Background Ovarian cancer is the third most prevalent form of cancer among women in India. The majority of patients are diagnosed at an advanced stage. Many women with late-stage ovarian cancer experience a recurrence and need subsequent treatment, even after initial therapy. The prognosis of patients who experience relapse after treatment is poor. The objective of this study was to assess the clinical characteristics and survival rates of individuals diagnosed with relapsed epithelial ovarian cancer (EOC). Methods This retrospective study included patients with a relapse of epithelial ovarian carcinoma who were treated at the Department of Medical Oncology, Institute of Obstetrics and Gynecology (IOG), Madras Medical College, Chennai, India, over a period of six years, from January 2015 to December 2020. Results Sixty-six patients were enrolled in this study. The median patient age was 52 years. Most patients were postmenopausal (66.67%, n=44) and multiparous (75.76%, n=50). The most common histological type was serous (72.72%, n=48), and the majority of patients were in the later stages of the illness (83.34%, n=55). The median post-relapse survival of the study population was 23 months (95% confidence interval (CI): 20.61-25.39). The median survival of patients who were upfront stage I, II, III, and IV was 30, 13, 23, and nine months, respectively (p<0.05). Patients who underwent optimal cytoreduction had better survival rates than those who did not (28 versus 18 months, p<0.05). The median post-relapse survival was better in the platinum-sensitive group than in the platinum-resistant group (26 versus 16 months, p<0.05). Patients with a single relapse site had better survival rates than those with multiple sites of recurrence (26 versus 13 months, p<0.05). Patients with mucinous histology showed maximum survival (p<0.05). Individuals who initially underwent surgery had superior median survival rates following relapse compared to those who received neoadjuvant chemotherapy as their first treatment (25 versus 23 months, p=0.404). Cox regression analysis revealed that platinum-sensitive patients were 4.204 times more likely to survive than platinum-resistant patients. Similarly, those presenting with single lesions were 7.275 times more likely to survive for a longer time than those with multiple lesions. Conclusion This study emphasizes the importance of achieving optimal cytoreduction and underscores the prognostic significance of platinum sensitivity and recurrence patterns in patients with relapsed ovarian cancer. Late detection can result in unfavorable outcomes.
Keywords: high-grade serous ovarian carcinoma; optimal cytoreduction; platinum-resistant relapse; platinum-sensitive relapse; recurrent ovarian cancer; suboptimal cytoreduction.
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