Disease-adapted relapse therapy for ovarian cancer: results of a prospective study

• Published in: International journal of oncology Vol. 13; no. 1; p. 57
• Main Authors: Kuhn, W, Schmalfeldt, B, Pache, L, Späthe, K, Ulm, K, Renziehausen, K, Nöschel, H, Canzler, E, Richter, B, Kroner, M, Tilch, G, Janicke, F, Graeff, H
• Format: Journal Article
• Language: English
• Published: Greece 01.07.1998
• Subjects: Adult; Aged; Antineoplastic Agents, Phytogenic - therapeutic use; Combined Modality Therapy; Disease-Free Survival; Etoposide - therapeutic use; Female; Humans; Middle Aged; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - surgery; Prognosis; Prospective Studies; Recurrence; Time Factors
• ISSN: 1019-6439
• DOI: 10.3892/ijo.13.1.57

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.