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European Journal of Gynaecological Oncology  2020, Vol. 41 Issue (6): 906-912    DOI: 10.31083/j.ejgo.2020.06.2090
Original Research Previous articles | Next articles
Complete cytoreductive surgery, the key factor for survival in advanced ovarian cancer. Experience of an intermediate volume hospital
Irina Esteves-Krasteva1, José Ángel Minguez2, José María Aramendía3, Marta Santisteban3, 5, Fernando Martinez-Regueira4, Gabriel Zozaya-Larequi4, Juan Luis Alcázar2, *(), Matías Jurado2
1Department of Obstetrics and Gynecology, Hospital de Estella, Estella, Navarra, Spain
2Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, Pamplona, Spain
3Department of Medical Oncology, Clinica Universidad de Navarra, Pamplona, Spain
4Department of Surgery, Clinica Universidad de Navarra, Pamplona, Spain
5IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
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Abstract  
Introduction: We aimed to analyze the outcome in a series of women with primary advanced ovarian cancer in an Intermediate Volume Hospital where new surgical and chemotherapy treatments were implemented over a period of 14 years. Material and Methods: One hundred and twenty-seven women with stage IIIB-IV disease underwent primary (76.4%) or interval debulking surgery (23.6%). Fifty-seven were operated on from 2000 to 2005 (Group 1) and 70 from 2006 to 2014 (Group 2). Results: No gross residual disease was achieved in 51.5% and 43.3% of women who underwent primary and interval surgery, respectively. For no gross and < 1 cm residual disease, median overall and progression-free survival were 94.7 vs. 60.6 months (p = 0.001) and 25.3 vs. 20.0 months, respectively (p = 0.02). The rate of no gross residual (36.8 to 60.0%) and 5-yr median overall survival (56.3 to 73.7 months) increased between 2000-2005 (Group 1) and from 2006 to 2014 (Group 2). On multivariate analysis, interval surgery, multiple peritoneal implants and residual disease were predictive of overall and progression-free survival. Conclusions: Survival after primary and interval debulking surgery progressively correlates with decrease in residual disease. Increasing rates of successful primary surgery are possible through standardization and adoption of best practices without increasing morbidity.
Key words:  Ovarian cancer      Cytoreduction      Neoadjuvant chemotherapy      Bevacizumab      Hospital volume     
Submitted:  13 March 2020      Accepted:  26 April 2020      Published:  15 December 2020     
*Corresponding Author(s):  JUAN LUIS ALCÁZAR     E-mail:  jlalcazar@unav.es

Cite this article: 

Irina Esteves-Krasteva, José Ángel Minguez, José María Aramendía, Marta Santisteban, Fernando Martinez-Regueira, Gabriel Zozaya-Larequi, Juan Luis Alcázar, Matías Jurado. Complete cytoreductive surgery, the key factor for survival in advanced ovarian cancer. Experience of an intermediate volume hospital. European Journal of Gynaecological Oncology, 2020, 41(6): 906-912.

URL: 

https://ejgo.imrpress.com/EN/10.31083/j.ejgo.2020.06.2090     OR     https://ejgo.imrpress.com/EN/Y2020/V41/I6/906

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