Secondary cytoreductive surgery for recurrent platinum-sensitive ovarian cancer☆
Received 19 May 2009; received in revised form 12 August 2009; accepted 23 September 2009. published online 05 November 2009.
Abstract
Objective
To determine the risks and benefits of secondary cytoreductive surgery for recurrent platinum-sensitive ovarian cancer.
Methods
Data were obtained retrospectively for all women with recurrent platinum-sensitive epithelial ovarian cancer who underwent a second debulking operation between 1998 and 2008 at the University of Texas Southwestern Medical Center. Survival analysis and comparisons were performed using the Kaplan-Meier method, log-rank test, and Cox multivariate proportional hazards model.
Results
Optimal secondary cytoreductive surgery (<5mm of residual disease) was achieved in 32 of 40 patients (80%). Nine women (23%) developed major complications. Two variables, residual disease of less than 5mm vs 5mm or greater (median 63months vs 11months; P=0.003); and less than 5 vs 5 or more sites of disease relapse (median 63months vs 22months; P=0.009), were independently associated with survival and retained prognostic significance on multivariate analysis.
Conclusions
Optimal secondary cytoreductive surgery was associated with a survival advantage and acceptable risks.
ABSTRACT