Annals of Surgical Oncology

, Volume 13, Issue 12, pp 1702–1710 | Cite as

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

  • Philipp Harter
  • Andreas du Bois
  • Maik Hahmann
  • Annette Hasenburg
  • Alexander Burges
  • Sibylle Loibl
  • Martina Gropp
  • Jens Huober
  • Daniel Fink
  • Willibald Schröder
  • Karsten Muenstedt
  • Barbara Schmalfeldt
  • Guenter Emons
  • Jacobus Pfisterer
  • Kerstin Wollschlaeger
  • Hans-Gerd Meerpohl
  • Georg-Peter Breitbach
  • Berno Tanner
  • Jalid Sehouli
Article

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 cancer Ovarian neoplasm Recurrence Secondary cytoreductive surgery 

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Copyright information

© Society of Surgical Oncology 2006

Authors and Affiliations

  • Philipp Harter
    • 1
  • Andreas du Bois
    • 1
  • Maik Hahmann
    • 2
  • Annette Hasenburg
    • 3
  • Alexander Burges
    • 4
  • Sibylle Loibl
    • 5
  • Martina Gropp
    • 6
  • Jens Huober
    • 7
  • Daniel Fink
    • 8
  • Willibald Schröder
    • 9
  • Karsten Muenstedt
    • 10
  • Barbara Schmalfeldt
    • 11
  • Guenter Emons
    • 12
  • Jacobus Pfisterer
    • 13
  • Kerstin Wollschlaeger
    • 14
  • Hans-Gerd Meerpohl
    • 15
  • Georg-Peter Breitbach
    • 16
  • Berno Tanner
    • 17
  • Jalid Sehouli
    • 18
  1. 1.Department of Gynecology & Gynecologic OncologyHSK, Dr. Horst Schmidt Klinik WiesbadenWiesbadenGermany
  2. 2.Coordinating Center for Clinical TrialsMarburg UniversityMarburgGermany
  3. 3.Department of Gynecology & ObstetricsFreiburg UniversityFreiburgGermany
  4. 4.Department of Gynecology & ObstetricsUniversity of Muenchen - GrosshadernMunichGermany
  5. 5.Department of Gynecology & ObstetricsFrankfurt UniversityFrankfurtGermany
  6. 6.Department of Gynecology & ObstetricsEVK DuesseldorfDuesseldorfGermany
  7. 7.Department of Gynecology & ObstetricsTuebingen UniversityTuebingenGermany
  8. 8.Department of Gynecology & ObstetricsZuerich UniversityZuerichSwitzerland
  9. 9.Department of Gynecology & ObstetricsCentral Hospital BremenBremenGermany
  10. 10.Department of Gynecology & ObstetricsGiessen UniversityGiessenGermany
  11. 11.Department of Gynecology & ObstetricsUniversity of Muenchen r.d.I.MunichGermany
  12. 12.Department of Gynecology & ObstetricsGoettingen UniversityGoettingenGermany
  13. 13.Department of Gynecology & ObstetricsUniversitätsklinikum Schleswig-Holstein Campus KielKielGermany
  14. 14.Department of Gynecology & ObstetricsMagdeburg UniversityMagdeburgGermany
  15. 15.Department of Gynecology & ObstetricsSt. Vincentius Hospital KarlsruheKarlsruheGermany
  16. 16.Department of Gynecology & ObstetricsCity Hospital NeunkirchenNeunkirchenGermany
  17. 17.Department of Gynecology & ObstetricsMainz UniversityMainzGermany
  18. 18.Department of Gynecology & ObstetricsBerlin University ChariteBerlinGermany

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