Tertiary cytoreductive surgery in recurrent epithelial ovarian cancer: A multicentre MITO retrospective study

F. Falcone, G. Scambia, P. Benedetti Panici, M. Signorelli, G. Cormio, G. Giorda, S. Bogliolo, M. Marinaccio, F. Ghezzi, E. Rabaiotti, E. Breda, G. Casella, F. Fanfani, V. Di Donato, U. Leone Roberti Maggiore, S. Greggi

Research output: Contribution to journalArticlepeer-review


OBJECTIVES: To evaluate the impact of tertiary cytoreductive surgery (TCS) on survival in recurrent epithelial ovarian cancer (EOC), and to determine predictors of complete cytoreduction. METHODS: A multi-institutional retrospective study was conducted within the MITO Group on a 5-year observation period. RESULTS: A total of 103 EOC patients with a >/=6month treatment-free interval (TFI) undergoing TCS were included. Complete cytoreduction was achieved in 71 patients (68.9%), with severe post-operative complications in 9.7%, and no cases of mortality within 60days from surgery. Multivariate analysis identified the complete tertiary cytoreduction as the most potent predictor of survival followed by FIGO stage I-II at initial diagnosis, exclusive retroperitoneal recurrence, and TCS performed >/=3years after primary diagnosis. Patients with complete tertiary cytoreduction had a significantly longer overall survival (median OS: 43months, 95% CI 31-58) compared to those with residual tumor (median OS: 33months, 95% CI 28-46; p/=6month TFI. The achievement of postoperative no residual disease is confirmed as the primary objective also in a TCS setting, with significant survival benefit and acceptable morbidity. Accurate patient selection is of utmost importance to have the best chance of complete cytoreduction.
Original languageEnglish
Pages (from-to)66-72
Number of pages7
JournalGynecologic Oncology
Issue number1
Publication statusPublished - Oct 1 2017


  • Adult
  • Aged
  • Cytoreduction Surgical Procedures/methods
  • Female
  • Humans
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Recurrence, Local/pathology/surgery
  • Neoplasms, Glandular and Epithelial/mortality/surgery
  • Ovarian Neoplasms/mortality/surgery
  • Retrospective Studies
  • Risk Factors
  • Young Adult
  • Cytoreductive surgery
  • Quality of surgery
  • Recurrent ovarian cancer


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