title: Disease-adapted relapse therapy for ovarian cancer: results of a prospective study.
abstract: Primary therapy of advanced ovarian cancer is standardized, the therapy in relapsed ovarian cancer however is still controversial. In a prospective study the benefit of secondary surgery and/or second-line chemotherapy were evaluated. 139 patients with relapsed ovarian cancer were stratified according to a treatment plan: patients with early relapse (recurrence-free interval 12 months) or primary progression during chemotherapy (n=43) were treated chemotherapeutically with etoposide (p.o. vs. i.v.). Patients with late relapse (recurrence-free interval >12 months, n=96) were referred, if possible, to a secondary debulking operation, followed by a platinum-based chemotherapy. Remission-rate, toxicity and survival time were analyzed. Median survival time in the <early relapse> group was 15 months compared to 30 months in patients with late relapse (p=0.0004). Within the <late relapse> group patients with secondary debulking and chemotherapy (n=59) had a statistically significant survival advantage compared to patients who had only chemotherapy (n=37) (38 vs. 12 months, p<0.0001). The unfavorable group of patients with early relapse should be treated chemotherapeutically, whereas in patients with late relapse a secondary debulking seems to improve prognosis.
authors.affiliation: Frauenklinik der Technischen Universität München, Klinikum rechts der Isar, D-81675 München, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Kuhn
authors.forename: B
authors.initials: B
authors.lastname: Schmalfeldt
authors.forename: L
authors.initials: L
authors.lastname: Pache
authors.forename: K
authors.initials: K
authors.lastname: Späthe
authors.forename: K
authors.initials: K
authors.lastname: Ulm
authors.forename: K
authors.initials: K
authors.lastname: Renziehausen
authors.forename: H
authors.initials: H
authors.lastname: Nöschel
authors.forename: E
authors.initials: E
authors.lastname: Canzler
authors.forename: B
authors.initials: B
authors.lastname: Richter
authors.forename: M
authors.initials: M
authors.lastname: Kroner
authors.forename: G
authors.initials: G
authors.lastname: Tilch
authors.forename: F
authors.initials: F
authors.lastname: Janicke
authors.forename: H
authors.initials: H
authors.lastname: Graeff
mesh_terms: D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005047:Etoposide / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000601:surgery; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide