| Abstract: | The aim of adjuvant chemotherapy is to cure micrometastatic disease and to prevent relapses after apparently complete surgical exeresis. It is almost always administered after initial surgical treatment, except for stage IA1 malignant epithelial tumours and stage I-II pur dysgerminomas. Chemotherapy combines anthracycline, an alkylating agent, a plant alkaloid and cis-platinum, for 4-8 months. After second-look laparotomy, if no more macro or microscopic tumor have been discovered, adjuvant chemotherapy does not seem necessary. However it is when all residual tumor has been excised or cyto- and/or histologic controls are positive. Optimal schedules are not yet perfectly defined. In some cases, a third look laparotomy should confirm the absence of tumor in order to stop treatment. Side effects (hematologic, gastrointestinal, neurologic, renal) are frequent. It is necessary to recognize patients able to benefit from chemotherapy and to define the least toxic treatment. |
