title: Surgery for Recurrent Epithelial Ovarian Cancer in the Netherlands: A Population-Based Cohort Study.
abstract: OBJECTIVE
  The value of secondary cytoreductive surgery (SCS) in patients with recurrent epithelial ovarian cancer is controversial. The aim of this population-based study was to investigate the role of SCS in the Netherlands.
  
  
  METHODS
  Data of 408 patients who underwent SCS between 2000 and 2013 were retrospectively collected from 38 Dutch hospitals. Survival after complete and incomplete SCS was estimated by Kaplan-Meier curves. Factors associated with overall survival (OS) were explored with Cox regression.
  
  
  RESULTS
  Median OS after SCS was 51 months (95% confidence interval [95% CI], 44.8-57.2). Complete SCS was achieved in 295 (72.3%) patients, with an OS of 57 months (95% CI, 49.0-65.0) compared with 28 months (95% CI, 20.8-35.2) in patients with incomplete SCS (log-rank test; P < 0.001). Nonserous histology (HR 0.65; 95% CI 0.45-0.95), a long progression free interval (hazard ratio [HR], 0.29; 95% CI, 0.07-1.18), a good performance status (HR, 0.68; 95% CI, 0.49-0.94), SCS without preoperative chemotherapy (HR, 0.72; 95% CI, 0.51-1.01), and complete SCS (HR, 0.46; 95% CI, 0.33-0.64) were prognostic factors for survival.
  
  
  CONCLUSIONS
  This population-based retrospective study showed that there might be a role for SCS in recurrent epithelial ovarian cancer especially when complete SCS can be accomplished. However, before adopting SCS as a standard treatment modality for recurrent epithelial ovarian cancer, results of 3 ongoing prospectively randomized trials are needed.
authors.affiliation: *Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen; †Department of Obstetrics and Gynecology, Maastricht University Medical Centre; and ‡GROW, School for Oncology and Developmental Biology, Maastricht University, Maastricht; and §Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
authors.forename: Rafli
authors.initials: R
authors.lastname: van de Laar
authors.forename: Roy F P M
authors.initials: RF
authors.lastname: Kruitwagen
authors.forename: Joanna
authors.initials: J
authors.lastname: IntHout
authors.forename: Petra L M
authors.initials: PL
authors.lastname: Zusterzeel
authors.forename: Toon
authors.initials: T
authors.lastname: Van Gorp
authors.forename: Leon F A G
authors.initials: LF
authors.lastname: Massuger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery*; D009375:Neoplasms, Glandular and Epithelial / Q000401:mortality / Q000601:surgery*; D009426:Netherlands / Q000453:epidemiology; D010051:Ovarian Neoplasms / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult