Residual Disease Status after Primary Cytoreductive Surgery in Patients with Advanced Ovarian, Fallopian Tube, or Peritoneal Carcinoma and Long-Term Progression-Free Survival

Objective: To investigate residual disease status after primary cytoreductive surgery(PCS)in patients with advanced ovarian, Fallopian tube, or peritoneal carcinoma and long-term progression-free survival(PFS).

Methods: The study included patients with stage III C/IVepithelial ovarian, fallopian tube, or peritoneal carcinoma who had undergone surgery and carbo- platin/taxane chemotherapy, and had a PFSduration of ≥48 months.

Results: The study group consisted of 11 patients with stage III C disease, which accounted for 23%(8/35)of stage III C patients aged ≤59 years and 11%(3/27)of stage III C patients aged ≥60 years. No stage IV patients had a long-term PFS(0/11). Of 8 patients aged ≤59 years, 2 had residual disease of 0.1-1 cm(optimal debulking), 5 had residual disease of >1 cm after PCS, and 1 who had received neoadjuvant chemotherapy(NAC)had optimal debulking during interval cytoreductive surgery. Of 3 patients aged ≥60 years, 2 had no macroscopic residual disease, and 1 had residual disease of >1 cm after PCS.

Conclusions: In patients with stage III C ovarian, fallopian tube, or peritoneal carcinoma, a subgroup of those aged ≤59 years had long-term PFSdespite suboptimal PCS. In this age group, carboplatin/taxane chemotherapy may improve the prognosis, irrespective of residual disease status after PCS. In contrast, complete cytoreduction during PCSappears to be necessary in patients aged ≥60 years who achieve long-term PFS.