In a meta-analysis reported in the Journal of Clinical Oncology, Baek et al found that increased rates of complete and optimal cytoreduction with secondary cytoreductive surgery were associated with improved overall survival in patients with platinum-sensitive recurrent ovarian cancer.
Study Details
The analysis included 36 studies with reported death rates in a meta-regression model to estimate the effect of complete cytoreduction and optimal cytoreduction on survival. To compensate for missing death rates among studies, a linear regression model including 57 studies with reported median overall survival used log-transformed median overall survival time with weighting by study size to estimate the effects of cytoreduction on median survival times.
Key Findings
Among the 36 studies in the meta-regression model, the median rates of complete and optimal cytoreduction were 69.8% (range = 9.4%–100%) and 85.7% (range = 43.5%–100%), respectively. The pooled death rate was 44.2%, with both complete (P < .001) and optimal (P = .005) cytoreduction being associated with improved survival. The pooled death rates were 53.8% and 52.8% with median proportions of complete or optimal cytoreduction of ≤ 70% and ≤ 85%, respectively, and 34.6% and 36.5% with complete and optimal resection rates of > 70% and > 85%, respectively.
In the multivariate linear regression model for median overall survival, median overall survival duration increased by 8.97% (P < .001) and 7.04% (P = .042) for each 10% increase in proportions of complete and optimal cytoreduction. In complete cytoreduction analysis, there was a 3.11% increase in survival for each increasing year of study publication (P < .001). In optimal cytoreduction analysis, there was a 3.49% increase in survival for each increasing year of study publication (P < .001). No significant association of increasing median age with survival was observed.
The investigators concluded, “Secondary cytoreductive surgery, resulting in maximal tumor resection, significantly prolongs overall survival in platinum-sensitive recurrent ovarian cancer.”
Myong Cheol Lim, MD, PhD, of the National Cancer Center, Goyang, South Korea, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by the National Cancer Center, Korea. For full disclosures of the study authors, visit ascopubs.org.
