EARLY DEBULKING SURGERY FOLLOWING CHEMOTH ERAPY IN ADVANCED OVARIAN-CANCER

The main prognostic factor in advanced ovarian cancer is the volume of residual disease after the initial laparotomy. Early debulking surger y after several cycles of chemotherapy, before the emergence of resist ant cell lines, could improve the prognosis of patients with bulky res idual disease. This study concerns patients with advanced ovarian canc er entered into three prospective trials including IV cisplatin and an thracycline-based chemotherapy, early debulking surgery after three cy cles of chemotherapy in case of initial residual disease superior 2 cm and intraperitoneal consolidation chemotherapy. Among 160 patients wi th stage III or IV, 80 (50%) had at least a residual tumor of more tha n 2 cm in diameter. Early debulking surgery was effectively performed in 54 patients (67.5%), leaving 39 patients with no residue over 2 cm. Twenty-one patients had no macroscopic residual disease. The median s urvival of all patients with initial residual disease over 2 cm was 23 months. Patients with no macroscopic residual disease at early debulk ing surgery had a median survival of 44 months. Early debulking surger y appears useful in advanced ovarian cancer with bulky residual diseas e. The objective of this operation is to achieve no macroscopic residu al lesion.