Improved survival after implementation of ultra-radical surgery in advanced epithelial ovarian cancer: Results from a tertiary referral center

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objective: To compare survival rates of surgically treated advanced epithelial ovarian cancer patients before and after a programmatic change in surgical approach from standard surgery towards ultra-radical surgery. Methods: 247 patients with FIGO stage IIIB-IV ovarian, tubal, and primary peritoneal carcinoma were operated during 2013–2019 either by primary or interval cytoreduction in Tampere University Hospital, Finland. Group 1 (n = 122) patients were operated during 2013 and February 2016. Group 2 patients (n = 125) were operated between March 2016 and March 2019, when a systematic change in surgical approach towards more extensive surgery was implemented. Results: The complete resection (R0) rate increased significantly from 17.2% (21/122) to 52.0% (65/125) within the study period (p < 0.001). The median progression-free survival (PFS) was 15.6 months vs 19.3 months (p = 0.037), and the median overall survival (OS) was 33.5 months vs 54.5 months in Groups 1 and 2, respectively (p = 0.028). Median OS for stage III patients in Group 1 was 36.1 months (95% CI 27.4–44.8) but could not be reached in Group 2 (p = 0.009). In Stage IV patients, OS was 32.0 months (16.4–47.7) and 39.3 months (24.8–53.8) in Group 1 and 2, respectively (p = 0.691). Multivariable Cox regression analysis revealed that OS was independently affected by the amount of residual tumor and complication grade. Conclusions: The change of surgical approach towards maximal surgical effort improved both progression-free and overall survival. The survival benefit was unquestionable for stage III patients but did not reach statistical significance in stage IV patients.

Original languageEnglish
Pages (from-to)478-485
Number of pages8
JournalGynecologic Oncology
Volume165
Issue number3
DOIs
Publication statusPublished - 2022
Publication typeA1 Journal article-refereed

Keywords

  • Ovarian cancer
  • Overall survival
  • Progression-free survival
  • Surgery
  • Ultraradical surgery

Publication forum classification

  • Publication forum level 2

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

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