RT Journal Article SR Electronic T1 Is There a Role for Tertiary (TCR) and Quaternary (QCR) Cytoreduction in Recurrent Ovarian Cancer? JF Anticancer Research JO Anticancer Res FD International Institute of Anticancer Research SP 6951 OP 6955 VO 35 IS 12 A1 FRANCESCO FANFANI A1 ANNA FAGOTTI A1 ALFREDO ERCOLI A1 VALERIO GALLOTTA A1 VITO CHIANTERA A1 STEFANO RESTAINO A1 GIORGIA MONTEROSSI A1 GIOVANNI SCAMBIA YR 2015 UL http://ar.iiarjournals.org/content/35/12/6951.abstract AB Background: The aim of the present study was to evaluate the efficacy of tertiary and quaternary cytoreduction in recurrent ovarian cancer patients. Patients and Methods: Between January 1997 and December 2014, 53 patients were submitted to cytoreductive surgery for second and third ovarian cancer recurrence at our Unit. Results: Median age at first diagnosis was 48 years (range=20-69). Forty-six patients (86.8%) underwent tertiary cytoreduction. At the time of surgery, isolated and diffuse disease was observed in 48 (90.6%) and 5 (9.4%) patients, respectively. Complete and optimal cytoreduction was obtained in 41 (77.5%) and in 1 (1.9%) patients, respectively. We did not observe any statistically significant survival differences according to residual tumor. Patients with TFI >12 months showed longer PFS (38 vs. 7 months, p<0.002) than those with TFI <12 months. In 18 of these patients a third recurrence was observed. In 12 patients (66.7%) a complete quaternary cytoreduction was performed. Longer PFS (16 vs. 21 months; p=0.032) and OS (152 vs. 116 months; p=0.015) in patients submitted to cytoreduction with respect to those treated with chemotherapy were observed. Conclusion: Our data suggest that selected ovarian cancer patients who develop a secondary and tertiary recurrence may benefit from additional cytoreductive attempts. The benefit seems to be greater in patients with TFI >12 months showing a single-site recurrence disease, in which complete cytoreduction is achievable. Further studies are required to better-define the role of tertiary and quaternary cytoreduction in recurrent ovarian cancer patients.