Intraperitoneal cisplatin-based chemotherapy vs. intravenous cisplatin-based chemotherapy for stage III optimally cytoreduced epithelial ovarian cancer

Objective: To compare the survival between intraperitoneal cisplatin-based chemotherapy (IPCT) and intravenous cisplatin-based chemotherapy (IVCT) in stage III epithelial ovarian cancer with minimal residual disease (<1 cm) a fter primary debulking surgery. Method: One hundred and thirty-two patients with stage: III epithelial ovarian cancer after optimal primary debulking surgery with minimal residual disease between April 1990 and March 1995 wer e entered into a randomized clinical trial in which IPCT or IVCT was admini stered at 3-week intervals. Patients in the IPCT arm received cisplatin-bas ed (100 mg/m(2)) intraperitoneal chemotherapy. Patients in the IVCT arm rec eived cisplatin-based (50 mg/m(2)) intravenous chemotherapy. The tumor resp onse was assessed every 3 months. The hematological toxicity using the Sout h West Oncology Group (SWOG) toxicity criteria was assessed. Catheter compl ications associated with intraperitoneal chemotherapy were also analyzed. R esult: The estimated median survival in the IPCT group was 43 months (95% c onfidence interval, 34-54) and IVCT group was 48 months (95% confidence int erval, 37-59). The hazard ratio of death was not statistically significant between IPCT and IVCT (hazard ratio, 1.13; 95% CI, 0.69-1.86; P = 0.317), T he frequencies of hematological toxic effects were significantly lower in t he IPCT group than in the IVCT group. Conclusion: Intravenous and intraperi toneal chemotherapy are associated with equivalent survival in patients wit h minimal residual stage III epithelial ovarian cancer after optimal cytore ductive surgery. (C) 2001 International Federation of Gynecology and Obstet rics. All rights reserved.