title: Secondary cytoreductive surgery in patients with isolated platinum-resistant recurrent ovarian cancer: a retrospective analysis.
abstract: OBJECTIVE
  To analyze the impact of secondary cytoreductive surgery (SCS) on survival outcome in a retrospective series of isolated platinum-resistant recurrent ovarian cancer.
  
  
  METHODS
  We evaluate a consecutive series of 268 ovarian cancer patients with platinum-resistant relapse. Isolated recurrence was defined as the presence of a single nodule, in a single anatomic site, and was observed in 27 cases (10.1%). In all women the presence of isolated relapse was assessed at radiological evaluation, and surgically confirmed in the SCS group.
  
  
  RESULTS
  Among the 27 patients with isolated recurrence, 16 (59.3%) received chemotherapy alone, and 11 (40.7%) complete SCS followed by non-platinum based chemotherapy. No significant differences were observed in the distribution of baseline clinico-pathological characteristics, pattern of recurrent disease, duration of PFI, and type of salvage chemotherapy between the two groups. In the SCS group, 6 patients (54.5%) showed isolated peritoneal relapse and 5 women (45.4%) showed isolated lymph nodal recurrence, and were treated with peritonectomy and lymphadenectomy, according with site of relapse. Two post-operative complications (18.2%) occurred: asymptomatic lymphocele and groin wound dehiscence. SCS significantly prolonged median time to first progression (12 months vs 3 months; p-value=0.016), median time to second progression (8 months vs 3 months; p-value=0.037), and post-relapse survival (PRS) (32 months vs 8 months; p-value=0.002). Residual tumor at 1st surgery (X(2)=5.690; p-value=0.017), duration of PFI (X(2)=5.401; p-value=0.020), and complete SCS (X(2)=4.250; p-value=0.039) retains independent prognostic role for PRS in multivariate analysis.
  
  
  CONCLUSIONS
  SCS prolongs PRS compared to chemotherapy alone in isolated platinum-resistant recurrent ovarian cancer.
authors.affiliation: Department of Obstetrics and Gynaecology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Petrillo
authors.affiliation: Department of Obstetrics and Gynaecology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Pedone Anchora
authors.affiliation: Department of Obstetrics and Gynaecology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Tortorella
authors.affiliation: Department of Obstetrics and Gynaecology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Fanfani
authors.affiliation: Department of Obstetrics and Gynaecology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Gallotta
authors.affiliation: Division of Minimally Invasive Gynaecological Surgery, St. Maria Hospital, University of Perugia, Terni, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Pacciani
authors.affiliation: Department of Obstetrics and Gynaecology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Scambia
authors.affiliation: Division of Minimally Invasive Gynaecological Surgery, St. Maria Hospital, University of Perugia, Terni, Italy. Electronic address: annafagotti@libero.it.
authors.forename: A
authors.initials: A
authors.lastname: Fagotti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D016190:Carboplatin / Q000627:therapeutic use; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000601:surgery*; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin
keywords: Isolated platinum-resistant relapse; Ovarian cancer; Secondary cytoreductive surgery