Clinical features of long-term survivors of recurrent epithelial ovarian cancer

• Published in: International journal of clinical oncology 2015-02, Vol.20 (1), p.143-149
• Main Authors: Iwase, Haruko, Takada, Toshio, Iitsuka, Chiaki, Nomura, Hidetaka, Abe, Akiko, Taniguchi, Tomoko, Sakamoto, Kimihiko, Takizawa, Ken, Takeshima, Nobuhiro
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Cancer Research; Carcinoma, Ovarian Epithelial; Chemotherapy; Disease-Free Survival; Female; Humans; Long term; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Neoplasms, Glandular and Epithelial - drug therapy; Neoplasms, Glandular and Epithelial - mortality; Neoplasms, Glandular and Epithelial - pathology; Oncology; Organoplatinum Compounds - therapeutic use; Original Article; Ovarian cancer; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - mortality; Ovarian Neoplasms - pathology; Prognosis; Retrospective Studies; Surgical Oncology; Survival analysis; Survivors; Treatment Outcome; Young Adult
• ISSN: 1341-9625; 1437-7772
• DOI: 10.1007/s10147-014-0687-1

Background Although recurrent epithelial ovarian cancer (EOC) is generally regarded as an incurable disease, some patients survive more than 5 years after the first recurrence. The aim of this study was to evaluate the clinical features of patients with recurrent EOC who achieve long-term survival. Methods We retrospectively reviewed the medical records of 164 patients with recurrent EOC and analyzed the clinical stage, histologic subtype, primary treatment, disease-free interval (DFI), recurrence site, secondary treatment, and overall survival from the time of the first recurrence (R-OS), using the Kaplan–Meier method and the log-rank test. Results The median R-OS for all 164 patients was 25 months and the 5-year R-OS rate was 25.4 %. There were no significant differences in R-OS according to the disease stage. The median R-OS was significantly shorter in the 6–12-month DFI group (23 months) than in the ≥12-month DFI group (61 months) ( p  = 0.0002), while there was no significant difference between the 6–12 and 3–6-month DFI groups (20 months) ( p  = 0.161). Of the 164 patients, only 14 survived >5 years after the first recurrence. Most of them underwent surgery and/or radiotherapy in combination with chemotherapy and underwent >18 cycles of platinum-based chemotherapy throughout their treatments (median 22 cycles; range 4–44). Conclusions If high sensitivity to platinum is maintained, patients with recurrent EOC may have prolonged survival following repeated platinum-based chemotherapy cycles. Moreover, their prognosis improves when chemotherapy is combined with secondary cytoreductive surgery and/or irradiation.