International Journal of Gynecology & Obstetrics
Volume 108, Issue 2 , Pages 123-127, February 2010

Secondary cytoreductive surgery for recurrent platinum-sensitive ovarian cancer

  • John O. Schorge

      Affiliations

    • Division of Gynecologic Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA
    • Corresponding Author InformationCorresponding author. Division of Gynecologic Oncology, Massachusetts General Hospital, Yawkey Center-9E, 55 Fruit Street, Boston, MA 02114, USA. Tel.: +1 617 724 4800; fax: +1 617 724 6898.
  • ,
  • Shana N. Wingo

      Affiliations

    • Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
  • ,
  • Rafia Bhore

      Affiliations

    • Division of Biostatistics, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
  • ,
  • Thomas P. Heffernan

      Affiliations

    • Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
  • ,
  • Jayanthi S. Lea

      Affiliations

    • Division of Gynecologic Oncology, Carolinas Medical Center, Charlotte, North Carolina, USA

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.

Keywords: Recurrent ovarian cancer, Secondary cytoreductive surgery

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 Presented at the New England Association of Gynecologic Oncologists 28th Annual Meeting, Chatham, MA, USA, June 2008.

PII: S0020-7292(09)00537-2

doi:10.1016/j.ijgo.2009.08.034

International Journal of Gynecology & Obstetrics
Volume 108, Issue 2 , Pages 123-127, February 2010