title: The Role of Quaternary Cytoreduction in Recurrent Epithelial Ovarian Cancer: A Single-center Experience.
abstract: OBJECTIVE
  to evaluate the efficacy and to determine safety and survival benefit after quaternary cytoreduction in recurrent epithelial ovarian cancer.
  
  
  METHODS
  We retrospectively reviewed data of all patients submitted to quaternary cytoreduction at the Dan Setlacec Center of Gastrointestinal Disease and Liver Transplantation, Fundeni Clinical Institute between January 2002 and May 2014.
  
  
  RESULTS
  Twenty patients with a mean age of 54.3 years were submitted to quaternary cytoreduction. At the time of initial diagnosis, International Federation of Gynaecology and Obstetrics stages were IA in four cases, IIA in three cases, IIC in two cases, IIIA in three cases, IIIB in two cases and IIIC in six cases. At the time of quaternary cytoreduction, R0 resection was achieved in seven cases. Postoperative complications occurred in three cases (15%), while the 30-day mortality was 0. The median overall survival after quaternary cytoreduction was 16 months.
  
  
  CONCLUSIONS
  quaternary cytoreduction in recurrent epithelial ovarian cancer appears to be a safe procedure and may bring survival benefit in selected cases.
authors.affiliation: Carol Davila University of Medicine and Pharmacy, Bucharest, Romania nicolae_bacalbasa@yahoo.ro.
authors.forename: Nicolae
authors.initials: N
authors.lastname: Bacalbaşa
authors.affiliation: Ponderas Hospital, Bucharest, Romania.
authors.forename: Irina
authors.initials: I
authors.lastname: Balescu
authors.affiliation: Dan Setlacec Center of Gastrointestinal Disease and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania.
authors.forename: Simona
authors.initials: S
authors.lastname: Dima
authors.affiliation: Dan Setlacec Center of Gastrointestinal Disease and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania.
authors.forename: Vladislav
authors.initials: V
authors.lastname: Brasoveanu
authors.affiliation: Carol Davila University of Medicine and Pharmacy, Bucharest, Romania Dan Setlacec Center of Gastrointestinal Disease and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania.
authors.forename: Irinel
authors.initials: I
authors.lastname: Popescu
mesh_terms: D000328:Adult; D000368:Aged; D000077216:Carcinoma, Ovarian Epithelial; D065426:Cytoreduction Surgical Procedures; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies
keywords: Epithelial ovarian cancer; prolonged survival; quaternary cytoreduction; recurrence