Factors influencing period of time between negative second-look laparotomyand ovarian carcinoma recurrence. Multicenter study in Poland

Objective: The aim of our study was to evaluate factors such as primary cli nical stage, presence of ascites, serum CA 125 antigen level, histological type of ovarian cancer, cell differentiation and number of chemotherapy cyc les influencing the time of recurrence after negative second-look operation s. Material and Methods: Having observed complete clinical remission in 356 pa tients with ovarian cancer, second-look laparotomy was performed. In 180 pa tients complete pathologic remission was detected and in 73 recurrence was observed. Correlation analysis between time of recurrence and the above-men tioned prognostic factors was carried out by means of the Mann-Whitney and Kruskal-Wallis tests. Results: The time from the second-look operation till diagnosis of relapse ranged from 7 to 36 months (average 21 months). The statistical analysis sh owed a correlation between the presence of ascites, increased serum CA 125 antigen level, the administration of six chemotherapy courses and the time of recurrence. In all these cases relapse occurred earlier than in patients without ascites, with normal CA 125 antigen levels and after ten courses o f chemotherapy. Conclusion: Our findings suggest that the stage of clinical advancement and histologic grading do not influence the time of recurrence. The presence o f ascites, increased serum CA 125 antigen level and the administration of f ewer chemotherapy courses (6 versus 10) after primary surgery affects the e arlier relapse of disease.