Secondary debulking for ovarian carcinoma relapse: The R-R dilemma – is the prognosis different for residual or recurrent disease?

Abstract

Objective: To analyze the kind of ovarian cancer relapse by separating residual from recurrent disease and correlating them with patientsurvival.Material and Methods: This was a retrospective study of 200 women with ovarian carcinoma relapse between 2005 and 2017.Results: The main sites of residual disease included the great omentum, epiploic appendices, liver round ligament, gallbladder, and cervical/vaginal stump. The median survival for women with residual disease treated with cytoreductive surgery (CRS) + hyperthermic intraperitonealchemotherapy (HIPEC) + systemic chemotherapy was 38 months compared with the control group, which reached 23.8 months. The morbidityrates were 18% vs 7%, respectively, and the mortality rates were 2.5% vs 1.3%. The main sites of recurrent disease included the mesenterium,pelvic floor, diaphragm, and Glisson’s capsule. Women with recurrent disease treated with CRS + HIPEC + systemic chemotherapy had mediansurvival rates of 26 months vs 16 months in the control group. The morbidity rates were 22% vs 15%, respectively, and the mortality rates were3.3% vs 0%.Conclusion: Patients undergoing secondary debulking plus HIPEC for ovarian carcinoma relapse have a different prognosis when comparedwith patients with residual and recurrent disease. A different prognosis is presented in women undergoing secondary debulking plus HIPEC forovarian carcinoma relapse when comparing patients with residual and recurrent disease.