TY - JOUR
T1 - Tertiary cytoreductive surgery in recurrent epithelial ovarian cancer: A multicentre MITO retrospective study
AU - Falcone, F.
AU - Scambia, G.
AU - Panici, P. Benedetti
AU - Signorelli, M.
AU - Cormio, G.
AU - Giorda, G.
AU - Bogliolo, S.
AU - Marinaccio, M.
AU - Ghezzi, F.
AU - Rabaiotti, E.
AU - Breda, E.
AU - Casella, G.
AU - Fanfani, F.
AU - Donato, V. Di
AU - Maggiore, U. Leone Roberti
AU - Greggi, S.
N1 - LR: 20171211; CI: Copyright (c) 2017; JID: 0365304; Ovarian epithelial cancer; OTO: NOTNLM; 2017/06/16 00:00 [received]; 2017/07/01 00:00 [revised]; 2017/07/06 00:00 [accepted]; 2017/07/19 06:00 [pubmed]; 2017/09/28 06:00 [medline]; 2017/07/19 06:00 [entrez]; ppublish
PY - 2017/10/1
Y1 - 2017/10/1
N2 - 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.
AB - 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.
KW - Adult
KW - Aged
KW - Cytoreduction Surgical Procedures/methods
KW - Female
KW - Humans
KW - Middle Aged
KW - Multivariate Analysis
KW - Neoplasm Recurrence, Local/pathology/surgery
KW - Neoplasms, Glandular and Epithelial/mortality/surgery
KW - Ovarian Neoplasms/mortality/surgery
KW - Retrospective Studies
KW - Risk Factors
KW - Young Adult
KW - Cytoreductive surgery
KW - Quality of surgery
KW - Recurrent ovarian cancer
U2 - S0090-8258(17)31025-9 [pii]
DO - S0090-8258(17)31025-9 [pii]
M3 - Article
SN - 0090-8258
VL - 147
SP - 66
EP - 72
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 1
ER -