Surgical treatment of recurrent ovarian cancer: report of 21 cases and a review of the literature

Aim: To evaluate the role of secondary cytoreductive surgery in patients wi th recurrent ovarian cancer. Patients and methods: A retrospective chart re view was conducted on 21 patients submitted to secondary cytoreductive surg ery for apparently isolated and resectable recurrence of ovarian cancer, af ter a disease-free interval of at least 12 months. Results: Fifteen patient s (71%) had complete surgical debulking with no macroscopic tumor at the co mpletion of the surgical procedure. Eight patients (38%) required an intest inal resection but no colostomy was performed. Eleven complications were re corded in nine patients, but no operative death occurred. The median surviv al time for all patients after diagnosis of recurrent disease was 29 months (range 6-96 months). Survival time after diagnosis of recurrence was not s ignificantly related either to known prognostic factors of ovarian cancer o r to the length of the clinical remission time. The absence of residual dis ease after salvage surgery was the only factory associated with prolonged s urvival. Conclusion: Secondary cytoreductive surgery is a safe procedure wh ich should be offered to recurrent ovarian cancer patients with apparently isolated and resectable disease, and without ascitis. (C) 1999 Elsevier Sci ence Ireland Ltd. All rights reserved.