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International Journal of Gynecological Cancer:
doi: 10.1097/IGC.0b013e318286665b
Ovarian Cancer

Prognostic Factors and Clinical Outcome of Patients With Recurrent Early-Stage Epithelial Ovarian Cancer: An Italian Multicenter Retrospective Study

Gadducci, Angiolo MD*; Cosio, Stefania MD*; Zola, Paolo MD; Sostegni, Benedetta MD; Fuso, Luca MD; Sartori, Enrico MD

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Abstract

Objective: The objective of this study was to assess the clinical outcome of patients with recurrent early-stage ovarian cancer.

Methods: The hospital records of 87 patients were reviewed. The median follow-up of survivors from recurrence was 87.6 months.

Results: The 25%, 50%, and 75% quantiles of time to recurrence were 15, 25, and 44 months, respectively. The pelvis was the most common site of failure (39.1%), followed by abdomen (18.3%) and retroperitoneal nodes (18.3%). Treatment at recurrence consisted of chemotherapy in 46 patients, surgery plus chemotherapy in 29, surgery in 3, surgery plus radiotherapy in 2, and other therapies in 7. A macroscopically complete cytoreduction was obtained in 29 (85.2%) of the 34 patients who underwent secondary surgery. Five- and 7-year survival rates after recurrence were 34.3% and 29.6%. By log-rank test, survival after recurrence was related to patient age (≤60 vs >60 years; P = 0.001), time to recurrence (>15 vs ≤15 months; P = 0.049), site of recurrence (retroperitoneum vs pelvis vs other; P = 0.004), and surgery at recurrence (yes vs not; P = 0.001), but not to substage, histotype, grade, prior adjuvant chemotherapy, examination that detected recurrence, and chemotherapy at recurrence. On multivariate analysis, patient age (hazard ratio, 1.836; 95% confidence interval, 1.060-3.180) and surgical treatment at recurrence (hazard ratio, 1.972; 95% confidence interval, 1.084–3.587) were independent prognostic variables for survival after recurrence.

Conclusions: Patient age and surgery at recurrence were independent prognostic variables for patients with recurrent early-stage ovarian cancer. When feasible, salvage surgery appears to give a survival advantage in this clinical setting.

Copyright © 2013 by IGCS and ESGO

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