Objectives to determine predictive factors of better survival and delayed recurrence in patients operated on for epithelial ovarian cancer.

Methods we reviewed retrospectively all the data of 184 patients receiving complete cytoreductive surgery, whether as primary or interval debulking between January 2005 and ocotber 2019 at Hôtel-Dieu de France University Hospital.

Results Median age at surgery was 56 years. 41,8% benefited from a primary cytoreductive surgery while 42,9% of patients received their surgery after a neoadjuvant chemotherapy. 74% of patients were in stage III. High-grade serous epithelial ovarian cancer was the most encountered histology (69%). Bowel resection and upper abdominal surgery was needed in 46% and 39,1% of cases, respectively. Survival rate was 66% (122 out of 184 patients). No recurrence was noted in 53,8% of cases and 74,7% of recurrences occurred after 12 months. According to cox regression test, better survival was significantly correlated to younger age (< 50 years), negative lymph node status, lymph node ratio (< 0,18),early stage, primary surgery, no bowel resection, no more than one positive lymph node (p=0.006, p=0.000, p=0.000, p=0.000,p=0.001,p=0.000,p=0.000, respectively). Early recurrence was correlated to advanced stage (p=0.000), positive lymph node status (p=0.002), bowel resection (p=0.046), interval surgery (p=0.025). In the multivariate analysis, survival was only correlated to lymph node status, lymph node ratio, stage, absence of bowel resection and number of positive lymph nodes.

Conclusion Negative lymph node status, LNR <0.18, early stage, absence of bowel resection and the presence of only one positive LN predict a better survival.