title: Recurrence patterns of advanced ovarian, fallopian tube, and peritoneal cancers after complete cytoreduction during interval debulking surgery.
abstract: OBJECTIVE
  Similar to primary debulking surgery, complete resection of all macroscopic diseases during interval debulking surgery (IDS) is the primary objective while using neoadjuvant chemotherapy followed by IDS for advanced ovarian, fallopian tube, and peritoneal cancers. However, most patients develop recurrent disease even after complete cytoreduction during IDS. This study aims to identify recurrence patterns of the ovarian, fallopian tube, and peritoneal cancers in patients who underwent complete cytoreduction during IDS.
  
  
  METHODS
  We retrospectively reviewed data of patients with stage III or IV ovarian, fallopian tube, and peritoneal cancers who were treated at our hospital from January 1, 2005, to December 31, 2011.
  
  
  RESULTS
  In this study, 105 patients underwent neoadjuvant chemotherapy followed by IDS and achieved complete cytoreduction. The median follow-up period was 42.1 months. Recurrence was documented in 70 patients (66.7%), and 35 (33.3%) showed no evidence of disease. Peritoneal dissemination was the most common recurrence (60.0%) observed. In multivariate analysis, positive peritoneal cytology (P = 0.0003) and elevated pre-IDS serum CA125 levels (P = 0.046) were independent risk factors for recurrence.
  
  
  CONCLUSIONS
  After complete cytoreduction during IDS in patients with stage III or IV ovarian, fallopian tube, and peritoneal cancers, positive peritoneal cytology at IDS and elevated pre-IDS CA125 levels are associated with an increased risk of cancer recurrence. Positive peritoneal cytology during IDS is a particularly strong predictive factor for poor outcomes in these patients.
authors.affiliation: Department of Gynecological Oncology, Cancer Institute Hospital, Tokyo, Japan.
authors.forename: Tomoka
authors.initials: T
authors.lastname: Usami
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kato
authors.forename: Tomoko
authors.initials: T
authors.lastname: Taniguchi
authors.forename: Akiko
authors.initials: A
authors.lastname: Abe
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Nomura
authors.forename: Akiko
authors.initials: A
authors.lastname: Yamamoto
authors.forename: Maki
authors.initials: M
authors.lastname: Matoda
authors.forename: Sanshiro
authors.initials: S
authors.lastname: Okamoto
authors.forename: Eiji
authors.initials: E
authors.lastname: Kondo
authors.forename: Kohei
authors.initials: K
authors.lastname: Omatsu
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Kawamata
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Takeshima
mesh_terms: D018293:Cystadenoma, Serous / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D005185:Fallopian Tube Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate