Article Text
Abstract
Introduction/Background The role of surgery in ovarian cancer recurrence is still debated. Previous studies indicate that only complete resection is associated with long-term benefits. Therefore, this study aimed to determine other clinical factors of ovarian cancer relapse in patients who might obtain survival benefits from secondary debulking surgery (SDS).
Methodology We retrospectively examined the clinical records of patients with ovarian high-grade serous carcinoma (HGSC) who underwent SDS for intraperitoneal recurrent disease. Platinum-free interval (PFI), residual tumor size at initial surgery and SDS, peritoneal washing cytology (PWC) at SDS, and performance-status (PS) score before SDS were investigated. All patients underwent assessment with computed tomography prior to surgery and during follow-up. Patients with short post-SDS follow-up were excluded.
Results From 2007 to 2018, 59 patients with ovarian, fallopian, or peritoneal HGSC were treated at our institute. Among them, 35 patients experienced relapse with intraperitoneal disease. Fourteen patients underwent SDS. One patient was excluded because of a short follow-up. The median patient age was 70 years, and the median PFI was 36 months. Complete resection at the initial surgery and a PS score of 0 were confirmed in 11 and 10 patients, respectively. Ascites was not observed in any patient. Complete resection at SDS was performed in 12 patients. PWC was negative in 9 patients and positive in 4 patients. All the cytology-positive patients experienced intraperitoneal recurrence after SDS, but none of the cytology-negative patients experienced recurrence during follow-up (median 78 months). The association between PWC and recurrence after SDS was significant (p = 0.0014, Fisher’s exact test).
Conclusion PWC, in addition to complete resection, seems a notable predictor of the long-term benefit of SDS for patients who experience ovarian cancer recurrence.