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Recurrence was arbitrarily defined as the first clinical manifestation of tumor progression by detecting a\u00a0new lesion or new lesions after clinical remission following primary surgery\u202f\u00b1\u2009chemotherapy. It was also defined as an increase in size of at least 30% of a\u00a0residual lesion after primary surgery and chemotherapy. Recurrences were diagnosed primarily during the first 3\u00a0years after diagnosis; only 10% of recurrences were diagnosed beyond 5\u00a0years. The majority of first recurrences were located in the peritoneal cavity, the pelvis, the liver parenchyma, and the paraaortic region. Combinations of different locations of first recurrence were common. The median cancer antigen (CA)\u00a0125 value at first recurrence was 163\u202fU\/ml (range\u00a07\u201314,187). In multivariate Cox regression analysis, isolated metastases in the paraaortic nodes, isolated extraabdominal metastases in the peripheral lymph nodes of the inguinal or supraclavicular region, macroscopic complete resection at primary cytoreductive surgery, and serous histology were independently associated with significantly improved survival after recurrence. In the present study, only a\u00a0minority of these patients underwent surgery for recurrence. Thus, the better prognosis of patients with isolated lymph node metastases may only in part be explained by secondary cytoreductive surgery. The majority of patients with isolated nodal metastases underwent radiotherapy plus chemotherapy.<\/jats:p>","DOI":"10.1007\/s10354-026-01193-0","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T11:03:57Z","timestamp":1790593437000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pattern of ovarian cancer recurrence and survival: final analysis of an extended cohort of 591 patients","Verteilungsmuster von Rezidiven des Ovarialkarzinoms und \u00dcberleben: finale Analyse eines erweiterten Studienkollektivs von 591\u00a0Patientinnen"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8822-257X","authenticated-orcid":false,"given":"Edgar","family":"Petru","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Eberhard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haro","family":"Stettner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Benedicic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Idris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Heydarfadai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"1193_CR1","doi-asserted-by":"publisher","first-page":"1508","DOI":"10.1002\/1097-0142(19891001)64:7","volume":"64","author":"PG Rose","year":"1989","unstructured":"Rose\u00a0PG, Piver\u00a0MS, Tsukada\u00a0Y, Lau\u00a0TS. 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