INTENTIONAL NONRADICAL SURGERY AND SURVIVAL IN ADVANCED OVARIAN-CANCER - RESULTS OF A PILOT-STUDY

Between 1991 and 1993, 31 patients with bulky advanced ovarian carcino ma were entered into a structured protocol where attempts at radical s urgery were deemed inappropriate should one or more bowel resections a nd/or splenectomy be required in order to possibly achieve optimum deb ulking, Only diagnostic and palliative procedures were undertaken and all patients had >2 cm residual disease. Adjuvant chemotherapy was adm inistered to 29 patients (25 platinum based). Follow-up of the study g roup was for a minimum of 24 months and a maximum of 55 months. The ov erall median survival was 16 months and, for those exposed to platinum agents, 17 months, Complete response to chemotherapy was achieved in 11 (35%) of patients. Median survival in this group was 29 months. Two patients are still alive, 39 and 55 months after primary surgery, Thi s series indicates that avoiding multiorgan resection does not adverse ly impact on survival, and concerns in proceeding with a prospective r andomized trial of primary debulking surgery is advanced ovarian carci noma are unfounded.