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In women with a first platinum-sensitive relapse selected by a simple score predicting complete resectability, surgery before chemotherapy lengthened survival by about a year, but only when all visible disease was removed.
Phase 3 trial of 407 patients with first relapse of ovarian cancer after a platinum-free interval of six months or more and a positive AGO score (good performance status, complete resection at first surgery, ascites under 500 ml), randomised to secondary cytoreductive surgery followed by chemotherapy or chemotherapy alone.
Median overall survival was 53.7 versus 46.0 months (hazard ratio 0.75) and progression-free survival 18.4 versus 14.0 months; patients with complete resection had a median survival of 61.9 months, while incomplete resection was worse than no surgery.
Secondary cytoreduction is recommended for AGO score-positive patients at first platinum-sensitive relapse in centres where complete resection can be achieved in most cases.
Shares Platinum-sensitive ovarian cancer, New England Journal of Medicine.
Shares DESKTOP III / ENGOT-ov20, Platinum-sensitive ovarian cancer.
Shares Platinum-sensitive ovarian cancer, New England Journal of Medicine.
Shares Platinum-sensitive ovarian cancer, New England Journal of Medicine.