title: What Characterizes Long-term Survivors of Recurrent Ovarian Cancer? Case Report and Review of the Literature.
abstract: Women with recurrent ovarian cancer have a poor prognosis and short survival. However, some women are long-term survivors and it is unclear whether they share specific common characteristics.
  
  
  
  We present the case of a 63-year-old woman with histologically-proven recurrent ovarian cancer and a survival time of 16 years after the diagnosis of recurrence. She underwent initial debulking surgery in 1994, followed by 6 cycles of adjuvant chemotherapy with cisplatin and paclitaxel. After recurrent disease was diagnosed by re-laparotomy in 2000, she underwent four lines of systemic chemotherapy from 2000 to 2009 (carboplatin/paclitaxel, topotecan, etoposide/treosulfan and liposomal doxorubicin) and four lines of endocrine therapy between 2002 and 2014 (tamoxifen, goserelin, tamoxifen and exemestane). In 2014, she underwent secondary debulking surgery and was tumor-free until 2015. Upon progression, she was then started on the fifth-line of endocrine therapy, fulvestrant, which was changed to the mTOR inhibitor everolimus in June 2016. In a PUBMED literature search, 360 cases of long-term survivors of recurrent ovarian cancer (LTSROC), defined as women with survival >5 years after the diagnosis of recurrence, were identified with a mean post-recurrence survival time of 7.5 years. Comparing the patient and therapy details of these women, we identified common characteristics of LTSROC, i.e. young age and optimal debulking at initial surgery, a long time span between first-line therapy and first recurrence and the combined use of optimal cytoreductive surgery and systemic chemotherapy.
  
  
  
  LTSROC are rare, with 360 cases described in the literature. LTSROC are characterized by young age, low tumor stage, long recurrence-free interval and combined modality treatment with optimal cytoreductive surgery and systemic chemotherapy.
authors: Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany.
authors: Ziad
authors: Z
authors: Hilal
authors: Department of Hematology/Oncology, Ruhr University Bochum, Bochum, Germany.
authors: Beate
authors: B
authors: Schultheis
authors: Department of Pathology, Ruhr University Bochum, Bochum, Germany.
authors: Franziska
authors: F
authors: Hartmann
authors: Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany.
authors: Askin
authors: A
authors: Dogan
authors: Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany.
authors: Cem
authors: C
authors: Cetin
authors: Department of Obstetrics and Gynecology, St. Anna Hospital, Herne, Germany.
authors: Harald
authors: H
authors: Krentel
authors: Department of Obstetrics and Gynecology, University of Witten/Herdecke, Witten, Germany.
authors: Sven
authors: S
authors: Schiermeier
authors: Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany clemens.tempfer@rub.de.
authors: Clemens B
authors: CB
authors: Tempfer
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery; D017741:Survivors
keywords: Ovarian cancer; chemotherapy; long-term survivor; recurrence; therapy response