Treatment of patients with advanced ovarian carcinoma with massive pleural effusions

Abstract. Imachi M, Tsukamoto N, Shimamoto T, Kamura T, Saito T, Nakano H. Treatment of patients with advanced ovarian carcinoma with massive pleural effusions. Int J Gynecol Cancer 1991; 1 : 263–267.
Twelve patients with advanced ovarian carcinoma who had massive pleural effusions were treated between 1985 and 1989. Clinical stages of these patients were stage IIa, 1 and stage IV, 11. Histologic diagnoses were six serous adenocarcinomas, three endometrioid carcinomas, one mucinous adenocarcinoma, one clear cell carcinoma, and one squamous cell carcinoma. Massive pleural effusions were noted in the chest roentgenograms in all patients. Eight patients had effusions in pleural cavity, and four in both. The volumes of fluid removed from the pleural cavities ranged from 440 to 3650 ml, with a mean of 1905 ml. Eleven patients (92%) had malignant cells in their pleural effusions. Before surgery, all patients received thoracocentesis, and nine of them underwent continuous drainage by thoracic tubes. Eleven patients were given cis -platinum-containing chemotherapy after operation. Seven patients died of disease within two years. However, four patients underwent second-look operation and showed no evidence of residual disease. Malignant pleural effusions in ovarian carcinoma showed a good response to cis-platinum containing systematic chemotherapy. From the above results, it is concluded that under the drainage of pleural effusions debulking surgery followed by systematic chemotherapy is useful for patients with advanced ovarian carcinomas and massive pleural effusions.