caa a22 4500 445333030 CHVBK 20180317142743.0 cr unu---uuuuu 170323e20110101xx s 000 0 eng 10.1245/s10434-010-1245-3 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1245-3 Clinical Outcome of Tertiary Surgical Cytoreduction in Patients with Recurrent Epithelial Ovarian Cancer [Elektronische Daten] [Christina Fotopoulou, Rolf Richter, Ioana Braicu, Sven-Christian Schmidt, Peter Neuhaus, Werner Lichtenegger, Jalid Sehouli] Background: The value of tertiary cytoreductive surgery (TCS) on overall survival (OS) of patients with relapsed epithelial ovarian cancer (ROC) is not well defined. Aim of the present study was to evaluate the operative and clinical outcome after TCS. Methods: We systematically evaluated all consecutive patients undergoing TCS. Tumor dissemination pattern, operative morbidity, residual tumor, and survival are described based on a validated intraoperative documentation tool. Predictors of survival and complete tumor resection are analyzed with Cox regression or logistic regression models. Results: Between October 2000 and December 2008, 135 patients (median age, 51years; range, 22-80years) of mainly initial FIGO stage ≥III (106 patients, 78.5%) were evaluated. In 53 patients (39.3%) a complete tumor-resection was obtained. The 1-month operative mortality was 6%. During a median follow-up period of 9.6months (range, 0.1-75months), 78 patients (57.8%) died, while 52 patients (38.5%) experienced a further relapse. Median OS was 19.1months for the total collective (95% confidence interval [95% CI], 14.84-23.35). Median OS was 37.8months (95% CI, 12.7-62.7) for patients without residual tumor; versus 19.0months (95% CI, 9.8-28.2) for residual tumor ≤1cm and 6.9months (95% CI, 3.05-10.7) for residual tumor >1cm (P<.001). The presence of peritoneal carcinomatosis did not seem to significantly affect OS. Complete tumor resection was identified as the strongest predictor of OS. Other independent predictors of OS were interval to primary diagnosis ≥3years (hazard ratio [HR], 0.28; 95% CI, 0.14-0.59) and serous papillary histology (HR, 0.23; 95% CI, 0.09-0.56). A total of 42 patients (31.1%) presented at least 1 major complication. Multivariate analysis identified tumor involvement of the middle abdomen and peritoneal carcinomatosis as independent predictors of complete tumor resection. Conclusions: Postoperative tumor residual disease remains the strongest predictor of survival even in TCS setting. To identify the optimal candidates for TCS, the predictive value of ascites and peritoneal carcinomatosis should be confirmed by future prospective trials. Society of Surgical Oncology, 2010 Fotopoulou Christina Department of Gynecology, Charité University Medical Center Berlin, Berlin, Germany aut Richter Rolf Department of Gynecology, Charité University Medical Center Berlin, Berlin, Germany aut Braicu Ioana Department of Gynecology, Charité University Medical Center Berlin, Berlin, Germany aut Schmidt Sven-Christian Department for General, Visceral and Transplant Surgery, Charité University Medical Center Berlin, Berlin, Germany aut Neuhaus Peter Department for General, Visceral and Transplant Surgery, Charité University Medical Center Berlin, Berlin, Germany aut Lichtenegger Werner Department of Gynecology, Charité University Medical Center Berlin, Berlin, Germany aut Sehouli Jalid Department of Gynecology, Charité University Medical Center Berlin, Berlin, Germany aut Annals of Surgical Oncology Springer-Verlag 18/1(2011-01-01), 49-57 1068-9265 18:1<49 2011 18 10434 https://doi.org/10.1245/s10434-010-1245-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1245-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fotopoulou Christina Department of Gynecology, Charité University Medical Center Berlin, Berlin, Germany aut NATIONALLICENCE 700 1- Richter Rolf Department of Gynecology, Charité University Medical Center Berlin, Berlin, Germany aut NATIONALLICENCE 700 1- Braicu Ioana Department of Gynecology, Charité University Medical Center Berlin, Berlin, Germany aut NATIONALLICENCE 700 1- Schmidt Sven-Christian Department for General, Visceral and Transplant Surgery, Charité University Medical Center Berlin, Berlin, Germany aut NATIONALLICENCE 700 1- Neuhaus Peter Department for General, Visceral and Transplant Surgery, Charité University Medical Center Berlin, Berlin, Germany aut NATIONALLICENCE 700 1- Lichtenegger Werner Department of Gynecology, Charité University Medical Center Berlin, Berlin, Germany aut NATIONALLICENCE 700 1- Sehouli Jalid Department of Gynecology, Charité University Medical Center Berlin, Berlin, Germany aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/1(2011-01-01), 49-57 1068-9265 18:1<49 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer