Comparison of secondary cytoreductive surgery plus chemotherapy with chemotherapy alone for recurrent epithelial ovarian, tubal, or peritoneal carcinoma: A propensity score-matched analysis of 112 consecutive patients

• Published in: Medicine (Baltimore) 2017-09, Vol.96 (37), p.e8006-e8006
• Main Authors: Takahashi, Akimasa, Kato, Kazuyoshi, Matsuura, Motoki, Katsuda, Takahiro, Matoda, Maki, Nomura, Hidetaka, Okamoto, Sanshiro, Kanao, Hiroyuki, Kondo, Eiji, Omatsu, Kohei, Utsugi, Kuniko, Takeshima, Nobuhiro
• Format: Article
• Language: English
• Subjects: Combined Modality Therapy; Cytoreduction Surgical Procedures; Disease-Free Survival; Fallopian Tube Neoplasms - drug therapy; Fallopian Tube Neoplasms - mortality; Fallopian Tube Neoplasms - surgery; Female; Humans; Middle Aged; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - surgery; Observational Study; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - mortality; Ovarian Neoplasms - surgery; Peritoneal Neoplasms - drug therapy; Peritoneal Neoplasms - mortality; Peritoneal Neoplasms - surgery; Propensity Score; Retrospective Studies; Survival Rate
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000008006

To compare secondary cytoreductive surgery (SCS) plus chemotherapy with chemotherapy alone in Japanese patients with recurrent epithelial ovarian, tubal, or peritoneal cancer (ROC).From our institutional database, we identified 112 patients who underwent therapy for ROC between 2005 and 2013. Of the 112 patients, 77 received salvage chemotherapy alone (CT group) and 35 received SCS plus chemotherapy (SCS group). To reduce the impact of treatment selection bias on treatment outcomes, propensity score-matching analysis was used.In the entire cohort, prognostic features were poorer in the CT group than in the SCS group. The platinum-free interval was significantly lower (15.35 months vs 30.77 months), cancer antigen 125 (CA125) level was significantly higher (247.38 IU/mL vs 83.17 IU/mL), and number of solitary recurrence sites was significantly lower in the CT group than in the SCS group. The matched cohort consisted of 29 CT and 29 SCS patients with a median follow-up period of 24 and 58 months, respectively. In the matched cohort, progression-free survival (PFS) was longer in the SCS group than in the CT group (P = .02); however, overall survival did not differ (P = .23).SCS might be associated with improved PFS in ROC patients. SCS is beneficial in appropriately selected ROC patients.