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Secondary Surgical Cytoreduction Not Superior in Ovarian Cancer

Addition of surgery prior to chemotherapy does not prolong overall survival in recurrent ovarian cancer

THURSDAY, Nov. 14, 2019 (HealthDay News) — For patients with platinum-sensitive recurrent ovarian cancer, secondary surgical cytoreduction followed by chemotherapy does not result in longer overall survival than chemotherapy alone, according to a study published in the Nov. 14 issue of the New England Journal of Medicine.

Robert L. Coleman, M.D., from the University of Texas MD Anderson Cancer Center in Houston, and colleagues randomly assigned patients with recurrent ovarian cancer to either undergo secondary surgical cytoreduction and then receive platinum-based chemotherapy or receive platinum-based chemotherapy alone (240 and 245, respectively).

Patients were followed for a median of 48.1 months. The researchers found that 67 percent of the patients who underwent surgery achieved complete gross resection. For surgery versus no surgery, the hazard ratio for death was 1.29 (95 percent confidence interval, 0.97 to 1.72; P = 0.08), corresponding to median overall survival of 50.6 and 64.7 months, respectively. The effect was not altered by adjustment for platinum-free interval and chemotherapy choice. For surgery versus no surgery, the hazard ratio for disease progression or death was 0.82 (95 percent confidence interval, 0.66 to 1.01; median progression-free survival of 18.9 and 16.2 months, respectively). At 30 days, surgical morbidity was 9 percent; one patient died from postoperative complications.

“Secondary surgical cytoreduction in patients with platinum-sensitive, recurrent epithelial ovarian cancer selected according to these criteria appears to be feasible, with acceptable postoperative morbidity, but did not result in longer overall survival than no surgery,” the authors write.

Roche/Genentech supported the National Cancer Institute cooperative research and development agreement enabling this trial.

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