When should Surgery be used for Recurrent Ovarian Carcinoma?

Bommert, Mareike; Harter, Philipp; Heitz, Florian; Bois, Andreas du

doi:10.1016/j.clon.2018.04.006

Cited by 31 publications

(20 citation statements)

References 31 publications

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“…The association between interval and survival is still unknown in patients with platinum-sensitive recurrent ovarian cancer eligible for SCS. Our findings suggest that delayed chemotherapy following SCS does not influence survival, suggesting that physicians should make their best effort to leave no gross residual disease during SCS, which is one of the most potent prognostic factors in this population, as shown in our and other studies [31].…”

Section: Discussionsupporting

confidence: 73%

Interval between secondary cytoreductive surgery and adjuvant chemotherapy is not associated with survivals in patients with recurrent ovarian cancer

et al. 2019

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BackgroundSecondary cytoreductive surgery (SCS) is possible in selected patients with recurrent epithelial ovarian cancer (EOC). The goal of SCS is complete resection, although chemotherapy is always followed. Delayed intervals between primary debulking surgery and adjuvant chemotherapy was reported to be associated with poorer survivals, however, the role of intervals in recurrent disease is still unknown.Materials and methodsThis retrospective cohort study reviewed data from electronic medical records of women with recurrent EOC treated at Samsung Medical Centre, Seoul, Korea, between January 1, 2002, and December 31, 2015. Patients who underwent SCS with adjuvant chemotherapy for recurrent EOC were eligible. We defined intervals as the period between the day of SCS and the first cycle of adjuvant chemotherapy.ResultsSeventy-nine patients were eligible for this study. Their median age was 48 (range, 18–69) years and median interval between the date of SCS and initiation of adjuvant chemotherapy was 10 (range, 4–115) days. The rate of complete resection was 72.2% (57/79). Division of the patients by interval (Group 1, interval ≤ 10 days; Group 2, interval > 10 days) revealed no difference in clinical parameters. No gross residual disease after SCS (no vs. any gross residual, p = 0.002) and longer platinum-free survival (over 12 vs. 6–12 months, p = 0.023) were independent favorable prognostic factors in Cox model; however, the intervals did not affect survival.ConclusionsDelayed intervals to adjuvant chemotherapy after secondary cytoreductive surgery is not associated with decreased survivals. It is important to identify recurrent EOC patients who might have no gross residual disease following SCS. Moreover, surgeons should strive for complete resection.

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Section: Discussionsupporting

confidence: 73%

Interval between secondary cytoreductive surgery and adjuvant chemotherapy is not associated with survivals in patients with recurrent ovarian cancer

et al. 2019

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“…This seems to be the second reported case of solitary colorectal metastasis from ovarian tumors more than ten years after surgery in the English literature (1). Secondary surgery would be the most recommended treatment for resectable recurrent ovarian tumors (2).…”

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confidence: 77%

Solitary Colorectal Metastasis from a Mucin-rich Ovarian Tumor

et al. 2020

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An asymptomatic 66-year-old woman underwent colonoscopy because of a positive fecal immunochemical test. Thirteen years earlier she underwent bilateral salpingo-oophorectomy for a left ovarian seromucinous borderline tumor. There was no recurrence during the postoperative follow-up. Colonoscopy showed a 25-mm submucosal tumor with ulceration in the rectosigmoid colon (Picture 1). The lesion was unexpectedly soft (Picture 2). Biopsy specimens

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“…14 It is not hard to understand that these prospective studies included a limited number of recurrent OCCC patients due to disease rarity. 15,16 One recent retrospective study collected recurrent OCCC cases from Tokai Ovarian Tumor Study Group (Nagoya University Hospital and 13 affiliated institutions) between 1990/01 and 2015/12. 10 A total of 25 patients who received secondary surgery and 144 patients with medical treatment only were analyzed.…”

Section: Discussionmentioning

confidence: 99%

<p>Recurrence Patterns and Survival Outcomes in Chinese Patients with Surgically Treated Recurrent Ovarian Clear Cell Carcinoma: A Single Institutional Analysis of 45 Cases</p>

Zhou

Chen

et al. 2020

CMAR

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Background: To evaluate the recurrence patterns and survival outcomes of surgically treated relapsed ovarian clear cell carcinoma (OCCC) patients. Methods: We performed a comprehensive retrospective analysis of all the patients who underwent secondary debulking from 2004/10 to 2019/04. Results: In total, 45 eligible patients were included. 75.6% of the patients had early-stage disease and platinum-sensitive recurrence accounted for 70.5%. The median progression-free survival after primary surgery (PFS 1) was 20 months (range, 2-137). Of all, 64.4% patients had solitary recurrence and 86.7% patients had no residual disease after secondary surgery. Regarding tumor distribution, the most common site was pelvis (47.5%), followed by lymph node metastases (18.0%) and abdominal wall lesions (8.2%). For the entire population, the median disease-free survival after recurrence (PFS 2) and post-relapse survival (PRS) was 15 months (range, 0-96), and 24 months (range, 3-159), respectively. Eight patients (17.8%) had a prolonged PFS2 more than 30 months. Patients with localized relapse had better survival including PFS 2 (P=0.023), PRS (P=0.004), and overall survival (OS) (P=0.029). Patients who achieved complete resection tended to have longer PFS 2 (P=0.017). After multivariate analysis, complete resection at recurrence remained as an independent positive predictor for PFS 2 (P=0.022). The median OS was 50 months and was significantly associated with platinum response (P=0.003) and number of relapsed lesions (P=0.002). Conclusion: A high rate of pelvic recurrence was noted in this population. Patients with focal recurrence had a favorable prognosis. Complete resection at secondary debulking proved to be an independent predictor for disease-free survival.

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When should Surgery be used for Recurrent Ovarian Carcinoma?

Cited by 31 publications

References 31 publications

Interval between secondary cytoreductive surgery and adjuvant chemotherapy is not associated with survivals in patients with recurrent ovarian cancer

Interval between secondary cytoreductive surgery and adjuvant chemotherapy is not associated with survivals in patients with recurrent ovarian cancer

Solitary Colorectal Metastasis from a Mucin-rich Ovarian Tumor

<p>Recurrence Patterns and Survival Outcomes in Chinese Patients with Surgically Treated Recurrent Ovarian Clear Cell Carcinoma: A Single Institutional Analysis of 45 Cases</p>

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