Surgery plus chemo better for treating relapsed ovarian cancer
(HealthDay)—For women with recurrent ovarian cancer, overall survival is longer with cytoreductive surgery followed by chemotherapy than with chemotherapy alone, according to a study published in the Dec. 2 issue of the New England Journal of Medicine.
Philipp Harter, M.D., Ph.D., from the Kliniken Essen-Mitte in Germany, and colleagues randomly assigned 407 patients with recurrent ovarian cancer who had a first relapse after a platinum-free interval of six months or more to either secondary cytoreductive surgery followed by platinum-based chemotherapy or platinum-based chemotherapy alone (206 and 201 patients, respectively). Eligible patients had a positive Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) score, ascites of less than 500 mL, and complete resection at initial surgery.
The researchers found that 75.5 percent of the patients in the surgery group who underwent the procedure achieved a complete resection. Median overall survival was 53.7 and 46.0 months in the surgery and no-surgery groups, respectively (hazard ratio for death, 0.75). The most favorable outcome was seen for patients with a complete resection, with a median overall survival of 61.9 months. There was no difference observed between the groups in quality-of-life measures through one year of follow-up; no perioperative mortality was seen within 30 days after surgery.
"The results of the current trial showed a benefit of surgery with respect to progression-free and overall survival, with an acceptable incidence of complications, and without a detrimental effect on quality of life in patients selected for inclusion on the basis of the AGO score," the authors write.
The study was supported by GlaxoSmithKline and Medac.
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