Objectives Epithelial ovarian cancers relapse in the majority of cases. We aimed to analyze overall survival prognostic factors in recurrent 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. The Kaplan-Meier method was used to calculate overall survival (OS) and Cox regression analysis was performed to define the effects of risk factors on survival.

Results The median age at diagnosis was 59 years [28–85 years]. Recurrent ovarian cancer were platinum sensitive in 35% (n=21), partially sensitive in 30% (n=18) and platinum-resistant in 35% (n=21) of cases. Surgery of the first recurrence was performed for 9 patients (15%). Fifty-three (88%) patients received at least one line of chemotherapy in the recurrence setting. The median number of received cycles was one [0–6]. Overall survivals at 1 year, 2 years and 5 years were respectively 83,3%, 62,1%, and 37,3%. Median overall survival was 32 months. Prognostic factors which were associated with better OS were early initial stage (I-IIA) (p=0.012), complete initial staging (p=0.001), platinum- sensitive relapse (p=0.001) and R0 resection of the relapse (p=0.001). Age, grade, relapse’s site didn’t impact significantly overall survival.

Conclusions Overall survival of recurrent ovarian cancer remains poor. Further studies in order to promote early detection are needed. Quality of surgery constitutes a major impact factor.