LONG-TERM RESULTS IN PATIENTS WITH ADVANCED EPITHELIAL OVARIAN-CARCINOMA TREATED WITH A COMBINATION OF CISPLATIN, DOXORUBICIN, AND CYCLOPHOSPHAMIDE

From 1984 to 1988, thirty-nine untreated patients with epithelial ovar ian cancer received Cisplatin 50 mg/m(2), Doxorubicin 50 mg/m(2), and Cyclophosphamide 750 mg/m(2) (CAP), at 3 weekly intervals. All patient s had FIGO stage III or IV tumors except 2 patients with stage IIb and IIc, respectively, After initial surgery 23 patients had residual dis ease > 2 cm in diameter. Twenty-five patients (64%) were evaluable for response to chemotherapy. Objective responses were observed in 13 out of 25 patients (52%, 95% confidence intervals (Cl), 32.42% to 71.58%) , 6 patients had a cCR (24% and 7 had a cPR (28%), Seventeen out of th e 39 patients(44%)had a second-look laparotomy. A pCR was achieved in 5 out of 17 patients (29%); a pPR was obtained in 8 patients (47%). Me dian duration of survival was 41,5 months (range 2-107+): median durat ion of time to failure was 21 months (range 2-107+). Median disease-fr ee survival was 86 months (range 3,5-107+). Eleven patients (28%) are alive and 9 patients (23%) are foe of recurrence at median follow-up o f 86 months, Only 4 of 11 long-term survivors had a pCR. In univariate analysis, histology, clinical response to chemotherapy, and the prese nce of ascites at the time of diagnosis, achieved a significant correl ation with survival and time to failure (TTF); in addition, TTF was si gnificantly affected by pathological response to Induction chemotherap y. The only important predictors of disease-free survival (DFS) were t umor grade and stage of disease, In multivariate analysis, the presenc e of ascites was the only significant prognostic factor with respect. to survival and TTF. Our study confirms the effectiveness of CAP in th e treatment of epithelial ovarian cancer and the relatively poor long term prognosis.