Intraperitoneal chemotherapy for ovarian carcinoma: results of long-term follow-up.
OBJECTIVE
To determine long-term survival and predictors of recurrence in a retrospective cohort of patients with epithelial ovarian cancer treated with intraperitoneal (IP) chemotherapy.


METHODS
Records were reviewed of 433 patients who received IP therapy for ovarian cancer between 1984 and 1998; follow-up data were available for 411 patients. IP therapy was provided as consolidation therapy (n = 89), or for treatment of persistent (n = 310) or recurrent (n = 12) disease after surgery and initial systemic therapy; therapy usually consisted of platinum-based combination therapy. Statistical analysis included tests for associations between potential prognostic factors, and between prognostic factors and survival. Survival probabilities were estimated by Kaplan-Meier methods, and prognostic factors for survival were evaluated by a Cox proportional hazard model.


RESULTS
The mean age of patients was 52 years (range, 25 to 76 years). Distribution by stage and grade was as follows: stage I, 7; II, 24; III, 342; IV, 52; not available (NA), 8; and grade 1, 30; 2, 99; and 3, 289; NA, 15. The median survival from initiation of IP therapy by residual disease was none, 8.7 years; microscopic, 4.8 years; less than 1 cm, 3.3 years; more than 1 cm, 1.2 years. In a multivariate analysis, the only significant predictors of long-term survival were grade and size of residual disease at initiation of IP therapy.


CONCLUSIONS
Prolonged survival was observed in selected patients receiving IP platinum-based therapy. It is not possible to determine the contribution of IP therapy to survival in this study. A relationship between size of disease at the initiation of IP therapy and long-term survival was demonstrated.
Barakat
Richard R
RR
Gynecology Service, Department of Surgery, Gynecology Disease Management Team, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. gynbreast@mskcc.org
Sabbatini
Paul
P
Bhaskaran
Dharmendra
D
Revzin
Margarita
M
Smith
Alex
A
Venkatraman
Ennapadam
E
Aghajanian
Carol
C
Hensley
Martee
M
Soignet
Steven
S
Brown
Carol
C
Soslow
Robert
R
Markman
Maurie
M
Hoskins
William J
WJ
Spriggs
David
D
D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D010984:Platinum / Q000008:administration & dosage; D011379:Prognosis; D012189:Retrospective Studies
D010984:Platinum