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| LETTER TO EDITOR |
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| Year : 2022 | Volume
: 5
| Issue : 1 | Page : 192-193 |
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Secondary cytoreductive surgery in recurrent ovarian carcinoma
Shuvadeep Ganguly, Ajay Gogia
Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| Date of Submission | 10-Jan-2022 |
| Date of Decision | 22-Jan-2022 |
| Date of Acceptance | 23-Jan-2022 |
| Date of Web Publication | 24-Feb-2022 |
Correspondence Address:
Ajay Gogia
Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi - 110 029
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/crst.crst_14_22
How to cite this article:
Ganguly S, Gogia A. Secondary cytoreductive surgery in recurrent ovarian carcinoma. Cancer Res Stat Treat 2022;5:192-3 |
Harter et al.[1] recently reported an improvement in survival with secondary cytoreductive surgery in recurrent ovarian carcinoma after a platinum-free interval (PFI) of more than 6 months. We noted with interest that a majority of patients (306/401; 76.3%) had a PFI >12 months. In this subgroup, the benefit of surgery could not be conclusively demonstrated. Similarly, in the previously published GOG-0213 trial,[2] in the subgroup of patients with PFI >12 months, secondary cytoreduction was actually detrimental to overall survival. A longer PFI predicts a better response to platinum re-treatment and improved survival.[3] In patients with a longer PFI, platinum re-treatment alone is thus expected to result in acceptable survival outcomes. Both the DESKTOP III trial[1] and the SOC-1 trial,[4] which demonstrated a survival benefit from secondary cytoreduction, had rigorous objective patient selection criteria, and the benefit of surgery was restricted to only those who achieved complete cytoreduction. The marginal benefit of surgery, if any, in patients with a longer PFI may be negated by the occurrence of surgical morbidities in the real world in the absence of a uniform model of patient selection for surgery.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Harter P, Sehouli J, Vergote I, Ferron G, Reuss A, Meier W, et al. Randomized trial of cytoreductive surgery for relapsed ovarian cancer. N Engl J Med 2021;385:2123-31.  |
| 2. | Coleman RL, Spirtos NM, Enserro D, Herzog TJ, Sabbatini P, Armstrong DK, et al. Secondary surgical cytoreduction for recurrent ovarian cancer. N Engl J Med 2019;381:1929-39. |
| 3. | Lee CK, Simes RJ, Brown C, Gebski V, Pfisterer J, Swart AM, et al. A prognostic nomogram to predict overall survival in patients with platinum-sensitive recurrent ovarian cancer. Ann Oncol 2013;24:937-43. |
| 4. | Shi T, Zhu J, Feng Y, Tu D, Zhang Y, Zhang P, et al. Secondary cytoreduction followed by chemotherapy versus chemotherapy alone in platinum-sensitive relapsed ovarian cancer (SOC-1): A multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 2021;22:439-49. |
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