The effect of secondary cytoreductive surgery on survival in recurrent epithelial ovarian cancer

Background: The purpose of this research was to determine the key factors that can predict the outcomes of secondary cytoreductive surgery and the criteria for selecting patients that would result in improved survival rates. Methods: The retrospective study analyzed a cohort of 97 individuals who were diagnosed with platinum-sensitive epithelial ovarian cancer at the Gynecologic Oncology Unit from 1990 to 2012, and who had undergone surgery for recurrence following initial treatment, which included primary surgery and adjuvant chemotherapy. Surgical intervention was recommended for patients who had a median disease-free interval (DFI) of at least 6 months from their initial treatment to the recurrence, and who exhibited an Eastern Cooperative Gynecologic Oncology Group performance status of 2 or lower. All patients were treated with platinum-based chemotherapy or other chemotherapy regimens in the postoperative period. Results: The DFI was 24.5 months (95% confidence interval (CI): 18.2–30.7). Optimal secondary cytoreduction was achieved in 63 (64.9%) patients, with a significant increase in survival compared to patient groups with suboptimal cytoreduction (142.9 months vs. 42.2 months and 33.7 months) (p < 0.001). Survival was significantly increased in patients with a DFI >14 months (p = 0.002). Multivariate analysis revealed that disease-free interval (DFI) and the presence of residual disease following secondary surgery emerged as pivotal independent predictors of survival. Conclusions: Secondary cytoreductive surgery stands out as a secure and efficient therapeutic approach for recurrent epithelial ovarian cancer, leading to a decrease in complication rates. Employing maximal surgical interventions notably extends patients’ survival times.