PLATINUM-BASED CHEMOTHERAPY OF HIGH-RISK STAGE-I EPITHELIAL OVARIAN-CANCER FOLLOWING COMPREHENSIVE SURGICAL STAGING

Objective: To determine the long-term outcome in patients with high-ri sk stage I epithelial ovarian cancer treated with adjuvant platinum-ba sed chemotherapy following comprehensive surgical staging. Methods: We conducted a retrospective review of 62 patients with stage IA and IB (grades 2 or 3) and stage IC (all grades) epithelial ovarian cancer tr eated with platinum-based chemotherapy following comprehensive surgica l staging. Clinicopathologic correlations were performed using disease -free survival as the end point. Results: The mean patient age was 47 years. The distribution by stage was IA in 19 (31%), IB in four (6%), and IC in 39 (63%). Eighty percent of the patients had grade 2 or 3 tu mors. The distribution by cell type was as follows: clear-cell 22 (35% ), endometrioid 15 (24%), mucinous 11 (18%), serous eight (13%), and u ndifferentiated six (10%). The patients underwent an average of six cy cles of platinum-based therapy. With a median follow-up of 40 months a mong survivors, 15 patients (24%) have relapsed, at a median interval of 22 months from diagnosis. Relapses occurred primarily in the perito neal cavity and retroperitoneal lymph nodes. No patient has been rende red free of disease after relapse. Patients with grade 3 tumors had an increased risk of relapse as compared to those with grade 1 or 2 tumo rs (46 versus 8%; P = .002). Patients with clear-cell tumors had a hig her risk of relapse than those with other cell types (41 versus 15%; P = .05). There was no statistically significant relationship between r isk of recurrence and sub-stage. None of 11 patients with stage IA, gr ade 2 disease had recurrence. Actuarial 5-year disease-free survival f or the entire group of 62 patients was 73%. Conclusion: Platinum-based chemotherapy for high-risk stage I ovarian cancer does not appear to improve survival over that previously reported with non-platinum regim ens.