Clinical significance of secondary cytoreductive surgery for recurrent advanced ovarian cancer / 中华肿瘤杂志

ABSTRACT

<p><b>OBJECTIVE</b>To study the role of secondary cytoreductive surgery (SCR) in patients with recurrent advanced epithelial ovarian cancer.</p><p><b>METHODS</b>From Jan. 1986 to Dec. 1997, 60 women with recurrent advanced epithelial ovarian cancer treated with SCR were retrospectively reviewed. Survival curves were computed using the Kaplan-Meier method with differences in survival estimated by log-rank test. Independent prognostic factors were identified by Cox's stepwise regression, and the affecting factors of SCR evaluated by Logistic stepwise regression.</p><p><b>RESULTS</b>Of the 60 patients, 23 (38.3%) were cytoreduced to small macroscopic residual (</= 1 cm) and 37 retained larger residual, with an estimated median survival of 19 months and 8 months respectively. Multivariate analysis revealed that residual disease (P = 0.0041) after SCR, as well as refractory ascites (P = 0.0191) and progression-free interval (P = 0.0116), were independent factors of survival. Refractory ascites (relative risk = 20.36, P = 0.0072) and residual disease after primary surgery (relative risk = 5.16, P = 0.0096) were factors affecting SCR.</p><p><b>CONCLUSION</b>Secondary cytoreductive surgery is definitely effective in the treatment of recurrent advanced epithelial ovarian carcinoma, particularly in those who have received primary optimal cytoreduction with a progression-free interval > 12 months and without refractory ascites.</p>