Long-term follow-up of women with ovarian cancer after positive second-look laparotomy

Sean C. Dowdy, Costas L. Constantinou, Lynn C. Hartmann, Gary L. Keeney, Vera J. Suman, David W. Hillman, Karl C. Podratz

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

Objective Previous reports indicate that cytoreduction and salvage therapy with P32 or whole abdominal radiation may improve survival in patients with positive findings at second-look laparotomy (SLL). The aim of this investigation was to determine whether these findings held true with extended follow-up and a larger patient cohort. Methods From 1977 (the year platinum-based chemotherapy was introduced to our institution) to 1989, 150 patients had persistent disease at SLL. Relevant clinical information was extracted through retrospective chart review. Results One hundred forty-five patients were followed until death, with a median follow-up of 15.4 years for the 5 living patients. Median actuarial survival from the time of SLL was 18 months. Tumor grade (P = 0.003) and pre- and post-SLL tumor size (P < 0.0001) were significant determinants of survival by univariate analysis. Patients with microscopic disease or those with ≤1 cm disease rendered microscopic at SLL had improved survival relative to those with ≤1 cm and macroscopic disease following SLL (P = 0.03) (median survivals of 3.3, 2.5, and 1.4 years, respectively). In contrast, median survival of those with >1 cm disease cytoreduced to microscopic disease was no different than those with macroscopic residual, even if ≤1 cm (1.3 and 1.0 years, respectively). After adjusting for tumor size, salvage treatment was not a significant predictor of survival. Conclusion With long-term follow-up there was no suggestion that the type of salvage therapy (e.g., P32 or WART) influenced survival. Rather, low-grade disease and low tumor burdens following cytoreduction were associated with improved survival on multivariate analysis.

Original languageEnglish (US)
Pages (from-to)563-568
Number of pages6
JournalGynecologic oncology
Volume91
Issue number3
DOIs
StatePublished - Dec 2003

Keywords

  • Ovarian cancer
  • Second-look laparotomy
  • Whole abdominal radiation

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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