Primary site disease and recurrence location in ovarian cancer patients undergoing primary debulking surgery vs. interval debulking surgery |
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| Affiliation: | 1. Department of Gynecology and Obstetrics, University of Parma, Parma, Italy;2. Department of Obstetrics and Gynecology, Ospedale Degli Infermi, ASL Biella, Biella, Italy;3. Department of Gynecologic Oncology, ARNAS Civico Hospital of Palermo, Palermo, Italy;4. Department of Obstetrics & Gynecology, Gynecologic Oncology and Minimally Invasive Pelvic Surgery, IRCCS Sacro Cuore Don Calabria Hospital, Negrar (Verona), International School of Surgical Anatomy, Italy;5. Department of Obstetrics and Gynecology, University of Verona, Verona, Italy;1. Amsterdam UMC, University of Amsterdam, Department of Biomedical Engineering & Physics, Cancer Center Amsterdam, Amsterdam, The Netherlands;2. Amsterdam UMC, University of Amsterdam, Department of Surgery, Cancer Center Amsterdam, Amsterdam, The Netherlands;3. Amsterdam UMC, University of Amsterdam, Department of Plastic, Reconstructive & Hand Surgery, Amsterdam, The Netherlands;4. Amsterdam UMC, University of Amsterdam, Department of Anesthesiology, Cancer Center Amsterdam, Amsterdam, The Netherlands;5. Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam Cardiovascular Sciences, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands;6. Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Department of Urology, Amsterdam, The Netherlands;1. Leeds Institute for Data Analytics, Level 11, Worsley Building, University of Leeds, Leeds, LS2 9JT, UK;2. Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UK;3. Leeds Teaching Hospitals NHS Trust, UK;4. Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9JT, UK;5. Nuffield Department of Population Health, Big Data Institute, Old Road Campus, University of Oxford, Headington, Oxford, OX3 7LF, UK;1. Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan;2. Division of Gastrointestinal Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan;1. Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, China;2. Department of Hepatobiliary Surgery, The Second Clinical College, Dalian Medical University, Dalian, 116044, China;1. Department of Obstetrics and Gynecology, Nan Fang Hospital, Southern Medical University, Guangzhou, Guangdong, China;2. Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, Shangxi, China;3. Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhengzhou University, Henan, China;4. Department of Gynecology, Fourth Hospital, Hebei Medical University, Shijiazhuang, China;5. Department of Obstetrics and Gynecology, Daping Hospital, Army Medical University, Chonqing, China;6. Department of Obstetrics and Gynecology, Xinqiao Hospital, Army Medical University, Chongqing, China;7. Department of Obstetrics and Gynecology, Yuncheng Central Hospital, Yuncheng, China;8. Department of Gynaecology, Anhui Cancer Hospital, HeFei, China;9. Department of Gynecology, The Maternity and Child Care Hospital of Guizhou Province, Guiyang, China;10. Department of Obstetrics and Gynecology, China-Japan Friendship Hospital, Beijing, China;11. Department of Obstetrics and Gynecology, Guizhou Provincial People’s Hospital, Guiyang, China;12. Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China |
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| Abstract: | IntroductionThe natural history and patterns of ovarian cancer (OC) relapse are still unclear. Recurrent disease can be peritoneal, parenchymal, or nodal. This study aims to analyze the location and pattern of OC recurrence according to the primary site of disease and to the type of surgical approach used.Material and methodsAll OC patients underwent primary debulking surgery (PDS) or interval debulking surgery (IDS), with 2014 FIGO stage III-IV, and with platinum-sensitive recurrence were included in the study. Primary disease location and site of recurrences were divided into peritoneal, parenchymal, and nodal, according to the presence of peritoneal carcinomatosis, parenchymal metastasis, and nodal involvement, respectively.ResultsA total of 355 patients were initially considered; of them, 295 met the inclusion criteria. Two hundred thirty-three patients obtained no macroscopic residual tumor at the end of primary surgical treatment. Primary parenchymal disease relapsed in 84.6% cases at a parenchymal site (p < 0.001), 97.2% of peritoneal diseases relapsed on the peritoneum (p < 0.001), and 100% of nodal diseases had a nodal recurrence (p < 0.001). Stratifying by the surgical approach all these correlations have been confirmed both in the PDS (p < 0.001) and IDS (p < 0.001) groups.ConclusionOur study shows that the site of relapse in cases of platinum-sensitive OC recurrence is closely related to the primary location of the disease, regardless of the type of initial treatment. Therefore, more attention during followup should be paid to areas where the initial tumor was present. |
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| Keywords: | Ovarian cancer Pattern of recurrence Primary site location Site of recurrence Recurrence |
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