The study included 160 patients with advanced ovarian cancer (OC) who underwent combined treatment from January 2000 to January 2013 at the N.N. Petrov Research Institute of Oncology. Compared to non-mutated patients, BRCA-positive patients were characterized by a longer platinum-free interval (BFI) (14 months [95% CI 9.6-36.4 months] versus 8 months [95% Ci 4.8-12.4 months]; P = 0.006), with the largest median of the BFI were established using the CAP scheme - 33.5 months versus 12 months using the TCbP scheme. Half of patients with a mutation in the BRCA1 gene (20/40 (50%)) had an isolated recurrence in the pelvic area versus 35/120 (29.2%) of patients without mutations (p = 0.00001). The progression of distant foci in the first recurrence of the disease in patients with mutations was significantly lower (15/40 (37.5%) versus 84/120 (70%), p = 0.00001). In addition 85% of recurrences in BRCA-positive patients were platinum-sensitive. Only the age of patients with advanced OC was an independent prognostic factor of BFI since the start of treatment (p = 0.00001).

To study the role of retroperitoneal lymphadenectomy in epithelial ovarian cancer (OC) the work was divided into two parts. In the first part for a retrospective analysis 852 patients with stage I-IV OC, who were treated from January 2000 to January 2014, were selected to investigate the localization of the first relapse of the disease. In the second part, prospective from August 2016 to April 2017, in 28 patients with stage I-IV OC the surgical stage of the combined treatment was supplemented by iliac-pelvic and para-aortic lymphadenectomy; in this group the results of surgical staging were studied. The incidence of isolated recurrence in para-aortic lymph nodes in the group of early OC was 3/28 (11%), in pelvic 2/28 (7%), whereas in the group of advanced OC - in para-aortic lymph nodes 9/24 (37%), in iliac-pelvic 10/24 (42%), combined in pelvic and para-aortic lymph nodes 5/24 (21%). In the prospective group the lesion of pelvic and para-aortic lymph nodes was observed in 2/28 (7%) of patients with the presumed I stage of the disease and in 2/28 (7%) with the presumed stage II, which resulted in re-staging of the disease. In 2 cases the clinical IA and IB stages were re-staged to IIIA and this required 6 courses of chemotherapy. In 2/28 (7%) patients metastases to para-aortic lymph nodes were detected in the absence of pelvic lesions.

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