title: Clinical features of long-term survivors of recurrent epithelial ovarian cancer.
abstract: BACKGROUND
  Although recurrent epithelial ovarian cancer (EOC) is generally regarded as an incurable disease, some patients survive more than 5 years after the first recurrence. The aim of this study was to evaluate the clinical features of patients with recurrent EOC who achieve long-term survival.
  
  
  METHODS
  We retrospectively reviewed the medical records of 164 patients with recurrent EOC and analyzed the clinical stage, histologic subtype, primary treatment, disease-free interval (DFI), recurrence site, secondary treatment, and overall survival from the time of the first recurrence (R-OS), using the Kaplan-Meier method and the log-rank test.
  
  
  RESULTS
  The median R-OS for all 164 patients was 25 months and the 5-year R-OS rate was 25.4 %. There were no significant differences in R-OS according to the disease stage. The median R-OS was significantly shorter in the 6-12-month DFI group (23 months) than in the ≥12-month DFI group (61 months) (p = 0.0002), while there was no significant difference between the 6-12 and 3-6-month DFI groups (20 months) (p = 0.161). Of the 164 patients, only 14 survived >5 years after the first recurrence. Most of them underwent surgery and/or radiotherapy in combination with chemotherapy and underwent >18 cycles of platinum-based chemotherapy throughout their treatments (median 22 cycles; range 4-44).
  
  
  CONCLUSIONS
  If high sensitivity to platinum is maintained, patients with recurrent EOC may have prolonged survival following repeated platinum-based chemotherapy cycles. Moreover, their prognosis improves when chemotherapy is combined with secondary cytoreductive surgery and/or irradiation.
authors.affiliation: Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan, haiwase@med.kitasato-u.ac.jp.
authors.forename: Haruko
authors.initials: H
authors.lastname: Iwase
authors.forename: Toshio
authors.initials: T
authors.lastname: Takada
authors.forename: Chiaki
authors.initials: C
authors.lastname: Iitsuka
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Nomura
authors.forename: Akiko
authors.initials: A
authors.lastname: Abe
authors.forename: Tomoko
authors.initials: T
authors.lastname: Taniguchi
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Ken
authors.initials: K
authors.lastname: Takizawa
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Takeshima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000077216:Carcinoma, Ovarian Epithelial; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology*; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D017741:Survivors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009944:Organoplatinum Compounds