Disease-adapted relapse therapy for ovarian cancer: results of a prospective study.
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.
Kuhn
W
W
Frauenklinik der Technischen Universität München, Klinikum rechts der Isar, D-81675 München, Germany.
Schmalfeldt
B
B
Pache
L
L
Späthe
K
K
Ulm
K
K
Renziehausen
K
K
Nöschel
H
H
Canzler
E
E
Richter
B
B
Kroner
M
M
Tilch
G
G
Janicke
F
F
Graeff
H
H
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
D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide