Published online Mar 20, 2008.
https://doi.org/10.3802/kjgo.2008.19.1.75
Clinical analysis for the prognostic factors in patients with recurrent epithelial ovarian cancer who underwent secondary cytoreductive surgery
Abstract
Objective
To identify clinical prognostic factor improving survival of recurrent epithelial ovarian cancer (EOC) patients treated with secondary cytoreductive surgery (SCS).
Methods
The indications of SCS were as follows; 1) complete response (CR) after primary cytoreductive surgery and adjuvant chemotherapy, 2) disease-free survival (DFS) (≥6 months). Clinical data of 17 patients including age, DFS, peritoneal seeding identified during SCS, the number of recurrent tumors (≥1 cm), serum CA-125 levels and maximal diameter of residual tumor after SCS were reviewed retrospectively between January 1990 and March 2007. Survival analyses were performed using Kaplan-Meier method with log-rank test and univariate Cox's regression analysis.
Results
Mean age of them was 51.7 years. No peritoneal seeding identified during SCS was a prognostic factor improving progression-free survival after SCS (PFS-SCS) (30 vs. 6 months, p<.01 hazard ratio 0.099, 95% confidence interval 0.011-0.929, p=.043). Furthermore, serum CA-125 level (≤37 U/ml) after SCS was a significant prognostic factors improving overall survival (51 vs. 19 months, p=.033; hazard ratio 0.212, 95% confidence interval 0.045-0.983, p=.045).
Conclusion
Serum CA-125 levels with normal value after SCS and no peritoneal seeding may be associated with the improvement of survival in recurrent epithelial ovarian cancer patients treated with SCS.
Fig. 1
Kaplan-Meier survival analysis with log-rank test for progression-free survival after secondary cytoreductive surgery (PFS-SCS) according to peritoneal seeding identified during secondary cytoreductive surgery (30 vs. 6 months, p=.0089).
Fig. 2
Kaplan-Meier survival analysis with log-rank test for overall survival (OS) according to serum CA-125 levels after secondary cytoreductive surgery (51 vs. 19 months, p=.033).
Table 1
General characteristics of 17 patients with recurrent epithelial ovarian cancer who underwent secondary cytoreductive surgery
References
-
2002 Annual Report of the Korea Central Cancer Registry. [Last accessed: November 18, 2007].Available at: http://www.ncc.re.kr/index.jsp.
-
-
Ozols RF, Bundy BN, Greer BE, Fowler JM, Clarke-Pearson D, Burger RA, et al. Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage III ovarian cancer: A Gynecologic Oncology Group study. J Clin Oncol 2003;21:3194–3200.
-
-
Benedetii Panici P, De vivo A, Bellati F, Manci N, Perniola G, Basile S, et al. Secondary cytoreductive surgery in patients with platinum-sensitive recurrent ovarian cancer. Ann Surg Oncol 2007;14:1136–1142.
-
-
Meier W, Stieber P, Hasholzner U, Gropp M, Fateh-Moghadam A. Prognostic significance of CA 125 in patients with ovarian cancer and secondary debulking surgery. Anticancer Res 1997;17:2945–2947.
-