Cytoreductive surgery for heavily pre-treated, platinum-resistant epithelial ovarian carcinoma: A two-center retrospective experience

Valentina Tuninetti, Marilena Di Napoli, Eleonora Ghisoni, Furio Maggiorotto, Manuela Robella, Giulia Scotto, Gaia Giannone, Margherita Turinetto, Dimitris Siatis, Riccardo Ponzone, Marco Vaira, Michele De Simone, Cono Scaffa, Sandro Pignata, Stefano Greggi, Massimo Di Maio, Giorgio Valabrega

Research output: Contribution to journalArticlepeer-review


Few retrospective studies have shown a benefit in selected patients affected by heavily pre-treated, platinum-resistant ovarian carcinomas (PROCs) who have undergone cytoreduction at relapse. However, the role of tertiary and quaternary cytoreductive surgery is not fully defined. Our aim was to evaluate survival and surgical morbidity and mortality after maximal cytoreduction in this setting. We evaluated all consecutive patients undergoing cytoreduction for platinum-resistance over an 8-year period (2010–2018) in two different centers. Fifty patients (median age 52.5 years, range 34–75) were included; the median number of previous chemotherapy lines was three (range 1–7) and the median number of previous surgeries was one (range 1–4). Completeness of cytoreduction (CC = 0) was achieved in 22 patients (44%). Rates of major operative morbidity and 30-day mortality were 38% and 8%, respectively. Median follow-up was 35 months. The absence of tumor residual (CC = 0) was associated with a significantly better overall survival (OS) compared to the CC > 0 subgroup (median OS 32.9 months (95%CI 21.6–44.2) vs. 4.8 months (95% CI n.a.–9.8), hazard ratio (HR) 4.21 (95%CI 2.07–8.60), p < 0.001). Optimal cytoreduction is feasible and associated with promising OS in selected, heavily pre-treated PROCs. Further prospective studies are required to better define the role of surgery in platinum-resistant disease.

Original languageEnglish
Article number2239
Pages (from-to)1-11
Number of pages11
Issue number8
Publication statusPublished - Aug 2020


  • Cytoreductive surgery
  • Epithelial ovarian carcinoma
  • Platinum resistance

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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