Secondary Cytoreductive Surgery for Ovarian Cancer With Second Platinum-Sensitive Recurrence: A Multicentre Retrospective Cohort Study

Abstract

Objective

To compare survival outcomes between patients with ovarian cancer with platinum-sensitive recurrence (PSR) who underwent secondary cytoreductive surgery (SCS) at the first recurrence and those who underwent SCS at the second recurrence.

Design

Multicentre cohort study.

Setting

Data were retrospectively collected from five hospitals in China.

Population

Patients with ovarian cancer who underwent SCS at either the first or second PSR.

Methods

Overall survival (OS) and time to second progression (PFS2), calculated from the time of recurrence to the next progression following SCS, were compared between the groups. Postsurgical complications were categorised according to the Clavien–Dindo classification system.

Main Outcome Measures

OS, PFS2, and postsurgical complications.

Results

Among the 231 patients included, 175 underwent SCS at the first PSR (Group 1) while 56 underwent SCS at the second PSR (Group 2). Complete resection was achieved in 84.0% of patients in Group 1 and 78.6% in Group 2. Postsurgical complication rates were similar between the groups. The median OS was not reached in Group 1, whereas Group 2 had a median OS of 77.3 months. Patients who underwent SCS at the second PSR had an OS comparable to that of those who underwent SCS at the first PSR. Multivariate analyses revealed that complete resection (hazard ratio [HR] = 0.120, p = 0.002) and optimal resection (HR = 0.228, p = 0.046) were independently associated with improved survival.

Conclusions

SCS is a safe and effective treatment for patients with platinum-sensitive recurrent ovarian cancer, regardless of whether it is performed at the first or second recurrence.