Annals of Surgical Oncology

, Volume 13, Issue 12, pp 1702–1710

Surgery in Recurrent Ovarian Cancer: The Arbeitsgemeinschaft Gynaekologische Onkologie (AGO) DESKTOP OVAR Trial

Authors

    • Department of Gynecology & Gynecologic OncologyHSK, Dr. Horst Schmidt Klinik Wiesbaden
  • Andreas du Bois
    • Department of Gynecology & Gynecologic OncologyHSK, Dr. Horst Schmidt Klinik Wiesbaden
  • Maik Hahmann
    • Coordinating Center for Clinical TrialsMarburg University
  • Annette Hasenburg
    • Department of Gynecology & ObstetricsFreiburg University
  • Alexander Burges
    • Department of Gynecology & ObstetricsUniversity of Muenchen - Grosshadern
  • Sibylle Loibl
    • Department of Gynecology & ObstetricsFrankfurt University
  • Martina Gropp
    • Department of Gynecology & ObstetricsEVK Duesseldorf
  • Jens Huober
    • Department of Gynecology & ObstetricsTuebingen University
  • Daniel Fink
    • Department of Gynecology & ObstetricsZuerich University
  • Willibald Schröder
    • Department of Gynecology & ObstetricsCentral Hospital Bremen
  • Karsten Muenstedt
    • Department of Gynecology & ObstetricsGiessen University
  • Barbara Schmalfeldt
    • Department of Gynecology & ObstetricsUniversity of Muenchen r.d.I.
  • Guenter Emons
    • Department of Gynecology & ObstetricsGoettingen University
  • Jacobus Pfisterer
    • Department of Gynecology & ObstetricsUniversitätsklinikum Schleswig-Holstein Campus Kiel
  • Kerstin Wollschlaeger
    • Department of Gynecology & ObstetricsMagdeburg University
  • Hans-Gerd Meerpohl
    • Department of Gynecology & ObstetricsSt. Vincentius Hospital Karlsruhe
  • Georg-Peter Breitbach
    • Department of Gynecology & ObstetricsCity Hospital Neunkirchen
  • Berno Tanner
    • Department of Gynecology & ObstetricsMainz University
  • Jalid Sehouli
    • Department of Gynecology & ObstetricsBerlin University Charite
Article

DOI: 10.1245/s10434-006-9058-0

Cite this article as:
Harter, P., Bois, A.d., Hahmann, M. et al. Ann Surg Oncol (2006) 13: 1702. doi:10.1245/s10434-006-9058-0

Abstract

Background

The role of cytoreductive surgery in relapsed ovarian cancer is not clearly defined. Therefore, patient selection remains arbitrary and depends on the center’s preference rather than on established selection criteria. The Descriptive Evaluation of preoperative Selection KriTeria for OPerability in recurrent OVARian cancer (DESKTOP OVAR) trial was undertaken to form a hypothesis for a panel of criteria for selecting patients who might benefit from surgery in relapsed ovarian cancer.

Methods

The DESKTOP trial was an exploratory study based on data from a retrospective analysis of hospital records. Twenty-five member institutions of the Arbeitsgemeinschaft Gynaekologische Onkologie Ovarian Committee (AGO OC) and AGO-OVAR boards collected data on their patients with cytoreductive surgery for relapsed invasive epithelial ovarian cancer performed in 2000–2003.

Results

Two hundred and sixty-seven patients were included. Complete resection was associated with significantly longer survival compared with surgery leaving any postoperative residuals [median 45.2 vs. 19.7 months; hazard ratio (HR) 3.71; 95% confidence interval (CI) 2.27–6.05; P < .0001]. Variables associated with complete resection were performance status (PS) [Eastern Cooperative Oncology Group (ECOG) 0 vs. > 0; P < .001], International Federation of Gynecology and Obstetrics (FIGO) stage at initial diagnosis (FIGO I/II vs. III/IV, P = .036), residual tumor after primary surgery (none vs. present, P <.001), and absence of ascites > 500 ml (P < .001). A combination of PS, early FIGO stage initially or no residual tumor after first surgery, and absence of ascites could predict complete resection in 79% of patients.

Conclusions

Only complete resection was associated with prolonged survival in recurrent ovarian cancer. The identified criteria panel will be verified in a prospective trial (AGO-DESKTOP II) evaluating whether it will render a useful tool for selecting the right patients for cytoreductive surgery in recurrent ovarian cancer.

Keywords

Ovarian cancerOvarian neoplasmRecurrenceSecondary cytoreductive surgery

Copyright information

© Society of Surgical Oncology 2006