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Recurrence Patterns of Advanced Ovarian, Fallopian Tube, and Peritoneal Cancers After Complete Cytoreduction During Interval Debulking Surgery

Usami, Tomoka MD; Kato, Kazuyoshi MD; Taniguchi, Tomoko MD; Abe, Akiko MD; Nomura, Hidetaka MD; Yamamoto, Akiko MD; Matoda, Maki MD; Okamoto, Sanshiro MD; Kondo, Eiji MD; Omatsu, Kohei MD; Kawamata, Yasutaka MD; Takeshima, Nobuhiro MD

International Journal of Gynecological Cancer: July 2014 - Volume 24 - Issue 6 - p 991–996
doi: 10.1097/IGC.0000000000000142
Ovarian Cancer

Objectives Similar to primary debulking surgery, complete resection of all macroscopic diseases during interval debulking surgery (IDS) is the primary objective while using neoadjuvant chemotherapy followed by IDS for advanced ovarian, fallopian tube, and peritoneal cancers. However, most patients develop recurrent disease even after complete cytoreduction during IDS. This study aims to identify recurrence patterns of the ovarian, fallopian tube, and peritoneal cancers in patients who underwent complete cytoreduction during IDS.

Methods We retrospectively reviewed data of patients with stage III or IV ovarian, fallopian tube, and peritoneal cancers who were treated at our hospital from January 1, 2005, to December 31, 2011.

Results In this study, 105 patients underwent neoadjuvant chemotherapy followed by IDS and achieved complete cytoreduction. The median follow-up period was 42.1 months. Recurrence was documented in 70 patients (66.7%), and 35 (33.3%) showed no evidence of disease. Peritoneal dissemination was the most common recurrence (60.0%) observed. In multivariate analysis, positive peritoneal cytology (P = 0.0003) and elevated pre-IDS serum CA125 levels (P = 0.046) were independent risk factors for recurrence.

Conclusions After complete cytoreduction during IDS in patients with stage III or IV ovarian, fallopian tube, and peritoneal cancers, positive peritoneal cytology at IDS and elevated pre-IDS CA125 levels are associated with an increased risk of cancer recurrence. Positive peritoneal cytology during IDS is a particularly strong predictive factor for poor outcomes in these patients.

Department of Gynecological Oncology, Cancer Institute Hospital, Tokyo, Japan.

Address correspondence and reprint requests to Tomoka Usami, MD, Department of Gynecological Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan. E-mail: tomoka.usami@jfcr.or.jp.

The authors declare no conflicts of interest.

Received January 4, 2014

Accepted March 11, 2014

© 2014 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.