Radical cytoreductive surgery combined with platinums-carboplatin and cisplatin chemotherapy for advanced ovarian cancer.
In an attempt to improve the therapeutic outcome for patients with advanced ovarian cancer, primary radical cytoreductive surgery consisting of hysterectomy, bilateral salpingo-oophorectomy, omentectomy and retroperitoneal lymph node resection, with optimal cytoreduction in case of metastatic lesions, was followed by five courses of chemotherapy of carboplatin 280 mg/m2 i.v. on day 1 and cisplatin 70 mg/m2 i.v. on day 2, every four weeks. A total of 51 patients with advanced epithelial ovarian cancer comprised the study (6 with stage IIC, 32 with stage III, and 13 with stage IV). Following radical cytoreductive surgery, 29 patients (57%) showed 2 cm or less of residual disease. There was a low incidence of severe complications and no postoperative mortality. An overall response rate of 76% of patients consisting of 42% pathologic complete response and 34% partial response was observed. The overall four-year survival rate for patients with stage III cancer was 70%. The dose-limiting toxicity was identified to be hematologic toxicity, which showed grade 3/4 of leuopenia 37% (neutropenia 73%) and thrombocytopenia 24%. The incidence of peripheral neurotoxicity was comparatively low. An evaluation of nerve conduction velocity revealed that motor neurotoxicity was liable to appear in the lower extremity, while sensory nerve damage was often noted in the periphery in both the upper and lower extremities. The combined chemo-surgery treatment resulted in good response and good survival without fatal toxicity for patients with advanced ovarian cancer.
Department of Obstetrics and Gynecology, Jichi Medical School, School of Medicine, Tochigi, Japan.
M.
M
Suzuki
M.
M
Ohwara
I.
I
Sekiguchi
I.
I
Sato