title: [Cytoreductive surgery in the management of stage IV epithelial ovarian cancer].
abstract: OBJECTIVE
  To determine the role of cytoreductive surgery in patients with stage IV epithelial ovarian cancer.
  
  
  METHODS
  From Jan. 1986 to Dec. 1997, 71 patients with stage IV epithelial ovarian cancer who were surgically treated in our hospital were retrospectively reviewed. Survival was calculated by Kaplan-Meier method with differences in survival estimated by Log-rank test. Independent prognostic factors were identified by the COX's stepwise regression model.
  
  
  RESULTS
  Thirty (42.3%) of 71 patients were successfully debulked (< or = 1 cm) at the time of initial surgery. The estimated 5-year total survival rate was 6.1%. There was a significant difference in survival between patients optimally (13.7%) vs. suboptimally (0.0%) cytoreduced, with an estimated medium survival of 23 months in optimal group vs. 9 months in suboptimal group (P < 0.001). When the variables were factorized, optimal cytoreduction could get the greatest benefit. Only in patients with malignant pleural effusion or positive supraclavicular lymph node. Multivariate analysis revealed that size of residual disease and ascites were independent factors for both overall and progression-free survival (P < 0.05).
  
  
  CONCLUSIONS
  Optimal cytoreductive surgery is an important determinant of survival in women with stage IV epithelial ovarian cancer, especially in those with malignant pleural effusion or positive supraclavicular lymph node pathology.
authors.affiliation: Department of Gynecologic Oncology, Cancer Hospital of Shanghai Medical University, Shanghai 200032, China.
authors.forename: R
authors.initials: R
authors.lastname: Zang
authors.forename: Z
authors.initials: Z
authors.lastname: Zhang
authors.forename: J
authors.initials: J
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D015996:Survival Rate