Factors Influencing The Efficacy Of Secondary Cytoreductive Surgery For Platinum Sensitive Recurrent Ovarian Cancer

Objective: To study the factors affecting the satisfaction of secondary cytoreductive surgery(SCRS),and to explore the feasibility and effect of the treatment of recurrent ovarian cancer and the effect on the prognosis of the patients.Methods: According to the size of the residual tumor after secondary cytoreductive surgery,the outcomes of SCRS were divided into complete cytoreduction(R0:no gross residual disease),the optimal cytoreduction(R1:residual focus < 1cm),and the suboptimal cytoreduction(R2: residual focus more than 1cm).43 cases of recurrent ovarian cancer were selected from January 2007 to July 2017 in the gynecologic department of the Department of gynaecology of the Guangxi cancer hospital.The clinicopathological data of these patients were summarized,including age,FIGO staging,pathological differentiation,histological type,initial tumor cell reduction,SCRS results,and the largest lesion in SCRS,the location and size of the largest lesion in SCRS,the number of recurrent tumors,the disease free interval(DFI),Kaplan Meier survival curve,logistic test and Cox model multiple factor regression analysis were used to study the factors affecting the degree of two tumor cell reduction and the prognostic factors of SCRS on patients with recurrent epithelial ovarian cancer.Results: 40 patients met the inclusion criteria.In SCRS,the number of recurrent tumors is positively correlated with the results of SCRS surgery(P<0.05).It is an independent risk factor affecting the effect of SCRS.The more the number of tumors,the lower the level of SCRS,the more easily the patients with isolated lesions reach complete reduction;the time of FIGO,the time to confirm the recurrence to SCRS,the size of the tumor and the SCRS hand The results of the operation were positive(P<0.05).The higher the tumor stage,the longer the tumor recurrence time and the large volume of the tumor were the risk factors for the effect of the SCRS operation,that is,the more advanced the FIGO staging,the longer the tumor recurrence time,the larger the tumor volume,the more dissatisfied with the SCRS.The age,the degree of differentiation,the histological type,the location of the tumor recurrence,the difference of DFI,SCRS and the difference of chemotherapy were not associated with the results of SCRS(all P>0.05).The survival analysis showed that the results of DFI,the outcomes of primary CRS and SCRS were statistically significant(P <0.05).The median survival time of 40 patients with SCRS was 27 months;the complete SCRS,optimal SCRS,and the suboptimal SCRS median survival time were 49 months,26 months,18 months.Conclusion: The complete secondary cytoreductive surgery with no residual eye lesions can significantly prolong the survival of patients with recurrent epithelial ovarian cancer.The stage of tumor,the length of the recurrence,the size and quantity of the lesion are related to the degree of SCRS satisfaction,which provides guidance for the surgical treatment of the patients with recurrent ovarian cancer,which can make the patients achieve complete tumor cell reduction and improve the prognosis.