EFFECT OF SURGICAL DEBULKING ON SURVIVAL IN STAGE-IV OVARIAN-CANCER

In order to determine whether optimal surgical debulking in Stage TV e pithelial ovarian cancer impacts survival, a retrospective review of p atients treated at the University of Pennsylvania Cancer Center (UPCC) from 1984 to 1995 diagnosed with Stage TV epithelial ovarian cancer w as performed. Data were collected regarding grade, histology, reason f or allocation to Stage TV, extent of surgery performed and residual di sease at initial staging procedure, major perioperative complications, first-line chemotherapy regimen, length of inpatient hospital stay, o utcome at second-look laparotomy, follow-up, and survival. For the pur poses of this study, optimal cytoreduction was defined as a residual d isease of 2 cm or less. Forty-seven patients with Stage IV epithelial ovarian cancer identified in the Society of Gynecologic Oncologists (S GO) Database at UPCC are included. Fourteen of 47 (30%) were optimally cytoreduced at the time of their staging procedure. Twenty-six of 47 (55%) were deemed Stage IV by virtue of positive pleural effusion cyto logy only. Twenty-one of 47 (45%) had intraparenchymal Liver involveme nt or metastatic disease outside of the abdomen. The median survival o f the suboptimally debulked group was 17 months, while median survival in the optimal group was 37 months (P = 0.0295). These data suggest t hat Stage IV epithelial ovarian cancer patients with less than 2 cm re sidual disease have a survival advantage over patients with greater th an 2 cm residual. (C) 1997 Academic Press