Introduction/Background Systemic therapy is the standard treatment for recurrent epithelial ovarian cancer (EOC). However, in some cases of oligometastatic recurrence, loco-regional treatment can be a useful therapeutic alternative. The aim of this study is to analyze loco-regional surgical and radiotherapy treatment in terms of efficacy and complications in patients affected by oligometastatic progression of EOC. The secondary objective is to evaluate the predictive factors of treatment response.

Methodology All the patients with relapsed EOC who underwent surgical or radiotherapy treatment for curative purposes at the Mauriziano Hospital in Turin and the Cardinal Massaia Hospital in Asti between January 2011 and December 2021 were retrospectively analyzed. They were evaluated overall and for each type of treatment. overall survival (OS), progression-free survival (PFS), local control (L-PFS). Predictors of response to treatments were also investigated.

Results A total of 52 patients were evaluated, 39 undergoing surgical treatment and 13 undergoing radiotherapy treatment. The two groups were comparable for the main clinical characteristics, except for the platinum free index and the number of previous chemotherapy and surgical treatments, indicative of the fact that in our current clinical practice, radiotherapy is proposed as a method of second choice for the management of oligometastatic disease

Surgery was significantly superior to radiotherapy in terms of OS (41 vs. 19 p=0.026) and PFS (13 vs. 9 p=0.006) but not as regards L-PFS (18 vs. 14 p =0.717).

Residual disease after surgery and chemotherapy following locoregional treatment were not significant in terms of survival. the residual tumor after surgery was instead associated with a better L-PFS in the group of patients undergoing surgery.

Conclusion The results obtained show an advantage of surgical treatment compared to radiotherapy in terms of survival, however, the data of equality in terms of local disease control is especially interesting for those patients unfit for surgery.

Disclosures The authors declare that there is no conflict of interest regarding the publication of this article.