Publications

Authors:

Uccella, Stefano; Puppo, Andrea; Garzon, Simone; Palladino, Simona; Zorzato, Pier Carlo; Leone Roberti Maggiore, Umberto; Zavallone, Laura; Calandra, Valerio; Galli, Liliana; Franchi, Massimo; Raspagliesi, Francesco

Title:

Secondary cytoreductive surgery for ovarian cancer recurrence and first-line maintenance therapy: A multicenter retrospective study

Year:

2025

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Referee:

No

Name of journal:

European Journal of Obstetrics Gynecology and Reproductive Biology

ISSN of journal:

0301-2115

N° Volume:

306

Page numbers:

160-167

Keyword:

Bevacizumab; Ovarian cancer; PARP inhibitors; Perioperative complications; Recurrence; Secondary surgery

Short description of contents:

Purpose: To investigate surgical and oncologic outcomes of secondary cytoreductive surgery for ovarian cancer recurrence, considering the exposure to previous first-line maintenance therapy. Methods: We retrospectively identified all women who underwent secondary cytoreductive surgery for ovarian cancer recurrence with cytoreductive intent at three Italian Gynecologic Oncology centers (1997-2022). Data on clinical, surgical, and pathological characteristics, neoadjuvant, adjuvant, and maintenance therapy, as well as follow-up information, were retrieved from prospectively collected databases and medical records. Results: We identified 189 patients. Maintenance therapy in the first-line setting was implemented in 108/189 (57 %) cases: bevacizumab in 77.7 % (84/108), PARP inhibitors (Olaparib, Niraparib, or Rucaparib) in 15.7 % (17/108), and bevacizumab + PARP-inhibitors in 4.6 % (5/108). Complete cytoreduction rate and perioperative complications in secondary surgery were not associated with previous maintenance therapy. Complete cytoreduction was achieved in 75 % (140/189) of patients, and any residual tumor was the strongest predictor of poor progression-free (Hazard ratio [HR] 3.91, 95 %CI 2.48-6.16) and cause-specific survival (HR 4.27, 95 %CI 2.36-7.70). First-line bevacizumab was independently associated with worse progression-free survival among patients with any residual tumor at secondary surgery. First-line PARP inhibitors were independently associated with worse progression-free and cause-specific survival regardless of complete cytoreduction. Second-line maintenance therapies were independently associated with better survival regardless of residual tumor after secondary surgery. Conclusion: Complete cytoreduction during secondary surgery for ovarian cancer recurrence is the strongest predictor of prognosis. First-line maintenance therapies do not appear to affect the safety and feasibility of secondary cytoreduction, although they may influence prognosis after secondary surgery.

Product ID:

146151

Handle IRIS:

11562/1163847

Last Modified:

June 5, 2025

Bibliographic citation:

Uccella, Stefano; Puppo, Andrea; Garzon, Simone; Palladino, Simona; Zorzato, Pier Carlo; Leone Roberti Maggiore, Umberto; Zavallone, Laura; Calandra, Valerio; Galli, Liliana; Franchi, Massimo; Raspagliesi, Francesco, Secondary cytoreductive surgery for ovarian cancer recurrence and first-line maintenance therapy: A multicenter retrospective study «European Journal of Obstetrics Gynecology and Reproductive Biology» , vol. 306 , 2025 , pp. 160-167

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