Systematic Review Of Prognosis Factors After Secondary Surgery In Recurrent Ovarian Cancer

Background: Despite most of patients with ovarian cancer achieve clinical remission after completion of primary cytoreductive surgery and platinum-based chemotherapy , more than 60% patients will ultimately develop recurrent disease. The treatment of recurrent ovarian cancer hasn't had a formula, but there is a trend to carry out secondary cytoreductive surgery combined with chemotherapy. However, secondary cytoreductive surgery(SCS) doesn't adapt to all the patients, selecting proper patient and evaluating patient's prognosis is necessary to address.Objective: Evaluate the prognosis factors of SCS and develop a selection standard, in order to supply evidences for selecting patients.Materials and Methods: A systematic review of clinical trials of secondary surgery of recurrent ovarian cancer was performed. Trials were identified by searching for Medline, Pubmed, Chinese Biological Medicine Database and CNKI. The admitted literatures were gathered and analysed. The factors which may affect the patients'prognosis after SCS were assessed. Fisher's method was used to perform statistical process in part of materials. Results: Twelve trials were included. Qualitative analysis was performed after extracting datum. The results as follows: Compared with chemotherapy, SCS combined with chemotherapy can improve median survival. The factors that can affect median survival after SCS include: number of recurrent tumors, size of maximum tumor, disease-free interval, residual tumor at PCS, residual tumor at SCS, age at recurrence, massive ascites, FIGO stage, histology, CA125 level at recurrence, chemotherapy before SCS. A significant difference in survival was found for the variables: number of recurrent tumors, size of maximum tumor, disease-free interval, residual tumor at PCS, residual tumor at SCS, massive ascites. Other factors didn't relate to median survival. As for CA125 level at recurrence, it can't affect median survival significantly.Conclusion: Optimal SCS can improve patient's prognosis significantly. The candidates of SCS should be chosen carefully. Using qualitative analysis to analyse the factors can provide some credible evidences for oncologists. But recurrent ovarian cancer was a high mortality disease, considering the ethics, there was no random control trial. To achieve more exact conclusion, larger-scale prospective random control studies were needed.