Analysis Of Factors Influencing The Secondary Surgical Treatment Of Recurrent Ovarian Cancer

Objective: To investigate the role of secondary cytoreductive surgery (SCR) inrecurrent ovarian cancer (ROC) and factors affecting surgical outcomes.Methods：The clinical data of30patients with recurrent ovarian cancer wereanalyzed retrospectively, who received secondary cytoreductive surgery during April2002to January2011in First Affiliated Hospital of Dalian Medical University. Survivalcurves were generated using the Kaplan-Meier method, statistical comparisons wereperformed using log-rank tests, logistic stepwise regression analyse determined whichvariables influenced the surgical outcome.Results:(1)In total,30patients underwent secondary cytoreduction, optimalcytoreductive surgery (residual disease≤1cm) was obtained in22(73.3%) patients.(2)The overall median survival of30patients with ROC was38months(95%CI:9.6-66.3), optimal cytoreductive surgery (residual disease≤1cm)wasassociated with significantly longer survival compared with suboptimal cytoreductivesurgery (residual disease>1cm)[median48vs.16months; P=0.024].(3)Univariatelogistic regression analysis showed that Eastern Cooperative Oncology Group (ECOG)score, residual tumor after primary surgery, volume of ascites, the extent of relapsedisease, the largest size of recurrenct tumor are factors of the surgical effects for ROC.(4)The logistic regression revealed that the outcome of SCR was significantly affectedby ECOG score (0[94.4%] vs.≥1[41.7%]; P=0.042), volume of ascites (ascites<500ml[87.5%] vs. ascites≥500ml[16.7%];OR=20.589;P=0.036), the extent of relapse disease(solitary site [94.4%] vs. Multiple sites [41.7%];OR=14.985;P=0.042).Conclusions：(1) Optimal cytoreductive surgery significantly improves furthersurvival in patients with recurrent ovarian cancer.(2)Optimal surgical outcomes were achieved easily in patients who had a good performance status(ECOG0), apparentlyhad solitary site and without ascites.