Value of Tertiary Cytoreductive Surgery in Epithelial Ovarian Cancer: An International Multicenter Evaluation

Fotopoulou, Christina; Zang, Rongyu; Gültekin, Murat; Cibula, David; Ayhan, Ali̇; Liu, Dongli; Richter, Rolf; Braicu, Elena Ioana; Mahner, Sven; Harter, Philipp; Trillsch, Fabian; Kumar, Sanjeev; Peiretti, Michele; Dowdy, Sean C.; Maggioni, Angelo; Tropé, Claes G.; Sehouli, Jalid

doi:10.1245/s10434-012-2673-z

Cited by 65 publications

(52 citation statements)

References 20 publications

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“…A recent, international multicenter study including 406 patients showed that even in the last stage of the disease, complete macroscopic tumor clearance has a significant favorable impact on overall survival (Overall survival: 49 vs 12 months) (Fotopoulou et al, 2013). Unlike previous studies, they showed for the first time that after controlling for resiual status, benefit of complete TC is clear, overruling the presence of peritoneal carcinomatosis which no prognostic significance was found.…”

Section: Discussionmentioning

confidence: 89%

“…Following studies questioned about the best candidates for TC, prognostic effect of TC and the impact of residual disease after TC (Karam et al, 2007;Gultekin et al, 2008;Shih et al, 2010;Fotopoulou et al, 2011;Hızlı et al, 2012;Tang et al, 2013;Fotopoulou et al, 2013). Results of the literature review regarding TC are presented in Table 3.…”

Section: Discussionmentioning

confidence: 99%

“…Results of the literature review regarding TC are presented in Table 3. Only 8 retrospective studies were published to date with different results (Leitao et al, 2004;Karam et al, 2007;Gultekin et al, 2008;Shih et al, 2010;Fotopoulou et al, 2011;Hızlı et al, 2012;Tang et al, 2013;Fotopoulou et al, 2013). Therefore, the questions still remain unanswered.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, postoperative systemic chemotherapy was shown for the first time to have a significant impact on overall survival. However, a selection bias was suspected while only those patients who were fit enough and able to tolerate chemotherapy had already more favorable prognosis than patients who were not able to tolerate or even so advanced that chemotherapy was not indicated (Fotopoulou et al, 2013). Progression-free interval was the most important survival determinant.…”

Section: Discussionmentioning

confidence: 99%

“…All of the previous 8 studies conclude mainly that TC may have a survival benefit in a highly select group of secondary recurrent EOC patients, especially in whom an optimal cytoreduction can be achieved (Shih et al, 2010;Leitao et al, 2004;Karam et al, 2007;Gultekin et al, 2008;Fotopoulou et al, 2011;Hızlı et al, 2012;Tang et al, 2013;Fotopoulou et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Tertiary Cytoreduction for Recurrent Epithelial Ovarian Cancer: a Multicenter Study in Turkey

Arvas¹,

Salihoğlu²,

Sal³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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Background: The purpose of this study was to determine the benefit of tertiary cytoreductive surgery (TC) for secondary recurrent epithelial ovarian cancer (EOC), focusing on whether optimal cytoreduction has an impact on disease-free survival, and whether certain patient characteristics could identify ideal candidates for TC. Materials and Methods: Retrospective analysis of secondary recurrent EOC patients undergoing TC at three Turkish tertiary institutions from May 1997 to July 2014 was performed. All patients had previously received primary cytoreduction followed by intravenous platinum-based chemotherapy and secondary cytoreduction for first recurrence. Clinical and pathological data were obtained from the patients' medical records. Survival analysis was caried out using the Kaplan Meier method. Actuarial curves were compared by the two tailed Logrank test with a statistical significance level of 0.05. Results: Median age of the patients was 49.6 years (range, 30-67) and thirty-eight (72%) had stage III-IV disease at initial diagnosis. Twenty six (49%) had optimal and 27 (51%) suboptimal cytoreduction during tertiary debulking surgery . Optimal initial cytoreduction, time to first recurrence, optimal secondary cytoreduction, time interval between secondary cytoreduction and secondary recurrence, size of recurrence, disease status at last follow-up were found to be significant risk factors to predict optimal TC. Optimal cytoreduction in initial and tertiary surgery and serum CA-125 level prior to TC were independent prognostic factors on univariate analysis. Conclusions: Our results and a literature review clearly showed that maximal surgical effort should be made in TC, since patients undergoing optimal TC have a better survival. Thus, patients with secondary recurrent EOC in whom optimal cytoreduction can be achieved should be actively selected.

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Section: Discussionmentioning

confidence: 89%