Prognostic Value of Residual Tumor Size in Patients With Epithelial Ovarian Cancer FIGO Stages IIA-IV Analysis of the OVCAD Data

Stephan Polterauer*, Ignace Vergote, Nicole Concin, Ioana Braicu, Radoslav Chekerov, Sven Mahner, Linn Woelber, Isabelle Cadron, Toon Van Gorp, Robert Zeillinger, Dan Cacsire Castillo-Tong, Jalid Sehouli

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objective: The objective of the study was to evaluate the prognostic impact of residual tumor size after cytoreductive surgery in patients with epithelial ovarian cancer. Methods: In this prospective, multicenter study, 226 patients with epithelial ovarian cancer (International Federation of Gynecology and Obstetrics stages IIAYIV) were included. Patients were treated with cytoreductive surgery and adjuvant platinum-based chemotherapy. Univariate and multivariable survival analyses were performed to investigate the impact of residual tumor size on progression-free and overall survival. Results: In 69.4% of patients, surgery resulted in complete tumor resection; minimal residual disease (1 cm), respectively (P <0.001). Multivariable survival analysis revealed residual tumor size (P = 0.04) and older patient age (P = 0.02) as independent prognosticators for impaired overall survival. Complete cytoreduction was predictive for a higher rate of treatment response (P = 0.001) andwas associated with prolonged progression-free and overall survival (P <0.001 and P = 0.001). Conclusions: The size of residual disease after cytoreduction is one of the most crucial prognostic factors for patients with ovarian cancer. Patients after complete cytoreduction have a superior outcome compared with patients with residual disease. Leaving no residual tumor has to be the aim of primary surgery for ovarian cancer; therefore, patients should receive treatment at centers able to undertake complex cytoreductive procedures.
Original languageEnglish
Pages (from-to)380-385
JournalInternational Journal of Gynecological Cancer
Issue number3
Publication statusPublished - Mar 2012


  • Ovarian cancer
  • Cytoreductive surgery
  • Residual disease
  • Optimal cytoreduction
  • Prognosis


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