Tertiary cytoreduction in patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer: An updated series Journal Article

  

Authors:	Shih, K. K.; Chi, D. S.; Barakat, R. R.; Leitao, M. M. Jr
Article Title:	Tertiary cytoreduction in patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer: An updated series
Abstract:	Objective: Surgical cytoreduction is an integral therapeutic modality for patients with epithelial ovarian (EOC), fallopian tube (FTC), or primary peritoneal (PPC) cancer in the primary setting. The role of surgical cytoreduction in the recurrent setting is not clearly defined and remains controversial. The objective of this study was to assess this potential survival benefit in a large cohort of patients with a long follow-up period. Methods: We performed a retrospective chart review of all patients with recurrent EOC, FTC, or PPC who underwent tertiary cytoreduction at our institution from 2/98 to 2/08. Disease-specific survival (DSS) was calculated from the time of tertiary cytoreduction to death or last follow-up. Univariate and multivariate analyses were used to analyze outcomes and to identify potential prognostic factors. Results: A total of 77 patients were identified, of which 38 (49%) have died of disease. The median time from secondary to tertiary cytoreduction was 25.7 months (range, 4.1-99.4 months). The median follow-up after tertiary cytoreduction was 28.9 months (range, 0.7-123.7 months), with a median DSS for the entire cohort of 47.7 months (95% CI, 25.5-69.9 months). On univariate analysis, residual disease after tertiary cytoreduction and TFI were found to be significant prognostic factors. On multivariate analysis, only residual disease after tertiary cytoreduction retained prognostic significance (P < 0.001). Conclusion: Tertiary surgical cytoreduction may offer a survival benefit in a highly select group of patients with recurrent EOC, FTC, or PPC. This benefit appears to be greatest in patients in whom a complete gross resection can be achieved. © 2010 Elsevier Inc. All rights reserved.
Keywords:	adult; cancer survival; aged; middle aged; survival rate; retrospective studies; major clinical study; recurrent cancer; follow up; follow-up studies; surgical cytoreduction; cytoreductive surgery; ovarian neoplasms; ovary cancer; peritoneum cancer; neoplasm recurrence, local; peritoneal neoplasms; recurrence; cancer mortality; multivariate analysis; fallopian tube neoplasms; epithelial ovarian cancer; uterine tube tumor; fallopian tube cancer; primary peritoneal cancer; tertiary cytoreduction
Journal Title:	Gynecologic Oncology
Volume:	117
Issue:	2
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2010-05-01
Start Page:	330
End Page:	335
Language:	English
DOI:	10.1016/j.ygyno.2010.01.046
PUBMED:	20189234
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-77950188150&partnerID=40&md5=f1499f469316bf159f23de3534b0fa87
Notes:	--- - "Cited By (since 1996): 4" - "Export Date: 20 April 2011" - "CODEN: GYNOA" - "Source: Scopus"

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