Evaluation of prognostic factors for secondary cytoreductive surgery in Chinese patients with recurrent epithelial ovarian carcinoma.

ABSTRACT

OBJECTIVE: Secondary cytoreductive surgery (SCS) is reported to be beneficial for patients with recurrent epithelial ovarian carcinoma (EOC). The current study is to evaluate risk factors that would affect the surgical optimal resection rate and prognosis of recurrent EOC after SCS in Chinese patients. METHODS: In our study, 44 patients with recurrent EOC treated with SCS at Shandong Cancer Hospital were retrospectively reviewed. Patient characteristics were collected and multivariate logistic regression was used to analyze factors that affect the optimal surgical resection rate. The overall survival rate was calculated by the Kaplan-Meier method. Cox proportional-hazards regression was used to analyze risk factors that affect the overall survival of these patients. RESULTS: 90.9% (40/44) patients achieved optimal cytoreductive surgery. Logistic regression did not find any factor that affects the optimal surgical resection rate. Among 24 cases that received chemotherapy before SCS, 18 cases achieved good response and thus had a better survival rate after SCS. Multivariate Cox proportional hazard regression analysis indicated that differentiation, the extent of surgical resection during the initial surgery, and course and efficacy of chemotherapy prior to SCS, and efficacy of chemotherapy after the first recurrence significantly correlated with survival of patients with recurrent cancer (P < 0.05; OR < 1). CONCLUSION: Selection of patients that are suitable to perform SCS will enhance the optimal surgical resection rate. The prognosis of Chinese patients with recurrent EOC after SCS is affected by histologic grade, the extent of residual disease and the effect of chemotherapy after first relapse.