2ND SURGICAL-TREATMENT OF RETROPERITONEAL PERSISTENT DISEASE IN EPITHELIAL OVARIAN-CANCER

Aims and Background: This report retrospectively analyzes 9 cases of e pithelial ovarian cancer with persistent retroperitoneal metastasis af ter intraperitoneal surgery (without systematic lymphadenectomy) and c hemotherapy. !Methods: All 9 patients were diagnosed as FIGO stage I t o IV at the time of primary surgery. They received combined postoperat ive chemotherapy (8 cases with a cisplatin-based regimen and 1 with ad riamycin and endoxan). They were submitted to pelvic and paraaortic ly mphadenectomy at the National Cancer Institute of Milan during the per iod 1990-1994. Results: All patients presented no evidence of disease in the abdominal cavity but retroperitoneal metastasis, which was the unique metastatic site. Chemotherapy was administered as adjuvant ther apy after lymphadenectomy. Six patients were free of disease for 14 to 61 months. One patient with vaginal recurrence at the 18th month was treated with radiotherapy and chemotherapy, but died of widespread dis ease 25 months after lymphadenectomy. Two patients with massive positi ve lymph nodes died of brain and lung metastasis 20 and 6 months later , respectively. Conclusions: We conclude that retroperitoneal metastas is may be the only site of persistent disease and that systematic lymp hadenectomy technically feasible in this situation to increase the opp ortunity for local disease control and to obtain a good result.