title: Radical surgery in patients referred with a diagnosis of unresectable ovarian cancer.
abstract: The purpose of this article was to review the second attempt at primary debulking operations performed on 13 patients with advanced ovarian carcinoma (stage III or IV disease) regarded as inoperable at exploratory laparotomy by the referring gynaecologists/surgeons and to determine whether such radical surgery was of benefit to this subgroup of patients. The average operating time was 5 hours and the patients required transfusion of a mean of 2,077 ml blood during the operation. Seven patients (54%) required major bowel surgery. There were no operative deaths. All patients were subsequently treated with combination intravenous chemotherapy consisting of cis-platinum, doxorubicin and cyclophosphamide (PAC 1). Patients were followed up for a minimum of 24 months and a maximum of 66 months and 69% were still alive 24 months after such operations. The median survival is 27 months. Currently 6 patients are alive: 3 with no evidence of disease at 31, 55 and 66 months; 2 with cytologically malignant pelviperitoneal washings at 24 and 27 months, and the remaining patient surviving at 29 months despite microscopic recurrent disease at the time of second-look laparotomy. On the basis of these findings it is concluded that second-attempt radical surgery is worth while.
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000601:surgery*; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000601:surgery*; D012086:Reoperation
chemical_list: D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin