[Clinical significance of secondary cytoreductive surgery for recurrent advanced ovarian cancer].
OBJECTIVE
To study the role of secondary cytoreductive surgery (SCR) in patients with recurrent advanced epithelial ovarian cancer.


METHODS
From Jan. 1986 to Dec. 1997, 60 women with recurrent advanced epithelial ovarian cancer treated with SCR were retrospectively reviewed. Survival curves were computed using the Kaplan-Meier method with differences in survival estimated by log-rank test. Independent prognostic factors were identified by Cox's stepwise regression, and the affecting factors of SCR evaluated by Logistic stepwise regression.


RESULTS
Of the 60 patients, 23 (38.3%) were cytoreduced to small macroscopic residual (</= 1 cm) and 37 retained larger residual, with an estimated median survival of 19 months and 8 months respectively. Multivariate analysis revealed that residual disease (P = 0.0041) after SCR, as well as refractory ascites (P = 0.0191) and progression-free interval (P = 0.0116), were independent factors of survival. Refractory ascites (relative risk = 20.36, P = 0.0072) and residual disease after primary surgery (relative risk = 5.16, P = 0.0096) were factors affecting SCR.


CONCLUSIONS
Secondary cytoreductive surgery is definitely effective in the treatment of recurrent advanced epithelial ovarian carcinoma, particularly in those who have received primary optimal cytoreduction with a progression-free interval > 12 months and without refractory ascites.
Zang
Rongyu
R
Department of Gynecological Oncology, Cancer Hospital, Fudan University, Shanghai 200032, China.
Zhang
Zhiyi
Z
Cai
Shumo
S
D000328:Adult; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D018365:Neoplasm, Residual / Q000601:surgery; D010051:Ovarian Neoplasms / Q000601:surgery*; D011379:Prognosis; D016019:Survival Analysis