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J Turk Ger Gynecol Assoc. 2019 Nov 28;20(4):213-217. doi: 10.4274/jtgga.galenos.2019.2018.0165. Epub 2019 Jul 31.

Secondary debulking for ovarian carcinoma relapse: The R-R dilemma – is the prognosis different for residual or recurrent disease?

Author information

1
Department of Surgical Oncology and HIPEC, Athens Medical Centre, Athens, Greece
2
Department of Surgical Oncology and HIPEC, European Interbalkan Medical Centre, Thessaloniki, Greece
3
Clinic of Gynecological Oncology, Metaxa Cancer Hospital, Piraeus, Greece
4
Clinic of Surgical Oncology, Metaxa Cancer Hospital, Piraeus, Greece
5
Clinic of Medical Oncology, Saint Andrews Hospital, Patra, Greece

Abstract

Objective:

To analyze the kind of ovarian cancer relapse by separating residual from recurrent disease and correlating them with patient survival.

Material and Methods:

This was a retrospective study of 200 women with ovarian carcinoma relapse between 2005 and 2017.

Results:

The main sites of residual disease included the great omentum, epiploic appendices, liver round ligament, gallbladder, and cervical/vaginal stump. The median survival for women with residual disease treated with cytoreductive surgery (CRS) + hyperthermic intraperitoneal chemotherapy (HIPEC) + systemic chemotherapy was 38 months compared with the control group, which reached 23.8 months. The morbidity rates were 18% vs 7%, respectively, and the mortality rates were 2.5% vs 1.3%. The main sites of recurrent disease included the mesenterium, pelvic floor, diaphragm, and Glisson’s capsule. Women with recurrent disease treated with CRS + HIPEC + systemic chemotherapy had median survival rates of 26 months vs 16 months in the control group. The morbidity rates were 22% vs 15%, respectively, and the mortality rates were 3.3% vs 0%.

Conclusion:

Patients undergoing secondary debulking plus HIPEC for ovarian carcinoma relapse have a different prognosis when compared with patients with residual and recurrent disease. A different prognosis is presented in women undergoing secondary debulking plus HIPEC for ovarian carcinoma relapse when comparing patients with residual and recurrent disease.

KEYWORDS:

HIPEC; ovarian carcinoma; relapse; residual; recurrence; management; survival; prognosis

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