Survival with intraperitoneal cisplatin in advanced ovarian cancer after second-look laparotomy. |
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Authors: | A de Gramont B Demuynck C Louvet G Gonzalez-Canali C Varette A Pigné L Marpeau P Herbulot B Lagadec J Cady |
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Affiliation: | GERCOD (Group d'Etude et de Recherche sur le Cancers de l'Ovaire et Digestifs) Cooperating Centers, H?pital Saint-Antoine, France. |
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Abstract: | We studied survival in 36 patients with Stage III/IV ovarian cancer who received intraperitoneal high-dose cisplatin (200 mg/m2) alone or in combination with cytarabine (2 g), after intravenous (i.v.) cisplatin-based chemotherapy followed by second-look laparotomy. Complete responders were scheduled for three courses of IP chemotherapy, and others for six. Eight patients (22%) did not complete treatment (6 catheter failures and 2 renal failures). Peritoneal cytology remained positive in 6 patients (17%). Median overall and progression-free survival after second-look laparotomy were 44 and 37 months, respectively, for 13 complete responders to i.v. chemotherapy; 24 months and 11 months for patients with residual tumors less than 2 cm (17 cases); 15 and 12 months with tumors greater than 2 cm (6 cases). There was a significant difference in overall (p = 0.05) and progression-free (p = 0.001) survival between complete responders to i.v. chemotherapy and patients whose tumor was less than 2 cm. We find no evidence that high-dose cisplatin-based intraperitoneal chemotherapy given after second-look laparotomy will enhance survival in advanced ovarian cancer with zero or minimal residual disease. |
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