DISEASE-ADAPTED RELAPSE THERAPY FOR OVARIAN-CANCER - RESULTS OF A PROSPECTIVE-STUDY

Primary therapy of advanced ovarian cancer is standardized, the therap y in relapsed ovarian cancer however is still controversial. In a pros pective study the benefit of secondary surgery and/or second-line chem otherapy were evaluated. 139 patients with relapsed ovarian cancer wer e stratified according to a treatment plan: patients with early relaps e (recurrence-free interval less than or equal to 12 months) or primar y progression during chemotherapy (n=43) were treated chemotherapeutic ally with etoposide (p.o. vs. i.v.). Patients with late relapse (recur rence-free interval >12 months, n=96) were referred, if possible, to a secondary debulking operation, followed by a platinum-based chemother apy. Remission-rate, toxicity and survival time were analyzed. Median survival tine in the 'early relapse' group was 15 months compared to 3 0 months in patients with late relapse (p=0.0004). Within the 'late re lapse' group patients with secondary debulking and chemotherapy (n=59) had a statistically significant survival advantage compared to patien ts who had only chemotherapy (n=37) (38 vs. 12 months, p<0.0001). The unfavorable group of patients with early relapse should be treated che motherapeutically, whereas in patients with late relapse a secondary d ebulking seems to improve prognosis.