title: Perioperative morbidity and outcome of secondary cytoreduction for recurrent epithelial ovarian cancer.
abstract: BACKGROUND
  Despite radical surgical and chemotherapeutic treatment of ovarian cancer, the majority of patients develop recurrent disease. Secondary cytoreductive surgery can result in favourable outcome in selected patients, but information regarding feasibility, safety and perioperative outcome of these often complex procedures is limited.
  
  
  METHODS
  Surgical parameters in patients with recurrent epithelial ovarian cancer selected for secondary cytoreduction were analysed and compared to patients undergoing primary cytoreduction.
  
  
  RESULTS
  In total, 222 patients undergoing radical cytoreduction were analysed (48 patients for relapsed disease and 174 patients at primary diagnosis of advanced ovarian cancer). The range of surgical procedures was similar in both groups. In 48% of secondary cytoreductions 'optimal surgical results' (residual tumour <1 cm) were obtained and 33% of the patients had no residual disease compared to 82% and 58% at primary cytoreduction. There was no significant difference in perioperative complication rates. The duration of surgery was shorter and the number of transfused blood products was smaller at secondary cytoreduction (p < 0.001 and p = 0.001).
  
  
  CONCLUSIONS
  Secondary cytoreduction in relapsed ovarian cancer is safe and feasible and perioperative outcome is not inferior compared to primary cytoreduction. Surgery-associated morbidity should represent a minor aspect in the selection and counselling of patients regarding treatment options for recurrent ovarian cancer.
authors.affiliation: Department of Gynaecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Woelber
authors.forename: S
authors.initials: S
authors.lastname: Jung
authors.forename: C
authors.initials: C
authors.lastname: Eulenburg
authors.forename: V
authors.initials: V
authors.lastname: Mueller
authors.forename: J
authors.initials: J
authors.lastname: Schwarz
authors.forename: F
authors.initials: F
authors.lastname: Jaenicke
authors.forename: S
authors.initials: S
authors.lastname: Mahner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D016015:Logistic Models; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome