Salvage intraperitoneal therapy of advanced epithelial ovarian cancer: impact of retroperitoneal nodal disease.
OBJECTIVE
The objective of this study was to evaluate the impact of retroperitoneal lymph node disease on the efficacy of salvage intraperitoneal (IP) chemotherapy for advanced epithelial ovarian cancer.


METHODS
We retrospectively reviewed the records of 41 patients with advanced epithelial ovarian cancer treated between 9/83-7/95, who had undergone retroperitoneal nodal sampling prior to salvage intraperitoneal chemotherapy.


RESULTS
Of the 41 patients treated with debulking surgery and platinum-based chemotherapy, 19 (46%) had disease noted in retroperitoneal lymph nodes at initial surgery or at reassessment laparotomy, while 22 (54%) had biopsy-proven negative nodes. The mean age of the node-positive group was 49 years. Residual disease prior to initiation of IP therapy was optimal (< or = 2 cm) in 16 patients and suboptimal in 3. Twenty-two patients with a mean age of 55 were found to be node-negative. Residual disease prior to initiation of intraperitoneal therapy was optimal (< or = 2 cm) in all 22 patients. All patients received salvage intraperitoneal chemotherapy. With a median follow-up of 26 months since surgical reassessment, the median survival in the node-positive group is 31 months compared to 40 months for the node-negative group (p = 0.47).


CONCLUSIONS
The presence of retroperitoneal nodal disease does not appear to be a contraindication to the use of salvage IP chemotherapy in advanced ovarian cancer.
Barakat
R R
RR
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Fennelly
D
D
Pizzuto
F
F
Venkatraman
E S
ES
Brown
C
C
Curtin
J P
JP
D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001707:Biopsy, Needle; D016190:Carboplatin / Q000008:administration & dosage; D002277:Carcinoma / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007274:Injections, Intraperitoneal; D007813:Laparotomy; D008207:Lymphatic Metastasis; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate; D016896:Treatment Outcome
D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D003561:Cytarabine; D005047:Etoposide; D016190:Carboplatin; D008942:Mitoxantrone; D002945:Cisplatin