Comparing And Analyzing The Prognosis Of Platinum-sensitive Recurrent Ovarian Cancer With Secondary Cytoreductive Surgery Combined With Chemotherapy And Simple Chemotherapy

Objective:To compare and analyze the prognosis of platinum-sensitive recurrent ovarian cancer with simple chemotherapy and secondary cytoreductive surgery combined with chemotherapy.Methods:The clinical and pathological data of 156 patients with platinum sensitive recurrent ovarian cancer treated in Jiangxi Maternal and Child Health Hospital from January 1,1995 to December 31,2015 were analyzed retrospectively.It was divided into non-operative group,namely 106 patients with simple chemotherapy and operative group,namely 50 patients with secondary cytoreductive surgery combined with chemotherapy.Age,pathological type,FIGO stage,differentiation degree,imaging examination,CA125 level,ascites volume,residual size after secondary cytoreductive surgery were included in this study.By calculating the overall survival,progressionfree survival and 1-5-year survival rate of the two groups,SPSS software was used to compare the prognosis of simple chemotherapy and secondary cytoreductive surgery combined with chemotherapy in recurrent ovarian cancer.Results:1.The single factor analysis suggests that age,differentiation degree,treatment method and the residual size after secondary operation are related to the progression free survival(PFS),and the difference is statistically significant(P < 0.05).The multiple factor analysis suggests that the treatment is an independent factor of recurrence in platinum-sensitive recurrent ovarian cancer(P < 0.05).2.The single factor analysis suggests that the treatment method and the residual size after secondary operation are related to the overall survival(OS),and the difference is statistically significant(P < 0.05).The multiple factor analysis suggests that the treatment is an independent factor of survival in platinum-sensitive recurrent ovarian cancer(P < 0.05).3.Pearson correlation analysis suggests that PFS has a moderate positive correlation with OS(r = 0.509,P < 0.001).4.According to the Mann-Whitney U test data,compared with the non-operative group,the OS、PFS of the surgical group are significantly elongated,which was statistically significant(P<0.05).5.The Chi-square test shows that the survival rate of 1,2,3 4 and 5 years after recurrence are 80.1%,42.9%,25.6%,18.6% and 14.1%,respectively.The PFS、OS and 3-,4-,5-year survival rates in the operation group are significantly improved compared to the non-operation group,with OR(95% CI)of 4.460(2.085-9.541),5.516(2.261-13.410),3.787(1.493-9.602).6.According to the KM survival curve,the two groups are different(Log Rank P < 0.001),and the operation group is better than the non-operation group.The KM survival curve of the three groups is also different(Log Rank P < 0.001),in which the R0 operation group is better than the non-operation group,while the non-operation group is better than the non-R0 operation group.Conclusions:1.Patients with the younger age,the higher differentiation degree,adopting secondary cytoreductive surgery combined with chemotherapy and the smaller residual size after the secondary cytoreductive surgery,the PFS of the patients will be longer.Adopting secondary cytoreductive surgery combined with chemotherapy and the smaller the residual size after the secondary cytoreductive surgery,the OS of the patients will be longer.Besides,the study finds that secondary cytoreductive surgery combined with chemotherapy is the independent factor of the recurrence and survival of platinum-sensitive recurrent ovarian cancer.2.The longer PFS,the longer the OS is in the platinum-sensitive recurrent ovarian cancer.3.Secondary cytoreductive surgery combined with chemotherapy can improve the long-term survival rate of the platinum-sensitive recurrent ovarian cancer.4.Overall,the survival analysis of the operation group is better than that of the non-operation group,but the non-R0 operation group does not benefit compared with the non-operation group.