Survival with intraperitoneal cisplatin in advanced ovarian cancer after second-look laparotomy.
We studied survival in 36 patients with Stage III/IV ovarian cancer who received intraperitoneal high-dose cisplatin (200 mg/m2) alone or in combination with cytarabine (2 g), after intravenous (i.v.) cisplatin-based chemotherapy followed by second-look laparotomy. Complete responders were scheduled for three courses of IP chemotherapy, and others for six. Eight patients (22%) did not complete treatment (6 catheter failures and 2 renal failures). Peritoneal cytology remained positive in 6 patients (17%). Median overall and progression-free survival after second-look laparotomy were 44 and 37 months, respectively, for 13 complete responders to i.v. chemotherapy; 24 months and 11 months for patients with residual tumors less than 2 cm (17 cases); 15 and 12 months with tumors greater than 2 cm (6 cases). There was a significant difference in overall (p = 0.05) and progression-free (p = 0.001) survival between complete responders to i.v. chemotherapy and patients whose tumor was less than 2 cm. We find no evidence that high-dose cisplatin-based intraperitoneal chemotherapy given after second-look laparotomy will enhance survival in advanced ovarian cancer with zero or minimal residual disease.
de Gramont
A
A
GERCOD (Group d'Etude et de Recherche sur le Cancers de l'Ovaire et Digestifs) Cooperating Centers, Hôpital Saint-Antoine, France.
Demuynck
B
B
Louvet
C
C
Gonzalez-Canali
G
G
Varette
C
C
Pigné
A
A
Marpeau
L
L
Herbulot
P
P
Lagadec
B
B
Cady
J
J
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000601:surgery; D012086:Reoperation; D016019:Survival Analysis
D003561:Cytarabine; D002945:Cisplatin