title: "The impact of debulking surgery in patients with node-positive epithelial ovarian cancer: Analysis of prognostic factors related to overall survival and progression-free survival after an extended long-term follow-up period".
abstract: OBJECTIVE
  to estimate the prognostic factors associated with survival and progression free survival (PFS) in patients with node-positive epithelial ovarian cancer (EOC) after an extended long-term follow-up period.
  
  
  METHODS
  Data was provided by the Tumor Registry of the Mayo Clinic, Scottsdale, Arizona on 116 node-positive EOC patients who underwent primary cytoreductive surgery observed over the period 1996-2014.
  
  
  RESULTS
  At censoring date, 21 patients were alive (18%), 95 dead (82%), 18 without evidence of disease (NED) (15 alive, 3 dead) and 76 with evidence of disease (ED) (2 alive, 74 dead). Twenty-nine ED patients (38.2%) experienced a recurrence within 2 years, 53 patients (69.7%) before 5 years. No recurrences were recorded after 10 years. The median follow-up in alive patients was 169.8 months (1.20-207.9 months), 34.9 months (0.30-196.2 months) in dead patients, 128.4 months for NED patients (72.8-202.5 months) and 34.6 months (0.1-106.9 months) in ED patients. Multivariate analysis showed an increased risk of dead in patients with age ≥ 60 years (HR: 3.20; p < 0.002), stage IVA/B (compared with stage IIIA1/2, HR: 4.31; p < 0.001 and stage IIIB/C, HR: 5.31; p < 0.010) and incomplete surgery (compared with complete surgery, HR: 3.10; 95% CI, 1.41-6.77; p < 0.003) and a decreased PFS in stage IVA/B (compared with stages IIIB/C; p = 0.003 and stage IIIA; p = 0.000) and residual volume after surgery >0.6 cm (compared with residual disease <0.5 cm; p < 0.023).
  
  
  CONCLUSIONS
  prognostic factors for an extended long-term PFS are similar as those for survival, because after 17-year follow-up period, the majority of alive patients are NED patients.
authors.affiliation: Division of Gynecologic Oncology, Gregorio Marañón University General Hospital, C/Maiquez, 7, 28009 Madrid, Spain. Electronic address: apereiras@sego.es.
authors.forename: Augusto
authors.initials: A
authors.lastname: Pereira
authors.affiliation: Department of Gynecologic Surgery, Puerta de Hierro University Hospital, C/Joaquin Rodrigo, 2, 28222 Madrid, Spain.
authors.forename: Tirso
authors.initials: T
authors.lastname: Pérez-Medina
authors.affiliation: Division of Gynecologic Surgery, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, 85259 AZ, USA.
authors.forename: Javier F
authors.initials: JF
authors.lastname: Magrina
authors.affiliation: Division of Gynecologic Surgery, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, 85259 AZ, USA.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Magtibay
authors.affiliation: Department of Gynecology and Obstetrics, College of Medicine, Autonomous University, C/Arzobispo Morcillo, 4, 28029 Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Rodríguez-Tapia
authors.affiliation: Division of Gynecologic Oncology, Gregorio Marañón University General Hospital, C/Maiquez, 7, 28009 Madrid, Spain.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Cuesta-Guardiola
authors.affiliation: Department of Obstetrics and Gynecology, Bronx-Lebanon Hospital Center, 1650 Grand Concourse, Bronx, 10457 NY, USA.
authors.forename: Irene
authors.initials: I
authors.lastname: Peregrin
authors.affiliation: Division of Gynecologic Oncology, Gregorio Marañón University General Hospital, C/Maiquez, 7, 28009 Madrid, Spain.
authors.forename: Elsa
authors.initials: E
authors.lastname: Mendizabal
authors.affiliation: Division of Gynecologic Oncology, Gregorio Marañón University General Hospital, C/Maiquez, 7, 28009 Madrid, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Lizarraga
authors.affiliation: Division of Gynecologic Oncology, Gregorio Marañón University General Hospital, C/Maiquez, 7, 28009 Madrid, Spain.
authors.forename: Luís
authors.initials: L
authors.lastname: Ortiz-Quintana
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018284:Cystadenocarcinoma, Serous / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D065426:Cytoreduction Surgical Procedures / Q000401:mortality*; D016889:Endometrial Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Extended long-term follow-up; Long-term follow up; Overall survival; Prognostic factors; Progression free survival