The role of secondary cytoreductive surgery for recurrent ovarian cancer

Objective. The aim of this study was to assess the survival benefit of salvage surgical cytoreduction in patients with recurrent ovarian cancer and compare the surgical outcorne with salvage chemotherapy alone. Methods. Seventy-five patients with recurrent ovarian cancer were reviewed for possible benefits of salvage therapy. Forty-four had salvage surgery and 31 patients had salvage chemotherapy alone for the treatment of gross recurrent disease. All patients had been clinically free of disease more than 6 months from the completion of primary treatment. Results. A macroscopically complete surgical cytoreduction was obtained in 34 (77%) patients. Survival was significantly longer in patients who had salvage surgery compared to those who had salvage chemotherapy alone (P = 0.03). Moreover, survival was significantly longer in patients who were completely cytoreduced compared to those who were not completely cytoreduced and those who were not operated (P = 0.007 and P = 0.005, respectively). Conclusions. Macroscopically complete surgical cytoreduction significantly improves further survival of recurrent ovarian cancer patients. However, we remain in need to evaluate the debulkability of tumor before surgery to maximize the survival benefit and minimize the number of ineffective surgeries. (c) 2005 Elsevier Inc. All rights reserved.