OBJECTIVE: The objective of the study was to evaluate the prognostic impact of residual tumor size after cytoreductive surgery in patients with epithelial ovarian cancer. METHODS: In this prospective, multicenter study, 226 patients with epithelial ovarian cancer (International Federation of Gynecology and Obstetrics stages IIA-IV) were included. Patients were treated with cytoreductive surgery and adjuvant platinum-based chemotherapy. Univariate and multivariable survival analyses were performed to investigate the impact of residual tumor size on progression-free and overall survival. RESULTS: In 69.4% of patients, surgery resulted in complete tumor resection; minimal residual disease (≤1 cm) was achieved in 87.2% of patients. Advanced tumor stage was associated with a lower rate of complete tumor resection (P < 0.001). After cytoreductive surgery, 3-year overall survival rates were 72.4%, 65.8%, and 45.2% for patients without, with minimal, and with gross residual disease (>1 cm), respectively (P < 0.001). Multivariable survival analysis revealed residual tumor size (P = 0.04) and older patient age (P = 0.02) as independent prognosticators for impaired overall survival. Complete cytoreduction was predictive for a higher rate of treatment response (P = 0.001) and was associated with prolonged progression-free and overall survival (P < 0.001 and P = 0.001). CONCLUSIONS: The size of residual disease after cytoreduction is one of the most crucial prognostic factors for patients with ovarian cancer. Patients after complete cytoreduction have a superior outcome compared with patients with residual disease. Leaving no residual tumor has to be the aim of primary surgery for ovarian cancer; therefore, patients should receive treatment at centers able to undertake complex cytoreductive procedures.
OBJECTIVE: The objective of the study was to evaluate the prognostic impact of residual tumor size after cytoreductive surgery in patients with epithelial ovarian cancer. METHODS: In this prospective, multicenter study, 226 patients with epithelial ovarian cancer (International Federation of Gynecology and Obstetrics stages IIA-IV) were included. Patients were treated with cytoreductive surgery and adjuvant platinum-based chemotherapy. Univariate and multivariable survival analyses were performed to investigate the impact of residual tumor size on progression-free and overall survival. RESULTS: In 69.4% of patients, surgery resulted in complete tumor resection; minimal residual disease (≤1 cm) was achieved in 87.2% of patients. Advanced tumor stage was associated with a lower rate of complete tumor resection (P < 0.001). After cytoreductive surgery, 3-year overall survival rates were 72.4%, 65.8%, and 45.2% for patients without, with minimal, and with gross residual disease (>1 cm), respectively (P < 0.001). Multivariable survival analysis revealed residual tumor size (P = 0.04) and older patient age (P = 0.02) as independent prognosticators for impaired overall survival. Complete cytoreduction was predictive for a higher rate of treatment response (P = 0.001) and was associated with prolonged progression-free and overall survival (P < 0.001 and P = 0.001). CONCLUSIONS: The size of residual disease after cytoreduction is one of the most crucial prognostic factors for patients with ovarian cancer. Patients after complete cytoreduction have a superior outcome compared with patients with residual disease. Leaving no residual tumor has to be the aim of primary surgery for ovarian cancer; therefore, patients should receive treatment at centers able to undertake complex cytoreductive procedures.
Authors: Nicole D Fleming; Alpa M Nick; Robert L Coleman; Shannon N Westin; Pedro T Ramirez; Pamela T Soliman; Bryan Fellman; Larissa A Meyer; Kathleen M Schmeler; Karen H Lu; Anil K Sood Journal: Obstet Gynecol Date: 2018-09 Impact factor: 7.661
Authors: Larissa A Meyer; Angel M Cronin; Charlotte C Sun; Kristin Bixel; Michael A Bookman; Mihaela C Cristea; Jennifer J Griggs; Charles F Levenback; Robert A Burger; Gina Mantia-Smaldone; Ursula A Matulonis; Joyce C Niland; David M O'Malley; Alexi A Wright Journal: J Clin Oncol Date: 2016-11-10 Impact factor: 44.544
Authors: Irene A Burger; Debra A Goldman; Hebert Alberto Vargas; Michael W Kattan; Changhon Yu; Lei Kou; Vaagn Andikyan; Dennis S Chi; Hedvig Hricak; Evis Sala Journal: Gynecol Oncol Date: 2015-06-17 Impact factor: 5.482
Authors: Andrew Bryant; Shaun Hiu; Patience T Kunonga; Ketankumar Gajjar; Dawn Craig; Luke Vale; Brett A Winter-Roach; Ahmed Elattar; Raj Naik Journal: Cochrane Database Syst Rev Date: 2022-09-26