Ten-year follow-up of ovarian cancer patients after second-look laparotomy with negative findings Journal Article


Authors: Rubin, S. C.; Randall, T. C.; Armstrong, K. A.; Chi, D. S.; Hoskins, W. J.
Article Title: Ten-year follow-up of ovarian cancer patients after second-look laparotomy with negative findings
Abstract: Objective: To determine long-term survival and predictors of recurrence in patients with platinum-treated ovarian cancer who were followed for 10 years after second-look laparotomy with negative findings. Methods: Records were reviewed of 91 consecutive patients with negative findings on second-look laparotomy after platinum-based chemotherapy between January 1978 and January 1987. Statistical analysis used Kaplan-Meier survival curves, Cox proportional hazards, and multiple logistic regression. Results: Mean age of patients was 57 (range 30-79) years. Distribution by stage and grade was as follows: stage I, ten; II,18; III, 57; IV,six; grade 1, 18; 2, 28; 3, 45. Forty-seven of 91 women had optimal initial cytoreduction. Recurrence-free survival rates for all subjects were 75% at 2 years, 55% at 5 years, and 52% at 10 years. For women with stage I disease, the recurrence-free survival rate was 90% at 2, 5, and 10 years. For women with stage II disease, recurrence-free survival rates were 78, 72, and 66% at 2, 5, and 10 years, respectively. Patients with stage III or nr disease had recurrence-free survival rates of 72, 44, and 40% at 2, 5,and 10 years, respectively. Risk of recurrent disease was related to tumor stage (relative risk [RR] 2.02; 95% confidence interval [CI] 1.2 3.3; P = .005), grade (RR 2.00; 95% CI 1.3, 3.2; P = .004), and presence of a residual tumor of more than 2 cm at the end of initial surgery (RR 3.19; 95% CI 1.2, 8.5; P = .02). Conclusion: Ovarian cancer patients face an appreciable risk of recurrence in the first 5 years after second-look laparotomy with negative findings after platinum-based chemotherapy, but those who remain disease free at 5 years have excellent long-term survival rates. Tumor stage, grade, and presence of a residual tumor of more than 2 cm after initial surgery are significant predictors of recurrence. (C) 1999 by The American College of Obstetricians and Gynecologists.
Keywords: cisplatin; recurrence; cyclophosphamide; 2nd-look laparotomy
Journal Title: Obstetrics and Gynecology
Volume: 93
Issue: 1
ISSN: 0029-7844
Publisher: Lippincott Williams & Wilkins  
Date Published: 1999-01-01
Start Page: 21
End Page: 24
Language: English
ACCESSION: WOS:000077885200005
DOI: 10.1016/s0029-7844(98)00334-2
PROVIDER: wos
PUBMED: 9916949
Notes: Article -- Source: Wos
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MSK Authors
  1. William Hoskins
    153 Hoskins
  2. Dennis S Chi
    496 Chi