Evaluation of survival after second-line intraperitoneal cisplatin-based chemotherapy for advanced ovarian cancer.
BACKGROUND
The authors sought to evaluate survival of patients with ovarian cancer treated with second-line intraperitoneal cisplatin-based chemotherapy.


METHODS
From August 1985 to September 1991, 63 patients with recurrent or persistent ovarian cancer after first-line cisplatin-based chemotherapy were on a protocol and treated with cisplatin, cytarabine, with or without bleomycin. Eligibility included Stage III/IV invasive adenocarcinoma of the ovary, documentation of the size of residual disease at reoperation, and prior treatment with first-line intravenous cisplatin-based chemotherapy.


RESULTS
The median survival from intraperitoneal chemotherapy was 29 months. For patients who responded to first-line chemotherapy and second-line intraperitoneal chemotherapy, the 5-year survival was 60%, but for patients with response to first-line chemotherapy but no response to intraperitoneal chemotherapy the 5-year survival was only 17%, and no patient survived 5 years who did not have a response to first- or second-line therapy (P < 0.0001). There was significant improvement in the 2-year survival from initiation of intraperitoneal chemotherapy for patients with < or = 5 mm residual tumor in greatest dimension (74%), compared with patients with residual tumor larger than 5 mm and smaller than or equal to 2 cm (38%), and patients with residual tumor larger than 2 cm (0%) (P < 0.0001).


CONCLUSIONS
Survival was increased for patients who (1) had a response to first-line intravenous chemotherapy and second-line intraperitoneal chemotherapy and (2) who had residual tumor 5 mm or smaller at the initiation of intraperitoneal therapy. The conclusion that the prolonged survival is secondary to cisplatin-based chemotherapy administered intraperitoneally must be made with caution because survival may have been secondary to the small residual disease at initiation of second-line chemotherapy or the systemic effect of cisplatin.
Piver
M S
MS
Department of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263.
Recio
F O
FO
Baker
T R
TR
Driscoll
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D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage* / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects; D002985:Clinical Protocols; D018284:Cystadenocarcinoma, Serous / Q000188:drug therapy* / Q000473:pathology; D003561:Cytarabine / Q000008:administration & dosage* / Q000009:adverse effects; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007274:Injections, Intraperitoneal; D007813:Laparotomy; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011446:Prospective Studies; D012074:Remission Induction; D012086:Reoperation; D015996:Survival Rate
D003561:Cytarabine; D001761:Bleomycin; D002945:Cisplatin