Tumour residuum after surgery

The size of residual tumour remaining after surgical cytoreduction for advanced ovarian cancer may reflect tumour biology i.e. its degree invasiveness of abdominal structures as well as the degree of surgical effort. It is the second most important prognostic factor after stage. There is an inverse ratio between the size of residual tumour and patient outcome and in a small meta-analysis of 4 randomised trials of platinum based chemotherapy, residual tumour size was the major determinant of survival (20). The relative risk of dying from the disease increases with residual tumour size (see table 7). Nejt (21) showed that 3 year survival was approximately 75%, 50% and 25 % respectively for those with no macroscopic residual tumour <1 cm and >5 cm respectively after primary cytoreductive surgery.

Table 7. Relative risk of death according to residual tumour size (20)

Size of residual tumour Relative risk of dying

_(95% confidence intervals)

Table 7. Relative risk of death according to residual tumour size (20)

Size of residual tumour Relative risk of dying

_(95% confidence intervals)

Table 8. Overall survival (all stages) between 1978 -1989 according to age group

Age

1978-1980

1987-1989

RR*

(n=9,996)

(n=l 0,575)

15-44

57%

64%

0.8

45-54

33%

44%

0.7

55-64

28%

34%

0.8

65-74

21%

20%

1.0

15+

20%

18%

1.1

Overall

30%

33%

0.9

* Relative risk of dying for ovarian cancer diagnosed between 1987-1989 versus

1978-1980

* Relative risk of dying for ovarian cancer diagnosed between 1987-1989 versus

1978-1980

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