Introduction/Background The role of secondary cytoreductive surgery (SCS) in patients (pts) with recurrent ovarian cancer (ROC) has been under debate. DESKTOP III trial demonstrated a meaningful benefit of SCS, exclusively seen in pts with a complete resection (CR). AGO score is a useful predictor for CR, validated to select pts for this strategy.
The aim of our study was to assess the efficacy of SCS in our population.
Methodology A retrospective, multicentric, observational study was conducted in pts with ROC that underwent SCS at 3 Portuguese institutions between 01/2012–12/2021.
Results A total of 22 pts was included, with a MED age of 55yo (41;76) and ECOG-PS ≤1. Nineteen pts (86%) were initially staged as FIGO III. Most were high-grade serous carcinoma. CR at initial surgery was achieved in 17 pts (77%).
All pts had received previous platinum-based chemotherapy (PBChT), 19 (86%) with platinum-free interval >12mos. Two pts (9%) received maintenance first-line treatment with Bevacizumab (BV). BRCA pathogenic variant was detected in 6 (27%) pts.
AGO-score was positive in 17 pts (77%). All pts underwent SCS, 3 (14%) combined with HIPEC, and all achieved RC. Most pts (15;68%) received postoperative PBChT, 7 (47%) continued with second-line maintenance treatment: 4 with PARP inhibitors (iPARP) and 3 with BV.
Relapse occurred in 15 pts (68%) with a MED time to relapse of 21 mos. With MED follow-up of 69mos, MED overall survival was 51mos (IC95%; 17–85). At the final analysis 10 pts (46%) are alive, 5 without recurrence.
Conclusion Our study is in line with the results of DESKTOP III trial. Although pts with negative AGO-score were included, all obtained CR. Retrospective nature and sample size are limitations. In selected pts, SCS might be an option. Due to improvement of maintenance treatment in earlier settings, further studies are warranted to evaluate the role of SCS.
Disclosures We have no conflicts of interest.
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