Comparison of Survival Outcomes Among Patients Receiving Chemotherapy with Secondary Cytoreductive Surgery Versus Chemotherapy Alone for Recurrent Epithelial Ovarian, Tubal, or Peritoneal Carcinoma: a Propensity Score-matched Cohort Study.

To compare the progression-free survival (PFS) and overall survival(OS) among patients diagnosed with platinum-sensitive recurrent ovarian cancer (PSROC) and undergoing secondary cytoreduction with chemotherapy versus chemotherapy alone. We did a 1:1 propensity score-matched analysis (PSM) on retrospectively collected data of all patients with PSROC patients treated at our center from January 2014 to December 2020. Patients were categorized into chemotherapy with secondary cytoreductive surgery (SCH) and chemotherapy alone (CH). PSM was done with baseline characteristics. Cox proportional hazard model was used to compare survivals between the matched cohorts. We identified 96 patients (SCH, N = 29; CH, N = 67). After matching, there were 58 patients (29 in each group). SCH patients had better OS and PFS compared to CH in the matched cohort [median OS 40.27 versus 23.17 months (p = 0.002) and median PFS was 26.5 versus 8.6 months (p < 0.001)] respectively. In univariate and multivariate Cox regression analysis, treatment modality (SCH vs. CH alone) at recurrence was the only significant factor for both OS and PFS. Our series had no perioperative mortality, and the morbidity was manageable. In patients with PSROC, chemotherapy with secondary cytoreductive surgery resulted in better OS and PFS than chemotherapy alone, with acceptable perioperative morbidity and no perioperative mortality.