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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 12/2013

01-11-2013 | Gynecologic Oncology

Timing and Pattern of Recurrence in Ovarian Cancer Patients with High Tumor Dissemination Treated with Primary Debulking Surgery Versus Neoadjuvant Chemotherapy

Authors: M. Petrillo, MD, G. Ferrandina, MD, A. Fagotti, MD, G. Vizzielli, MD, P. A. Margariti, MD, Anchora L. Pedone, MD, C. Nero, MD, F. Fanfani, MD, Giovanni Scambia, MD

Published in: Annals of Surgical Oncology | Issue 12/2013

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Abstract

Purpose

To compare the timing and pattern of recurrence in patients with advanced ovarian cancer (AOC) receiving primary debulking surgery (PDS) versus neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS).

Methods

We retrospectively evaluated a consecutive series of 175 stage IIIC–IV epithelial ovarian cancer patients, with diffuse peritoneal carcinomatosis documented at initial surgical exploration. Forty patients received complete PDS, and the remaining 135 were treated with NACT followed by IDS with absent residual tumor after surgery.

Results

No differences were observed in the distribution of clinical pathological characteristics at the time of diagnosis between the two groups. The median follow-up was 31 months (range 9–150 months). We observed 20 (50.0 %) recurrences in the PDS group compared to 103 (76.3 %) in the IDS group (p = 0.001). Duration of primary platinum-free interval (PFI) was shorter in IDS compared to PDS group (13 vs. 21 months, respectively; p = 0.014). A significantly higher percentage of patients in the IDS group experienced platinum-resistant recurrences (35.9 vs. 5.0 %; p = 0.006) and carcinomatosis at the time of relapse (57.3 vs. 20.0 %; p = 0.0021). Finally, in women with platinum-sensitive recurrence, we observed a shorter secondary PFI in the IDS compared to PDS group (p = 0.006).

Conclusions

We documented a better behavior of recurrent disease in AOC patients with diffuse peritoneal carcinomatosis treated with complete PDS compared to women submitted to NACT followed by IDS with no residual tumor after surgery.
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Metadata
Title
Timing and Pattern of Recurrence in Ovarian Cancer Patients with High Tumor Dissemination Treated with Primary Debulking Surgery Versus Neoadjuvant Chemotherapy
Authors
M. Petrillo, MD
G. Ferrandina, MD
A. Fagotti, MD
G. Vizzielli, MD
P. A. Margariti, MD
Anchora L. Pedone, MD
C. Nero, MD
F. Fanfani, MD
Giovanni Scambia, MD
Publication date
01-11-2013
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 12/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-3091-6

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