INTERVENTION DEBULKING SURGERY IN ADVANCED EPITHELIAL OVARIAN-CANCER

Objective To study whether intervention debulking surgery improves sur vival in patients with advanced ovarian cancer who have bulky (> 2 cm) residual disease after primary surgery. Design A prospective multicen tre randomised study. Setting Hospitals in the West Midlands. Subjects Ovarian cancer patients with bulky residual disease after primary sur gery who considered well enough to receive cis-platinum based chemothe rapy and further surgery. Methods Eligible patients were randomised to receive combination chemotherapy alone or combined with intervention debulking surgery. Main outcome measure Survival was assessed using pr oduct limit method and log-rank test. Results Seventy-nine patients we re entered into the study. Thirty-seven patients were randomised to in tervention debulking surgery, 25 (67%) of whom underwent intervention debulking surgery, which was performed a median of 13 weeks after prim ary surgery. The median survival for the intervention debulking surger y group was 15 months (95% CI 10-20 mo) and that of those randomised t o chemotherapy alone, which was 12 months (95% CI 8-16 mo), were not s ignificantly different (hazard ratio = 0.71; 95% CI 0.44-1.13). Conclu sion Intervention debulking surgery may not improve survival in patien ts with advanced ovarian cancer.