Secondary cytoreductive surgery for recurrent platinum-sensitive ovarian cancer

Objective: To determine the risks and benefits of secondary cytoreductive surgery for recurrent platinum-sensitive ovarian cancer. Methods: Data were obtained retrospectively for all women with recurrent platinum-sensitive epithelial ovarian cancer who underwent a second debulking operation between 1998 and 2008 at the University of Texas Southwestern Medical Center. Survival analysis and comparisons were performed using the Kaplan-Meier method, log-rank test, and Cox multivariate proportional hazards model. Results: Optimal secondary cytoreductive surgery (<5 mm of residual disease) was achieved in 32 of 40 patients (80%). Nine women (23%) developed major complications. Two variables, residual disease of less than 5 mm vs 5 mm or greater (median 63 months vs 11 months: P = 0.003); and less than 5 vs 5 or more sites of disease relapse (median 63 months vs 22 months; P = 0.009), were independently associated with survival and retained prognostic significance on multivariate analysis. Conclusions: Optimal secondary cytoreductive surgery was associated with a survival advantage and acceptable risks. (C) 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.