LONG-TERM FOLLOW-UP AFTER ADJUVANT CHEMOTHERAPY IN COMPLETELY RESECTED EARLY-STAGE OVARIAN-CARCINOMA

Objective: To evaluate the impact of standardized staging, surgery and adjuvant chemotherapy on survival of patients with completely resecte d early ovarian carcinoma. Study design: We performed a multicentric r etrospective analysis of 283 patients with early stage ovarian carcino ma consecutively treated between 1977 and 1993. Borderline tumours wer e excluded. A comprehensive staging was performed during initial lapar otomy. Patients were treated by standardized surgical resection and al l excepted stage IA received a 6-course adjuvant chemotherapy. Results : Eighty patients were excluded because of incorrect substaging, inade quate surgery and adjuvant therapy. The analysis was performed on 203 patients with completely resected early stage ovarian cancer (139, sta ge I; 64, stage II). Relapse-free survival and overall survival rates for stage I were 66 and 69%, respectively. Relapse-free survival and o verall survival rates for stage II were 57 and 61%, respectively. Medi an time of relapse was 18 months (range, 1-107 months). Sites of relap se were peritoneum (45%), retroperitoneal lymph nodes (37%) and distan t metastases (18%). Relapses occurring within 18 months had a median s urvival after relapse of 9 months while later relapses had a median su rvival of 22 months (P = 0.005). There was no significant difference i n relapse-free and overall survival according to the age, performance status and pathology. Cisplatin-based chemotherapy improved the 10-yea r overall survival of patients with stage IIB and IIC as compared to c hemotherapy without cisplatin (oral melphalan, CMF regimen); 91 vs. 33 % (P = 0.012) and 75 vs. 42% (P = 0.05), respectively. Cisplatin-based regimens did not improve survival in stage IA, IB and IIA. Conclusion s: Early ovarian cancers have a good prognosis after comprehensive sta ging, complete surgery and adjuvant chemotherapy. Cisplatin-based regi mens compared to melphalan and CMF showed a significant increase of su rvival in stage IIB and IIC. Prognosis of relapse depends on the relap se-free interval duration. (C) 1997 Elsevier Science Ireland Ltd.