@article {Greer1341, author = {Anna Greer and Allison Gockley and Beryl Manning-Geist and Alexander Melamed and Rachel Clark Sisodia and Ross Berkowitz and Neil Horowitz and Marcela Del Carmen and Whitfield B Growdon and Michael Worley Jr}, title = {Impact of residual disease at interval debulking surgery on platinum resistance and patterns of recurrence for advanced-stage ovarian cancer}, volume = {31}, number = {10}, pages = {1341--1347}, year = {2021}, doi = {10.1136/ijgc-2020-001505}, publisher = {BMJ Specialist Journals}, abstract = {Objective To evaluate the impact of size and distribution of residual disease after interval debulking surgery on the timing and patterns of recurrence for patients with advanced-stage epithelial ovarian cancer.Methods Patient demographics and data on disease treatment/recurrence were collected from medical records of patients with stage IIIC/IV epithelial ovarian cancer who were managed with neoadjuvant chemotherapy/interval debulking surgery between January 2010 and December 2014. Among patients without complete surgical resection but with <=1 cm of residual disease, the number of anatomic sites (\<1 cm single anatomic location vs \<1 cm multiple anatomic locations) was used to describe the size and distribution of residual disease. Results A total of 224 patients were included. Of these, 70.5\% (n=158) had a complete surgical resection, 12.5\% (n=28) had \<1 cm single anatomic location, and 17.0\% (n=38) had \<1 cm multiple anatomic locations. Two-year progression-free survival for complete surgical resection, \<1 cm single anatomic location, and \<1 cm multiple anatomic locations was 22.2\%, 17.9\% and 7\%, respectively (p=0.007). Size and distribution of residual disease after interval debulking surgery did not affect location of recurrence and most patients had recurrence at multiple sites (complete surgical resection: 64.7\%, \<1 cm single anatomic location: 55.6\%, and \<1 cm multiple anatomic locations: 71.4\%). Controlling for additional factors that may influence platinum resistance and surgical complexity, the rate of platinum-resistant recurrence was similar for patients with complete surgical resection and \<1 cm single anatomic location (OR=1.07, 95\% CI 0.40 to 2.86; p=0.888), but women with \<1 cm multiple anatomic locations had an increased risk of platinum resistance (OR=3.09, 95\% CI 1.41 to 6.78 p=0.005).Conclusions Despite current classification as {\textquoteleft}optimal,{\textquoteright} \<1 cm multiple anatomic location at the time of interval debulking surgery is associated with a shorter progression-free survival and increased risk of platinum resistance.Data are available upon reasonable request. In accordance with the journal{\textquoteright}s guidelines, we will provide our data for the reproducibility of this study in other centers if such is requested.}, issn = {1048-891X}, URL = {https://ijgc.bmj.com/content/31/10/1341}, eprint = {https://ijgc.bmj.com/content/31/10/1341.full.pdf}, journal = {International Journal of Gynecologic Cancer} }