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Abstract
Highlights
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- Anatomic site of relapse is a strong predictor of post-relapse survival in patients with localized recurrent ovarian cancer.
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- Secondary cytoreductive surgery ensure a relevant survival benefit in women with localized recurrent ovarian cancer.
Abstract
Objective
We
evaluated the clinical outcome and prognostic factors for post-relapse
survival (PRS), in a large retrospective series of ovarian cancer
patients with localized relapse.
Patients and Methods
The
following radiological inclusion criteria were adopted: relapse in
single anatomic site, and ≤ 3 nodules. All cases were followed for at
least 24 months after recurrent disease.
Results
220
ovarian cancer patients met the inclusion criteria. Serous histotype
and G3 tumors were observed in 173 (78.6%) and 151 (77.4%) cases,
respectively. All women received platinum-based first-line chemotherapy.
Overall, the median follow-up was 46 (8-249) months, and platinum
resistant relapse was documented in 51 women (23.2%). Eighty-one (36.8%)
patients recurred in the peritoneum (LPeR), 76 (34.5%) in the abdominal
lymph nodes (LLNR), and 63 (28.7%) in parenchymal organs (LPaR); 142
(64.5%) patients recurred with a single nodule, and 78 (35.5%) with 2-3
nodules. Secondary cytoreductive surgery (SCS) was attempted in 73 cases
(33.2%), and complete debulking was achieved in all patients. On
multivariate analysis: platinum-free interval (PFI, X2= 13.457,
p value=0.001), complete SCS (median PRS, 69 months vs 25 months;
p=0.001), anatomic site of relapse (median PRS, 41 months in LPeRs, 63
months in LLNRs and 24 months in LPaRs; p=0.001), number of nodules
(median PRS, 58 months in patients with one nodule, 24 months in
patients with 2-3 nodules; p=0.001) were identified as predictors of
PRS.
Conclusions
Beside the
duration of PFI, complete SCS, anatomic site of relapse, and the number
of nodules were independent prognostic factor for duration of PRS.
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