Analysis of failures and clinical outcome of advanced epithelial ovarian cancer in patients with microscopic residual disease at second-look reassessment following primary cytoreductive surgery and first-line platinum-based chemotherapy

A. Gadducci, R. Tana, F. Landoni, F. Ferrari, M. Peiretti, F. Perrone, E. Sartori

Research output: Contribution to journalArticle

Abstract

Aim: to assess the pattern of failure and survival of advanced ovarian cancer patients with microscopic residual disease at second-look following cytoreductive surgery and platinum-based chemotherapy. Materials and Methods: Nine-five women were retrospectively analyzed. Residual disease after initial surgery was > one cm in 58 (61.1%) patients, first-line chemotherapy was paclitaxel/platinum-based in 70 (73.7%) patients, second-look findings showed no macroscopic residuum but positive random peritoneal biopsies and/or positive washing ("true" microscopic residual disease) in 79 (83.2%) patients, and a macroscopic residuum which was completely resected (converted complete response) in 16 (16.8%) patients. Results: Eight-one (85.2%) patients developed recurrent disease after a median time of 14 months (range four to 51). The abdomen (29.6%) and the pelvis (28.4%) were the most common sites of failure. Two- and five-year survival after second-look were 78.1% and 31.0%, respectively. The clinical and pathological features with prognostic relevance at presentation (age, histotype, and tumor grade), as well as type of first-line chemotherapy and treatment after second-look were not related to the clinical outcome. There was a trend for a better survival in patients with optimal primary cytoreduction compared with those with suboptimal primary cytoreduction (five-year survival = 42.7% vs 23.4%). There was no significant difference in survival between the converted complete responders and the patients with "true" microscopic residual disease. Conclusions: These data confirm the unsatisfactory clinical outcome of patients with microscopic residual disease after first-line chemotherapy and the limited benefit of second-look reassessment.

Original languageEnglish
Pages (from-to)213-217
Number of pages5
JournalEuropean Journal of Gynaecological Oncology
Volume34
Issue number3
Publication statusPublished - 2013

Keywords

  • Chemotherapy
  • Epithelial ovarian cancer
  • Second-look surgery
  • Surgical cytoreduction
  • Survival

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology

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