Ten-year follow-up of ovarian cancer patients after second-look laparotomywith negative findings

Objective: To determine long-term survival and predictors of recurrence in patients with platinum-treated ovarian cancer who were followed for 10 year s after second-look laparotomy with negative findings. Methods: Records were reviewed of 91 consecutive patients with negative fin dings on second-look laparotomy after platinum-based chemotherapy between J anuary 1978 and January 1987. Statistical analysis used Kaplan-Meier surviv al curves, Cox proportional hazards, and multiple logistic regression. Results: Mean age of patients was 57 (range 30-79) years. Distribution by s tage and grade was as follows: stage I, ten; II,18; III, 57; IV,six; grade 1, 18; 2, 28; 3, 45. Forty-seven of 91 women had optimal initial cytoreduct ion. Recurrence-free survival rates for all subjects were 75% at 2 years, 5 5% at 5 years, and 52% at 10 years. For women with stage I disease, the rec urrence-free survival rate was 90% at 2, 5, and 10 years. For women with st age II disease, recurrence-free survival rates were 78, 72, and 66% at 2, 5 , and 10 years, respectively. Patients with stage III or nr disease had rec urrence-free survival rates of 72, 44, and 40% at 2, 5,and 10 years, respec tively. Risk of recurrent disease was related to tumor stage (relative risk [RR] 2.02; 95% confidence interval [CI] 1.2 3.3; P = .005), grade (RR 2.00 ; 95% CI 1.3, 3.2; P = .004), and presence of a residual tumor of more than 2 cm at the end of initial surgery (RR 3.19; 95% CI 1.2, 8.5; P = .02). Conclusion: Ovarian cancer patients face an appreciable risk of recurrence in the first 5 years after second-look laparotomy with negative findings af ter platinum-based chemotherapy, but those who remain disease free at 5 yea rs have excellent long-term survival rates. Tumor stage, grade, and presenc e of a residual tumor of more than 2 cm after initial surgery are significa nt predictors of recurrence. (C) 1999 by The American College of Obstetrici ans and Gynecologists.