Complete cytoreductive surgery, the key factor for survival in advanced ovarian cancer. Experience of an intermediate volume hospita
Irina Esteves-Krasteva (1), José Ángel Minguez (2), José M. Aramendía (3), Marta Santisteban (3, 5), Fernando Martinez-Regueira (4), Gabriel Zozaya-Larequi (4), Juan Luis Alcázar (2), Matías Jurado (2)
(1) Department of Obstetrics and Gynecology, Hospital de Estella, Estella, Navarra, Spain
(2) Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, Pamplona, Spain
(3) Department of Medical Oncology, Clinica Universidad de Navarra, Pamplona, Spain
(4) Department of Surgery, Clinica Universidad de Navarra, Pamplona, Spain
(5) IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
Introduction: We aimed to analyze the outcome in a series of women with primary advanced ovarian cancer in an Intermediate Volume Hospital where new surgical and chemotherapy treatments were implemented over a period of 14 years.
Material and Methods: One hundred and twenty-seven women with stage IIIB-IV disease underwent primary (76.4%) or interval debulking surgery (23.6%). Fifty-seven were operated on from 2000 to 2005 (Group 1) and 70 from 2006 to 2014 (Group 2).
Results: No gross residual disease was achieved in 51.5% and 43.3% of women who underwent primary and interval surgery, respectively. For no gross and < 1 cm residual disease, median overall and progression-free survival were 94.7 vs. 60.6 months (p = 0.001) and 25.3 vs. 20.0 months, respectively (p = 0.02). The rate of no gross residual (36.8 to 60.0%) and 5-yr median overall survival (56.3 to 73.7 months) increased between 2000-2005 (Group 1) and from 2006 to 2014 (Group 2). On multivariate analysis, interval surgery, multiple peritoneal implants and residual disease were predictive of overall and progression-free survival.
Conclusions: Survival after primary and interval debulking surgery progressively correlates with decrease in residual disease. Increasing rates of successful primary surgery are possible through standardization and adoption of best practices without increasing morbidity.
CITA DEL ARTÍCULO European Journal of Gynaecological Oncology 2020, Vol. 41 Issue (6): 906-912 DOI: 10.31083/j.ejgo.2020.06.2090