Surgery for Recurrent Epithelial Ovarian Cancer in the Netherlands: A Population-Based Cohort Study

Rafli van de Laar*, Roy F. P. M. Kruitwagen, Joanna IntHout, Petra L. M. Zusterzeel, Toon Van Gorp, Leon F. A. G. Massuger

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objective: The value of secondary cytoreductive surgery (SCS) in patients with recurrent epithelial ovarian cancer is controversial. The aim of this population-based study was to investigate the role of SCS in the Netherlands. Methods: Data of 408 patients who underwent SCS between 2000 and 2013 were retrospectively collected from 38 Dutch hospitals. Survival after complete and incomplete SCS was estimated by Kaplan-Meier curves. Factors associated with overall survival (OS) were explored with Cox regression. Results: Median OS after SCS was 51 months (95% confidence interval [95% CI], 44.8-57.2). Complete SCS was achieved in 295 (72.3%) patients, with an OS of 57 months (95% CI, 49.0-65.0) compared with 28 months (95% CI, 20.8-35.2) in patients with incomplete SCS (log-rank test; P <0.001). Nonserous histology (HR 0.65; 95% CI 0.45-0.95), a long progression free interval (hazard ratio [HR], 0.29; 95% CI, 0.07-1.18), a good performance status (HR, 0.68; 95% CI, 0.49-0.94), SCS without preoperative chemotherapy (HR, 0.72; 95% CI, 0.51-1.01), and complete SCS (HR, 0.46; 95% CI, 0.33-0.64) were prognostic factors for survival. Conclusions: This population-based retrospective study showed that there might be a role for SCS in recurrent epithelial ovarian cancer especially when complete SCS can be accomplished. However, before adopting SCS as a standard treatment modality for recurrent epithelial ovarian cancer, results of 3 ongoing prospectively randomized trials are needed.
Original languageEnglish
Pages (from-to)268-275
JournalInternational Journal of Gynecological Cancer
Issue number2
Publication statusPublished - Feb 2016


  • Recurrent
  • Ovarian cancer
  • Secondary cytoreductive surgery


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