title: Long-term follow-up of patients with advanced ovarian carcinoma treated with chemotherapy.
abstract: BACKGROUND
  The evolution of the management of advanced ovarian carcinoma over the last fifteen years has resulted from a number of well-designed randomized trials involving large numbers of patients.
  
  
  METHODS
  A critical review of long-term follow-up of patients entered onto eleven major randomized trials of advanced ovarian carcinoma has been performed.
  
  
  RESULTS
  In the pre-platinum era no long-term survival benefit was obtained with combination compared with single agent chemotherapy. When adding cisplatin to front-line therapy at least a short-term gain in terms of superior response rate and progression-free intervals is obtained compared with non-cisplatin combination chemotherapy. Survival data are more difficult to assess due to the use of cisplatin-containing salvage therapy. Cisplatin-based combination therapy also offers enhanced patient benefit when compared with cisplatin alone. A slight advantage favouring anthracycline-containing therapy is observed, whereas no advantage is obtained with alternating cisplatin and non-cisplatin regimens or by adding BCG.
  
  
  CONCLUSIONS
  Platinum-based combination chemotherapy is clearly associated with improved response rates and progression-free survival and, at least in some studies, better overall survival. At least six cycles of therapy should be given. Such approaches should yield long-term survival rates of 10% or better for patients with large-volume disease and 20% or better for small-volume disease.
authors.affiliation: Department of Medicine, University of Mississippi School of Medicine, Jackson.
authors.forename: J T
authors.initials: JT
authors.lastname: Thigpen
authors.forename: K
authors.initials: K
authors.lastname: Bertelsen
authors.forename: E A
authors.initials: EA
authors.lastname: Eisenhauer
authors.forename: N F
authors.initials: NF
authors.lastname: Hacker
authors.forename: B
authors.initials: B
authors.lastname: Lund
authors.forename: C
authors.initials: C
authors.lastname: Sessa
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000453:epidemiology*; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents