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Clinical features of long-term survivors of recurrent epithelial ovarian cancer. BACKGROUND: Although recurrent epithelial ovarian cancer (EOC) is generally regarded as an incurable disease, some patients survive more than 5 years after the first recurrence. The aim of this study was to evaluate the clinical features of patients with recurrent EOC who achieve long-term survival. METHODS: We retrospectively reviewed the medical records of 164 patients with recurrent EOC and analyzed the clinical stage, histologic subtype, primary treatment, disease-free interval (DFI), recurrence site, secondary treatment, and overall survival from the time of the first recurrence (R-OS), using the Kaplan-Meier method and the log-rank test. RESULTS: The median R-OS for all 164 patients was 25 months and the 5-year R-OS rate was 25.4 %. There were no significant differences in R-OS according to the disease stage. The median R-OS was significantly shorter in the 6-12-month DFI group (23 months) than in the ≥12-month DFI group (61 months) (p = 0.0002), while there was no significant difference between the 6-12 and 3-6-month DFI groups (20 months) (p = 0.161). Of the 164 patients, only 14 survived >5 years after the first recurrence. Most of them underwent surgery and/or radiotherapy in combination with chemotherapy and underwent >18 cycles of platinum-based chemotherapy throughout their treatments (median 22 cycles; range 4-44). CONCLUSIONS: If high sensitivity to platinum is maintained, patients with recurrent EOC may have prolonged survival following repeated platinum-based chemotherapy cycles. Moreover, their prognosis improves when chemotherapy is combined with secondary cytoreductive surgery and/or irradiation.