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摘要
Objective. To analyze the impact of secondary cytoreductive surgery (SCS) on survival outcome in a retrospective series of isolated platinum-resistant recurrent ovarian cancer. %26lt;br%26gt;Methods. We evaluate a consecutive series of 268 ovarian cancer patients with platinum-resistant relapse. Isolated recurrence was defined as the presence of a single nodule, in a single anatomic site, and was observed in 27 cases (10.1%). In all women the presence of isolated relapse was assessed at radiological evaluation, and surgically confirmed in the SCS group. %26lt;br%26gt;Results. Among the 27 patients with isolated recurrence, 16 (59.3%) received chemotherapy alone, and 11 (40.7%) complete SCS followed by non-platinum based chemotherapy. No significant differences were observed in the distribution of baseline clinico-pathological characteristics, pattern of recurrent disease, duration of PFI, and type of salvage chemotherapy between the two groups. In the SCS group, 6 patients (54.5%) showed isolated peritoneal relapse and 5 women (45.4%) showed isolated lymph nodal recurrence, and were treated with peritonectomy and lymphadenectomy, according with site of relapse. Two post-operative complications (18.2%) occurred: asymptomatic lymphocele and groin wound dehiscence. SCS significantly prolonged median time to first progression (12 months vs 3 months; p-value = 0.016), median time to second progression (8 months vs 3 months; p-value = 0.037), and post-relapse survival (PRS) (32 months vs 8 months; p-value = 0.002). Residual tumor at 1st surgery (X-2 = 5.690; p-value = 0.017), duration of PFI (X-2 = 5.401; p-value = 0.020), and complete SCS (X-2 = 4.250; p-value = 0.039) retains independent prognostic role for PRS in multivariate analysis. %26lt;br%26gt;Conclusions. SCS prolongs PRS compared to chemotherapy alone in isolated platinum-resistant recurrent ovarian cancer.
- 出版日期2014-8
- 单位Perugia
