Objectives The platinum-free interval (PFI) in epithelial ovarian cancer is a major factor that guides the management and predicts prognosis of the disease. We aimed to study predictive factors which impact PFI in epithelial ovarian cancer in Tunisia.

Methods We conducted a retrospective monocentric study including 60 Tunisian patients with relapsed epithelial ovarian cancer between October 2012 and December 2018. Clinico- pathological data, treatment and survival data were collected from medical records. Predictive factors were identified by logistic regression following the Cox regression model.

Results The median age at first diagnosis was 59 years [28–85 years]. Relapsed ovarian cancers were platinum-sensitive in 65% (n=39) and resistant in 35% (n=21) of cases. Overall 2-year survival was 87% in the sensitive relapse group versus 11% in the resistant group (p<0.001). Age, Body mass index, histologic type, grade and timing of initial surgery didn’t impact significantly the interval of relapse. However, short platinum-free interval (< 6 months) was correlated with : advanced stage at diagnosis (IIA to IV) (Odds ratio, OR:1.67, 95% Confidence interval, CI [1.34–2.09]) and incomplete staging at the initial surgery (OR: 3.4, 95% CI [1.07–10.84].

Conclusions The interval of relapse is correlated with the extension of the disease and/or with the quality of surgery. Patients should be referred to expert centers.