3. Patient characteristics in different subgroup
In the entire cohort, 19 patients (26.8%) received systematic therapy and 52 patients (73.2%) received secondary cytoreductive surgery (SCS). Patients who treated with SCS were younger than those with non-SCS. 63.5% and 31.6% patients were initially diagnosed before 50 years in the SCS and non-SCS subgroup, respectively (P=0.017, Table1). More patients received myomectomy in SCS subgroup (32.7% vs 0.0%, P=0.003, Table1). The majority of patients were assigned to stage I at the time of original diagnosis in SCS subgroup than in non-SCS subgroup (86.5% vs 52.6%, P=0.008, Table1). More patients experienced first recurrence after 12 months since diagnosis in SCS subgroup than in non-SCS subgroup (73.1% vs 47.4%, P=0.043, Table1).
The recurrent pattern was different in SCS and non-SCS subgroup. Patients treated with SCS were more likely to experience recurrence in isolated sites (36.5% vs 5.3%, P=0.009, Table1), and less likely to recurred in multiple locations (17.3% vs 47.4%, P=0.015, Table1). Patients treated with SCS were more likely to experience recurrence in abdominal/pelvic peritoneum (71.2%), abdominal wall (21.2%) and vaginal cuff (9.6%) (Table 2). Of patients received systematic treatment, 68.4% and 21.1% had lung metastases and bone metastases, respectively (Table 2).
4. Secondary cytoreductive surgery treatment
Of the 52 patients undergoing secondary cytoreductive surgery, a complete resection with no residual disease was reported in 47 patients (90.4%) (Table 4). 69.2% patients had a tumor larger than 5 cm found at secondary cytoreduction. 38.5% (20/52) patients received non-genital organ surgeries. 10 (19.2%) patients had received thoracic surgery because of lung-only recurrences. Bowel, bladder surgery was performed in 15.4%, 5.8% of the cases, respectively. 1 (1.9%) patient had received liver surgery because of liver recurrence. 34.6% patients had estimated blood loss more than 500 ml (Table 4).