplan–Meier estimates. This post hoc analysis of 5-y OS suggests that adding maintenance ola to bev should be considered for all HRD+ pts with newly diagnosed AOC, irrespective of their clinical risk status. Particular benefit was observed in HRD+ lower-risk pts who achieved 5-y OS rates of 88.3%.

Upfront Boost Followed by Elective Node Radiation [UBER] for Treatment of Locally Advanced Cancer of the Vulva in Older (> 70 years) Women

<h3>Purpose/Objective(s)</h3> Three key radiation metrics identified for optimizing treatment of cancer (ca) of the vulva include: completion of ≥ 20 fractions, overall treatment duration of < 8 weeks (56 days), and <1 week treatment break. Among older women (≥ 66 years) compliance to all 3 metrics is noted only 50% of the time.¹ Our study aims to evaluate treatment metrics of a radiation sequence that delivers upfront boost to the primary and positive inguinal nodes followed by adding a pelvic field for elective regional node radiation [UBER]. We reasoned that by initially targeting the highest risk volume of disease, and delaying the onset of acute (gastrointestinal, hematologic) toxicity generally associated with pelvic field radiation we may observe better compliance to RT delivery metrics in older women. <h3>Materials/Methods</h3> From September 2019 to October 2021, we identified 5 patients over the age of 70 years diagnosed with ca of the vulva and treated with radiation using the UBER sequence. All 5 patients had locally advanced clinical stage (cT3/T4 and/or node positive). Three patients received primary RT+ weekly cisplatin, 1 patient each received primary RT, and adjuvant RT alone. The RT dose/ fractionation prescribed was at the discretion of the treating physician, and 4/5 patients were treated using IMRT plans. <h3>Results</h3> The median age is 79 years [73-88 years]. The upfront boost dose delivered to the primary and positive inguinal nodes ranged from 900cGy to 2400cGy. The larger pelvic field including the primary, inguinal and pelvic nodes received a dose that ranged from 3420cGy to 4500cGy. The composite RT dose/ fractions ranged from 4320cGy/ 24 fractions to 6480cGy/36 fractions delivered over an average of 54 elapsed days [range: 37 to 69 days]. The average treatment break was 4 days [range: 0 to 6 days]. Two of the 3 patients received all 6 cycles of concomitant weekly cisplatin, and 1/3 patients received 5 cycles. Patient status at median follow up of 6 months (range: 3 to 22 months) is: 2 alive with no evidence of disease, 1 alive with partial response, 1 alive with disease progression, and 1 died of disease. <h3>Conclusion</h3> Early experience with the UBER sequence suggests high compliance to clinically important RT delivery metrics i.e., completion of > 20 fractions, average overall treatment time of < 8 weeks with < 1 week treatment break. Additionally, patients were able to receive 5-6 cycles of concomitant weekly cisplatin. In a particularly challenging older patient population with ca of the vulva further study of the UBER sequence is warranted. ¹ Swanick CW et al: Gynecol Oncol 146:87, 2017

Adoptive Cell Therapy in Gynecologic Cancers: A Systematic Review and Meta-analysis

(Abstracted from Gynecol Oncol 2022;165:664–670) Adoptive cell therapy (ACT) is a form of immunotherapy that has shown promising results in hematologic malignancies and some solid tumors. In ACT, autologous immune cells are extracted, expanded, and stimulated or engineered for reinfusion alongside growth factors to augment in vivo anticancer activity.

Malnutrition as a Risk Factor for Post-Operative Morbidity in Gynecologic Cancer: Analysis Using a National Surgical Outcomes Database

(Abstracted from Gynecol Oncol 2022;165:309–316) Nutritional status has been shown to independently predict postoperative morbidity and mortality among patients undergoing surgery for cancer, including gynecologic cancer. Many definitions of malnutrition have been proposed, including the European Society for Clinical Nutrition and Metabolism (ESPEN) definition as a combination of 2 factors: body mass index (BMI) 18.5–20 if age &lt;70 years or BMI 18.5–22 if age &gt;70 years, as well as unintended weight loss of &gt;10% over any period of &gt;5% over 3 months (ESPEN 1).

Endometrial Carcinoma Molecular Subtype Correlates With the Presence of Lymph Node Metastases

(Abstracted from Gynecol Oncol 2022;165:376–384) Endometrial cancer (EC) continues to increase in incidence and mortality globally and represents the most common gynecologic cancer in North America. Approximately 22% of patients with stage 1 EC have extrauterine disease, most commonly in pelvic and/or para-aortic lymph nodes.

Abstract 1965: Complete remission in advanced epithelial ovarian cancer is predicted by metabolic signatures measured in the media of patient’s primary culture 3D tumor explants: A metabolomic analysis

Abstract Ovarian cancer is the leading cause of gynecologic cancer death with over 21,000 new diagnosis and 13,000 deaths each year in the US. Treatment with platinum-based chemotherapy induces remission in up to 80% of patients yet the majority relapse and die from their disease within 5 years. We recently reported the analysis of patients with advanced ovarian cancers using plasma metabolomics to predict response and survival (D’Amora et al Gynecol Oncol, October 2021). As part of that study human tumor explants were submitted for the measurement of platinum resistance by ex vivo analysis of programmed cell death (EVA/PCD࣪). Media obtained from the non-drug exposed control cultures were examined by mass spectrometry for the quantification of 186 individual metabolites using the Biocrates’ p180 platform. Results obtained with the tissue culture media identify biochemical signatures that correlate with the achievement of complete pathologic remission. Among the most discrimination findings were the media concentrations of phosphatidyl choline (PC) aa c42:0 and the ratio of (PC) aa C40:2 divided by (PC) ae C42:1 suggesting either hyperactivity of lipid elongases or defective beta oxidation of very long chain fatty acids in drug refractory patients. When we compared the results of 8 patients who achieved pCR with 3 patients with residual disease the aa C42:0 concentration and the ratio aa C42:0/ae C42:1 provided an AUC= 0.958 (p. &amp;lt; 0.01) The findings suggest that peroxisomal dysfunction leads to the accumulation of very long chain fatty acid lipids. These species are known to induce endoplasmic reticulum and oxidative stress and are associated with the neurodegenerative diseases like Zellweger syndrome. We have reported similar findings in drug refractory breast cancer patients (da Silva et al, Oncotarget, August Aug 2018) suggesting common lipid metabolic changes in drug resistant adenocarcinomas. The results of these analyses could provide prognostic and predictive information for patients diagnosed with advanced epithelial ovarian cancers. Further studies correlating these findings with plasma metabolic signatures are underway as will be reported. Citation Format: Adam J. Nagourney, Paulo D'Amora, Ismael Dale Cotrim Guerreiro Silva, Steven S. Evans, Robert A. Nagourney. Complete remission in advanced epithelial ovarian cancer is predicted by metabolic signatures measured in the media of patient’s primary culture 3D tumor explants: A metabolomic analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1965.

39P Longitudinal increases in albumin-adjusted serum calcium predict ovarian cancer

39P Longitudinal increases in albumin-adjusted serum calcium predict ovarian cancer

Impact of Homologous Recombination Status and Responses With Veliparib Combined With First-Line Chemotherapy in Ovarian Cancer in the Phase 3 VELIA/GOG-3005 Study

(Abstracted from Gynecol Oncol 2022;164:245–253) Cancers with genetic homologous repair defects such as the breast cancer susceptibility genes BRCA1 and BRCA2 are particularly sensitive to poly (ADP-ribose) polymerase (PARP) inhibition. Identification of other homologous recombination deficiencies (HRD) beyond BRCA loss could expand utilization of PARP inhibitors (PARPi).

Cost-Effectiveness Analysis of Tumor Molecular Classification in High-Risk Early-Stage Endometrial Cancer

(Abstracted from Gynecol Oncol 2022;164:129–135) Endometrial cancer (EC) remains the most common gynecologic cancer in the United States, accounting for nearly 13,000 deaths in 2020 alone. Surgery remains the mainstay of treatment for early-stage EC; however, adjuvant treatment is often indicated.

Outcomes After Targeted Treatment Based on Somatic Tumor Genetic Testing for Women With Gynecologic Cancers

(Abstracted from Gynecol Oncol 2021;163:220–228) Molecular tumor profiling with next-generation sequencing (NGS) has become increasingly used in the evaluation and treatment planning for primary and recurrent gynecologic cancer. This is driven by studies demonstrating that NGS-guided treatment results in longer time to treatment failure and overall survival while also being better tolerated than conventional chemotherapy.

Talc, Body Powder, and Ovarian Cancer: A Summary of the Epidemiologic Evidence

(Abstracted from Gynecol Oncol 2021;163:199–208) Talc is a soft and inert mineral with a high capacity to bind water, making it a popular component of baby powder and feminine hygiene products as a drying agent. Talc has similar chemical features and often cooccurs with asbestos, a known carcinogen.

Surgical treatment of recurrent ovarian cancer: A review

Aim. To analyze the data available in the modern literature on the role of repeated cytoreduction in the complex treatment of relapses ovarian cancer (OC).&#x0D; Materials and methods. Sources were searched in the following systems Clinicaltrials.gov, PubMed, Medline, NCCN, Scopus, Gynecol Oncol, Elibrary. After analyzing the literature review, 31 sources were used, published from January 1989 to December 2020.&#x0D; Results. The main method of treatment relapses of ОС is administration of systemic chemotherapy. The role of surgical treatment has been actively discussed for several decades. According to the available data of retrospective, prospective, randomized trials, performing surgery following chemotherapy had a favorable effect on the long-term results of treatment just in case of achieving complete cytoreduction in comparison with only chemotherapeutic treatment of platinum-sensitive recurrence of ОС. A validated prognostic model helps to perform the selection of suitable patients for surgical treatment, therefore, the correct selection for secondary cytoreduction allows to identify the patients with a high chance of achieving сomplete cytoreduction, which reduces the number of ineffective operations in patients with residual tumors.&#x0D; Conclusion. Complete cytoreduction of all macroscopically detectable recurrent tumor lesions in combination with subsequent systemic chemotherapy leads to an improvement in progression-free survival and life expectancy in a carefully selected group of patients with platinum-sensitive recurrent OC. Secondary cytoreduction in platinum-refractory and platinum-resistant relapses deteriorates the prognosis and doesn't lead to an increase in survival rates. Patient selection is the key point in secondary cytoreductive surgery. The choice of the methodology of selection of patients is in the process of discussion. When planning treatment, all patients with recurrent OC should be discussed at multidisciplinary teams with the participation of specialists in related specialties. Considering a surgical treatment option should be performed it in large centers with extensive experience in the surgical treatment of OC, relapses, performing complex multi-organ resections.