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Predictive factors in relapsed ovarian cancer for complete tumor resection
Blanca Gil-Ibáñez1, Gulten Oskay-Özcelik, Rolf Richter
1Department of Gynecology, Charité-Campus Virchow Klinikum, University Medicine of Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. blancalabacin@hotmail.com
Aim:
The aim of this study was to identify predictive factors for complete tumor resection in patients with relapsed ovarian cancer.
Patients And Methods:
All patients with first relapse of ovarian cancer who underwent secondary cytoreduction at our center between September 2000 and April 2006 were evaluated according to a validated intraoperative documentation tool. Predictive factors were identified by logistic regression following the Cox regression model.
Results:
Overall, 177 consecutive patients (pts) were analyzed. The median age at first diagnosis was 55 years (range, 23-83 years). The complete tumor resection rate was 44.6%. Predictive factors that correlated with an adverse surgical outcome in terms of residual tumor were ascites <500 ml (Odds ratio, OR=0.3; 95% Confidence interval, CI=0.1-0.8 p<0.05), tumor involvement of the small bowel (OR=0.22; 95% CI=0.07-0.71 p<0.05), tumor spread in the upper abdomen (OR=0.33; 95% CI=0.1-0.9 p<0.05) and platinum resistance (OR=0.1, 95% CI=0.06-0.5 p<0.01). Serous tumor histology (OR=5.8) appeared to have a protective effect. Age and initial FIGO stage were of no predictive significance.
Conclusion:
Platinum-sensitive patients without ascites, no intestinal tumor involvement, tumor restricted to middle and lower abdomen, and of serous papillary histology have significantly higher complete tumor resection rates. Prospective studies are warranted to evaluate the predictive value of these factors.
