Clinical Outcome of Tertiary Surgical Cytoreduction in Patients with Recurrent Epithelial Ovarian Cancer

Background The value of tertiary cytoreductive surgery (TCS) on overall survival (OS) of patients with relapsed epithelial ovarian cancer (ROC) is not well defined. Aim of the present study was to evaluate the operative and clinical outcome after TCS. Methods We systematically evaluated all consecutive patients undergoing TCS. Tumor dissemination pattern, operative morbidity, residual tumor, and survival are described based on a validated intraoperative documentation tool. Predictors of survival and complete tumor resection are analyzed with Cox regression or logistic regression models. Results Between October 2000 and December 2008, 135 patients (median age, 51 years; range, 22–80 years) of mainly initial FIGO stage ≥III (106 patients, 78.5%) were evaluated. In 53 patients (39.3%) a complete tumor-resection was obtained. The 1-month operative mortality was 6%. During a median follow-up period of 9.6 months (range, 0.1–75 months), 78 patients (57.8%) died, while 52 patients (38.5%) experienced a further relapse. Median OS was 19.1 months for the total collective (95% confidence interval [95% CI], 14.84–23.35). Median OS was 37.8 months (95% CI, 12.7–62.7) for patients without residual tumor; versus 19.0 months (95% CI, 9.8–28.2) for residual tumor ≤1 cm and 6.9 months (95% CI, 3.05–10.7) for residual tumor >1 cm ( P