Guidelines and selection criteria for secondary cytoreductive surgery in patients with recurrent, platinum-sensitive epithelial ovarian carcinoma Journal Article


Authors: Chi, D. S.; McCaughty, K.; Diaz, J. P.; Huh, J.; Schwabenbauer, S.; Hummer, A. J.; Venkatraman, E. S.; Aghajanian, C.; Sonoda, Y.; Abu-Rustum, N. R.; Barakat, R. R.
Article Title: Guidelines and selection criteria for secondary cytoreductive surgery in patients with recurrent, platinum-sensitive epithelial ovarian carcinoma
Abstract: BACKGROUND. The benefit of cytoreductive surgery for patients with recurrent epithelial ovarian cancer has not been defined clearly. The objective of this study was to identify prognostic factors for survival in patients who underwent secondary cytoreduction for recurrent, platinum-sensitive epithelial ovarian cancer and to establish generally applicable guidelines and selection criteria. METHODS. The authors reviewed all patients who underwent secondary cytoreduction for recurrent epithelial ovarian cancer from 1987 to 2001. Potential prognostic factors were evaluated in univariate and multivariate analyses. RESULTS. In total, 157 patients underwent secondary cytoreduction, and 153 of those patients were evaluable. After secondary cytoreduction, the median follow-up was 36.9 months (range, 0.2-125.6 months), and the median survival was 41.7 months (95% confidence interval, 36.0-47.2 months). For patients who had a disease-free interval prior to recurrence of between 6 months and 12 months, the median survival was 30 months compared with 39 months for patients who had a disease-free interval between 13 months and 30 months and 51 months for patients who had a disease-free interval >30 months (P = .005). For patients who had a single site of recurrence, the median survival was 60 months compared with 42 months for patients who had multiple sites of recurrence and 28 months for patients who had carcinomatosis (P < .001). The median survival for patients who had residual disease that measured ≤0.5 cm was 56 months compared with 27 months for patients who had residual disease that measured >0.5 cm (P < .001). On multivariate analysis, disease-free interval (P = .004), the number of recurrence sites (P = .01), and residual disease (P < .001) were significant prognostic factors. CONCLUSIONS. In the authors' analysis of secondary cytoreduction for recurrent epithelial ovarian cancer, a significant survival benefit was demonstrated for residual disease that measured ≤ 0.5 cm. The disease-free interval and the number of recurrence sites should be used as selection criteria for offering secondary cytoreduction. © 2006 American Cancer Society.
Keywords: adult; cancer survival; aged; middle aged; major clinical study; review; cisplatin; patient selection; follow up; ovarian cancer; cytoreductive surgery; ovarian neoplasms; neoplasm recurrence, local; practice guideline; ovary carcinoma; surgery; platinum; disease free interval; multivariate analysis; univariate analysis; neoplasms, glandular and epithelial; recurrent ovarian cancer; secondary cytoreduction; practice guidelines
Journal Title: Cancer
Volume: 106
Issue: 9
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2006-05-01
Start Page: 1933
End Page: 1939
Language: English
DOI: 10.1002/cncr.21845
PUBMED: 16572412
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 111" - "Export Date: 4 June 2012" - "CODEN: CANCA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Venkatraman Ennapadam Seshan
    288 Seshan
  2. Amanda J Hummer
    60 Hummer
  3. Richard R Barakat
    600 Barakat
  4. Dennis S Chi
    496 Chi
  5. Yukio Sonoda
    286 Sonoda
  6. John Paul Diaz
    48 Diaz
  7. Jae Huh
    16 Huh