Secondary debulking for ovarian carcinoma relapse: The R-R dilemma – is the prognosis different for residual or recurrent disease?

Objective: To analyse the kind of ovarian cancer relapse by separating residual from recurrent disease and correlating them with patients’ survival.

Material and methods: Retrospective study of 200 women with ovarian carcinoma relapse during the period 2005-2017.

Results: The main sites of residual disease included great omentum, epiploic appendices, liver round ligament, gallbladder, cervical/vaginal stump. Median survival for women with residual disease treated with cytoreductive surgery (CRS) + hyperthermic intraperitoneal chemotherapy (HIPEC)+ systemic chemotherapy was 38 months compared to the control group which reached 23,8 months. The morbidity rates were 18% versus 7% respectively while the mortality rates were 2.5% versus 1.3%. The main sites of recurrent disease included mesenterium, pelvic floor, diaphragm, and Glisson’s capsule. Women with recurrent disease treated with CRS +HIPEC+ systemic chemotherapy had median survival rates of 26 months versus 16 months in the control group. The morbidity rates were 22% versus 15% respectively while the mortality rates were 3.3% versus 0%.

Conclusion: Patients undergoing secondary debulking plus HIPEC for ovarian carcinoma relapse have a different prognosis when comparing cases with residual to those with recurrent disease. A different prognosis is presented in women undergoing secondary debulking plus HIPEC for ovarian carcinoma relapse when comparing cases with residual to those with recurrent disease.