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Makiko So,Taito Miyamoto,Ryusuke Murakami,Kaoru Abiko,Junzo Hamanishi,Tsukasa Baba,Masaki Mandai 대한부인종양학회 2019 Journal of Gynecologic Oncology Vol.30 No.6
Objective: In patients with recurrent ovarian cancer (ROC) in whom surgery is likely torender them disease-free, it is unclear whether secondary cytoreductive surgery (SCS)combined with chemotherapy is superior to chemotherapy alone. The aim of this study wasto evaluate the 2 treatment options in Tian-model low-risk patients. Methods: We retrospectively reviewed 118 ROC cases treated in our hospital between2004 and 2016. Of these, 52 platinum-sensitive cases were classified as low-risk (completeresection anticipated) using the Tian model. Prognostic factors were assessed with univariateand multivariate analysis using Cox's regression model. Progression-free survival (PFS)and overall survival (OS) were compared in patients treated with SCS plus chemotherapy(SCS group) and those treated with chemotherapy alone (chemotherapy group), using apropensity-score-based matching method. Results: By multivariate analysis, the only factor associated with better OS was SCS. PFS and OSwere significantly longer in the SCS group compared to the chemotherapy group in the matchedcohort (median PFS: 21.7 vs. 15.1 months, p=0.027 and median OS: 91.4 vs. 33.4 months,p=0.008, respectively). In cases with multiple-site recurrence, the SCS group also showedsignificantly longer OS than the chemotherapy group (median 91.4 vs. 34.8 months, p=0.022). In almost all SCS cases, cooperation was required from other departments, and operation timewas lengthy (median 323 minutes); however, no serious complications occurred. Conclusion: SCS combined with chemotherapy results in better PFS and OS than chemotherapyalone in first platinum-sensitive ROC patients categorized as low-risk by Tian's model.