Annals of Surgical Oncology

, Volume 16, Issue 5, pp 1324–1330 | Cite as

Surgery for Recurrent Ovarian Cancer: Role of Peritoneal Carcinomatosis: Exploratory Analysis of the DESKTOP I Trial About Risk Factors, Surgical Implications, and Prognostic Value of Peritoneal Carcinomatosis

  • P. Harter
  • M. Hahmann
  • H. J. Lueck
  • M. Poelcher
  • P. Wimberger
  • O. Ortmann
  • U. Canzler
  • B. Richter
  • U. Wagner
  • A. Hasenburg
  • A. Burges
  • S. Loibl
  • W. Meier
  • J. Huober
  • D. Fink
  • W. Schroeder
  • K. Muenstedt
  • B. Schmalfeldt
  • G. Emons
  • A. du Bois
Gynecologic Oncology

Abstract

Background

Almost all retrospective trials pointed out that a benefit of surgery for recurrent ovarian cancer may be limited to patients in whom a macroscopic complete resection could be achieved. Peritoneal carcinomatosis has been reported to be either a negative predictor for resectability or a negative prognostic factor, or both. The role of peritoneal carcinomatosis in a multicenter trial was investigated.

Methods

Exploratory analysis of the DESKTOP I trial (multicenter trial of patients undergoing surgery for recurrent ovarian cancer, 2000 to 2003).

Results

A total of 125 patients (50%) who underwent surgery for recurrent ovarian cancer had peritoneal carcinomatosis. Univariate analyses showed worse overall survival for patients with peritoneal carcinomatosis compared with patients without carcinomatosis (< .0001). Patients with and without peritoneal carcinomatosis had a complete resection rate of 26% and 74%, respectively (< .0001). This corresponded with the observation that patients with complete resection had a better prognosis than those with minimal residual disease of 1 to 5 mm, which commonly reflects peritoneal carcinomatosis (P = .0002). However, patients who underwent complete resection, despite peritoneal carcinomatosis, had a 2-year survival rate of 77%, which was similar to the 2-year survival rate of patients with completely debulked disease who did not have peritoneal carcinomatosis (81%) (P = .96). Analysis of prognostic factors did not show any independent effect of peritoneal carcinomatosis on survival in patients who underwent complete resection.

Conclusions

Peritoneal carcinomatosis was a negative predictor for complete resection but had no effect on prognosis if complete resection could be achieved. Improving surgical skills might be one step to increase the proportion of patients who might benefit from surgery for recurrent disease.

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Copyright information

© Society of Surgical Oncology 2009

Authors and Affiliations

  • P. Harter
    • 1
  • M. Hahmann
    • 2
  • H. J. Lueck
    • 3
  • M. Poelcher
    • 4
  • P. Wimberger
    • 5
  • O. Ortmann
    • 6
  • U. Canzler
    • 7
  • B. Richter
    • 8
  • U. Wagner
    • 9
  • A. Hasenburg
    • 10
  • A. Burges
    • 11
  • S. Loibl
    • 12
  • W. Meier
    • 13
  • J. Huober
    • 14
  • D. Fink
    • 15
  • W. Schroeder
    • 16
  • K. Muenstedt
    • 17
  • B. Schmalfeldt
    • 18
  • G. Emons
    • 19
  • A. du Bois
    • 1
  1. 1.Department of Gynecology and Gynecologic OncologyHSK, Dr. Horst Schmidt KlinikWiesbadenGermany
  2. 2.Coordinating Center for Clinical TrialsMarburg UniversityMarburgGermany
  3. 3.Department of Gynecology and ObstetricsMedizinische Hochschule HannoverHannoverGermany
  4. 4.Department of Gynecology and ObstetricsBonn UniversityBonnGermany
  5. 5.Department of Gynecology and ObstetricsEssen UniversityEssenGermany
  6. 6.Department of Gynecology and ObstetricsCaritas St. Josef HospitalRegensburgGermany
  7. 7.Department of Gynecology and ObstetricsDresden UniversityDresdenGermany
  8. 8.Department of Gynecology and ObstetricsKlinikum RadebeulRadebeulGermany
  9. 9.Department of Gynecology and ObstetricsMarburg UniversityMarburgGermany
  10. 10.Department of Gynecology and ObstetricsFreiburg UniversityFreiburgGermany
  11. 11.Department of Gynecology and ObstetricsLMU MunichMunichGermany
  12. 12.Department of Gynecology and ObstetricsFrankfurt UniversityFrankfurtGermany
  13. 13.Department of Gynecology and ObstetricsEVK DüsseldorfDüsseldorfGermany
  14. 14.Department of Gynecology and ObstetricsTübingen UniversityTübingenGermany
  15. 15.Department of Gynecology and ObstetricsZurich UniversityZurichSwitzerland
  16. 16.Department of Gynecology and ObstetricsKlinikum Bremen MitteBremenGermany
  17. 17.Department of Gynecology and ObstetricsGiessen UniversityGiessenGermany
  18. 18.Department of Gynecology and ObstetricsMunchen rdIMunchenGermany
  19. 19.Department of Gynecology and ObstetricsGoettingen UniversityGoettingenGermany

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