Quaternary cytoreductive surgery in ovarian cancer: does surgical effort still matter?

To evaluate surgical outcome and survival benefit after quaternary cytoreduction (QC) in epithelial ovarian cancer (EOC) relapse. We systematically evaluated all consecutive patients undergoing QC in our institution over a 12-year period (October 2000-January 2012). All relevant surgical and clinica...

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Bibliographic Details
Published in:British journal of cancer 2013-01, Vol.108 (1), p.32-38
Main Authors: FOTOPOULOU, C, SAVVATIS, K, KOSIAN, P, BRAICU, I. E, PAPANIKOLAOU, G, PIETZNER, K, SCHMIDT, S.-C, SEHOULI, J
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Carcinoma, Ovarian Epithelial
Chemotherapy, Adjuvant
Clinical Study
Female
Female genital diseases
Gynecology. Andrology. Obstetrics
Humans
Medical sciences
Middle Aged
Neoplasm Invasiveness
Neoplasms, Glandular and Epithelial - drug therapy
Neoplasms, Glandular and Epithelial - mortality
Neoplasms, Glandular and Epithelial - pathology
Neoplasms, Glandular and Epithelial - surgery
Ovarian cancer
Ovarian Neoplasms - drug therapy
Ovarian Neoplasms - mortality
Ovarian Neoplasms - pathology
Ovarian Neoplasms - surgery
Prognosis
Recurrence
Survival Rate
Treatment Outcome
Tumors
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Summary:To evaluate surgical outcome and survival benefit after quaternary cytoreduction (QC) in epithelial ovarian cancer (EOC) relapse. We systematically evaluated all consecutive patients undergoing QC in our institution over a 12-year period (October 2000-January 2012). All relevant surgical and clinical outcome parameters were systematically assessed. Forty-nine EOC patients (median age: 57; range: 28-76) underwent QC; in a median of 16 months (range:2-142) after previous chemotherapy. The majority of the patients had an initial FIGO stage III (67.3%), peritoneal carcinomatosis (77.6%) and no ascites (67.3%). At QC, patients presented following tumour pattern: lower abdomen 85.7%; middle abdomen 79.6% and upper abdomen 42.9%. Median duration of surgery was 292 min (range: a total macroscopic tumour clearance could be achieved. Rates of major operative morbidity and 30-day mortality were 28.6% and 2%, respectively.Mean follow-up from QC was 18.41 months (95% confidence interval (CI):12.64-24.18) and mean overall survival (OS) 23.05 months (95% CI: 15.5-30.6). Mean OS for patients without vs any tumour residuals was 43 months (95% CI: 26.4-59.5) vs 13.4 months (95% CI: 7.42-19.4); P=0.001. Mean OS for patients who received postoperative chemotherapy (n=18; 36.7%) vs those who did not was 40.5 months (95% CI: 27.4-53.6) vs 12.03 months (95% CI: 5.9-18.18); P
ISSN:0007-0920
1532-1827
DOI:10.1038/bjc.2012.544