Secondary cytoreductive surgery for recurrent XXXX .

@entity43 @entity1 @entity204 @entity66
OBJECTIVE: To review our experience with secondary cytoreductive surgery for recurrent @entity43 with regard to its feasibility, morbidity, mortality, @entity1 selection, and survival. METHODS: Forty-six @entity1 who underwent secondary cytoreductive surgery at the Royal Hospital for @entity1 , Sydney, between July 1988 and October 1996 were retrospectively reviewed. The mean age at surgery was 50.3 years, and the median disease-free interval was 26 months. Eighty-nine percent of @entity1 had a disease-free interval of at least 12 months. Twenty-five @entity1 (54%) had localized disease at the time of surgery. Univariate survival outcomes were analyzed using the log rank test, and survival curves were calculated using the method of Kaplan-Meier. RESULTS: Two @entity1 (4%) were inoperable and 19 @entity1 (41%) were cytoreduced to no macroscopic disease. There was one @entity204 (2%), and four @entity1 (8.7%) had significant postoperative morbidity. With a median follow-up of 88 months, the overall median survival was 22.5 months. @entity1 with a disease-free interval of less than 12 months after their initial treatment had a median survival of 6 months, compared with 11 months if the disease-free interval was 12-24 months and 39 months for those with a disease-free interval of 24 months or more (P =.001, log rank). @entity1 who had any @entity66 had a median survival of 11 months, whereas those with no @entity66 had a median survival of 38 months (P =.002, log rank). CONCLUSION: For carefully selected @entity1 with recurrent @entity43 : 1) complete surgical resection is feasible more commonly than with primary cytoreduction, 2) serious morbidity and mortality are acceptable, and 3) significant survival benefit accrues when a) all macroscopic disease can be resected, or b) the disease-free interval is 24 months or more.
