Treatment of Recurrent Ovarian Cancer – a Retrospective Study

Česká verzia

Authors: M. Tkáčová ^1,2; B. Belohorská ^1,2; K. Ševčíková ^1,2; L. Heľpianska ¹; D. Ondruš ¹; M. Ondrušová ³; S. Špánik ^1,2
Authors place of work: I. onkologická klinika LF UK, Bratislava, Slovenská republika ¹; Interná- onkologická klinika OÚSA, Bratislava, Slovenská republika ²; Ústav experimentálnej onkológie SAV, Bratislava, Slovenská republika ³
Published in the journal: Klin Onkol 2010; 23(2): 115-123
Category: Original Articles

Summary

Backgrounds:
Treatment of recurrent ovarian cancer is not standardized. Pre-clinical tests have confirmed the synergistic effect of gemcitabine and platinum, which can break through drug resistance to platinum. Therefore, efficacy of a combined gemcitabine and platinum-based regimen can be expected not only in therapy platinum-sensitive but also in platinum-resistant disease. Surgery – so-called secondary (eventually tertiary) cytoreductive surgery, should be considered in recurrent disease before planning the chemotherapy.

Patients and methods:
This is a retrospective analysis of 58 patients with recurrent ovarian cancer treated with a gemcitabine and platinum-based regimen (GP) as the second or third-line chemotherapy. Some of the patients underwent secondary cytoreductive surgery before starting the systemic treatment. The aim of the study was to detect the response rate, progression-free survival and overall survival in the whole group of patients and in subgroups with platinum-sensitive and platinum-resistant disease. Another aim was to detect the correlation between secondary cytoreductive surgery and the efficacy of chemotherapy.

Results:
Systemic treatment (GP) has helped to achieve a response rate of 53.5%, with time to progression 10 months and overall survival 23.5 months. A better response rate, progression free survival and overall survival were achieved in the group of patients with platinum-sensitive disease compared to patients with platinum-resistant disease, but this difference was not statistically significant. 20 patients underwent effective secondary cytoreductive surgery before the systemic treatment. Patients who underwent effective secondary cytoreductive surgery had a statistically better response rate (RR: 80% vs 39.5%), longer progression-free survival (PFS: 13.5 m vs 9 m, p = 0.006) and longer overall survival (OS: 40 m vs 16.9 m, p = 0.006) when compared to patients without secondary cytoreductive surgery.

Conclusion:
We have confirmed the efficacy of a gemcitabine and platinum-based regimen in the therapy of recurrent ovarian cancer, in both platinum-sensitive and platinum-resistant disease. An important prognostic factor in the whole group of patients was the realization of effective secondary cytoreductive surgery.

Key words:
recurrent ovarian cancer – gemcitabine – carboplatin – cisplatin – surgical treatment

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