Simplified Selection Criteria for Secondary Cytoreductive Surgery in Recurrent Ovarian Cancer

Abstract

(1) Background: Multiple confounding factors influence the indications for secondary cytoreductive surgery (SCS) in patients with ovarian cancer (OC). We aimed to identify the factors associated with patients most likely to benefit from SCS. (2) Methods: We retrospectively reviewed the medical records of patients with recurrent ovarian cancer from 2003 to 2021. The potential factors influencing treatment outcomes and survival between patients who received chemotherapy alone and those who received SCS after recurrence were evaluated. (3) Results: Recurrent OC was identified in 262 patients, with a median age of 53 (20–80) years. Of these patients, 87.4% had an initial stage III/IV disease. Eighty-nine (34%) patients received SCS. The median survival was 41.0 (95% confidence interval [CI], 37.4–44.5) months and 88.0 (95% CI, 64.2–111.7) months in the chemotherapy and surgery groups, respectively. A multivariate analysis showed limited regional carcinomatosis (single region or up to three regions with limited carcinomatosis) (p = 0.045) as the only significant factor for predicting no residual disease after SCS. In platinum-sensitive recurrent patients with limited regional recurrence, the complete resection rate was 87.6%. (4) Conclusions: SCS had a significant impact on survival in the selected patient population. Limited regional recurrence (single region or up to three regions with limited carcinomatosis) may be a simple criterion for SCS in platinum-sensitive recurrent OC patients.

Optimum selection criteria for secondary cytoreductive surgery in patients with recurrent epithelial ovarian cancer: A multicenter study from the Gynecologic Oncology Research Investigators coLLaborAtion group (GORILLA‐3001)

“…In our previous study, we evaluated the clinical characteristics of 262 patients with recurrent ovarian cancer to assess the impact of SCS on patient survival, following which we established simplified criteria for the selection of patients most likely benefit from SCS 11 . Our analysis identified limited regional recurrence (up to three regions or limited carcinomatosis) ( p = 0.045) as the only factor significantly predictive of no residual disease after SCS.…”

“…Likewise, while CA‐125 is associated with disease burden, it may not be associated with resectability. In our previous single‐center retrospective study, we suggested simplified criteria for SCS based only on the sites of recurrence 11 . However, as the previous investigation was a small, single‐institution study, the value of the simplified criteria and their relevance to small‐volume disease after SCS must be validated in large‐scale trials.…”