Secondary cytoreductive surgery for recurrent platinum-sensitive ovarian cancer.
OBJECTIVE
To determine the risks and benefits of secondary cytoreductive surgery for recurrent platinum-sensitive ovarian cancer.


METHODS
Data were obtained retrospectively for all women with recurrent platinum-sensitive epithelial ovarian cancer who underwent a second debulking operation between 1998 and 2008 at the University of Texas Southwestern Medical Center. Survival analysis and comparisons were performed using the Kaplan-Meier method, log-rank test, and Cox multivariate proportional hazards model.


RESULTS
Optimal secondary cytoreductive surgery (<5mm of residual disease) was achieved in 32 of 40 patients (80%). Nine women (23%) developed major complications. Two variables, residual disease of less than 5mm vs 5mm or greater (median 63 months vs 11 months; P=0.003); and less than 5 vs 5 or more sites of disease relapse (median 63 months vs 22 months; P=0.009), were independently associated with survival and retained prognostic significance on multivariate analysis.


CONCLUSIONS
Optimal secondary cytoreductive surgery was associated with a survival advantage and acceptable risks.
Schorge
John O
JO
Division of Gynecologic Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA. jschorge@partners.org
Wingo
Shana N
SN
Bhore
Rafia
R
Heffernan
Thomas P
TP
Lea
Jayanthi S
JS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000188:drug therapy / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000601:surgery*; D010984:Platinum / Q000627:therapeutic use; D012086:Reoperation; D012189:Retrospective Studies
D010984:Platinum