PO-GO14 : Impact of intervals between secondary cytoreductive surgery and adjuvant chemotherapy in patients recurrent epithelial ovarian cancer

Objective: When epithelial ovarian cancer(EOC) patients recur, secondary cytoreductive surgery(SCS) and adjuvant chemoteherapy(AC) are performed in selected patients. This study was performed to identify the impact of intervals between SCS and AC in recurrent EOC patients. Methods: Recurrent EOC patients performed SCS and AC from January 2002 to December 2015 were enrolled in this retrospective study. The treatment interval(TI) was defined as the period between SCS date and initiation date of AC. Overall survival(OS) and progression-free survival(PFS) were calculated by the Kaplan-Meier method. Univariate and multivariate analyses were used to evaluate the association of demographic and clinical variables with OS in Cox-proportional hazard models. Results: A total of 79 patients met the inclusion criteria. We divided into two groups according to the median level of TI, 10 days(range, 4-42). Each group was included 42(53.1%) and 37(46.9%) patients. Two groups were similar in clinical and pathological characteristics. The TI was not a significant prognostic factor for recurrence and death in recurrent EOC (HR for PFS 0.67, p=0.670, HR for OS 0.772, p=0.433). However, CA-125 level before SCS, residual status after SCS, and platinum-free interval were significantly prognostic factors of recurrence and death in patients with SCS and AC. (HRs for PFS were 1.976, 2.366, and 0.509, HRs for OS were 2.664, 3.699, and 0.462, all p-value<0.05). Survival rates were improved when disease were resected completely at SCS, when CA-125 level before SCS was lower, when platinum-free interval was longer, and when surgery type was laparoscopic (all p-value<0.05). However, the TI was not related with survival rates(p=0.431). Conclusion: In this study, when SCS and AC were performed in recurrent EOC patients, the TI was not related with survival and the most powerful prognostic factor was ‘complete resection at SCS’. Larger cohort study will need to confirm the impact of TI.