Pattern of care: epithelial ovarian cancer in case of incomplete previous surgery

No, Jae Hong; Park, Young Soo; Kim, Sun Min; Chung, Hyun Hoon; Kim, Jae Weon; Park, Noh Hyun; Song, Yong Sang; Kang, Soon Beom; Lee, Hyo Pyo

Abstract

OBJECTIVE
A significant number of patients with ovarian cancer are referred to tertiary center after inadequate staging operation. The purpose of this study was to evaluate the impact of pattern of care, including restaging operation or chemotherapy in these patients.
METHODS
We conducted a retrospective analysis of patients with epithelial ovarian cancer (n=29) or borderline tumor (n=15) who were inadequately staged elsewhere at the time of initial surgery between April 1996 and March 2006.
RESULTS
In the patients with ovarian cancer, restaging operation was performed in 65.5% (19/29), and primary chemotherapy in 24.1% (7/29). Older age and higher parity was noted in the restaged group, however, it was statistically insignificant. In the restaged group, 26.3% (5/19) were upstaged due to residual tumors. Presence of residual tumor was not associated with histologic type and grade of tumor. Six patients (31.6%) without residual tumor escaped adjuvant chemotherapy. During median 50 months follow up, 13.8% (4/29) of patients with ovarian cancer recurred. There was no difference in recurrence rate according to whether a restaging operation was performed. However, residual tumor status was significantly associated with recurrence rate (60% vs 0%). Restaging operation was undergone in 46.7% (7/15) of patients with borderline tumors and there were no recurrence or residual tumor in patients with borderline tumors.
CONCLUSION
It is suggested that restaging operation could reveal residual tumors which are important prognostic factor in predicting recurrence. Nonetheless, Restaging operation seems to have no impact on the prognosis of ovarian cancer.