Elsevier

Gynecologic Oncology

Volume 47, Issue 2, November 1992, Pages 159-166
Gynecologic Oncology

The influence of cytoreductive surgery on recurrence-free interval and survival in small-volume Stage III epithelial ovarian cancer: A gynecologic oncology group study,☆☆,

https://doi.org/10.1016/0090-8258(92)90100-WGet rights and content

Abstract

Gynecologic Oncology Group Protocol 52, a randomized trial of cisplatin and cyclophosphamide with or without doxorubicin in “optimal” Stage III epithelial ovarian cancer, failed to demonstrate a significant difference in the outcome in 349 evaluable patients. Additional review of the records was carried out to determine the influence of cytoreductive surgery on survival. Since eligibility for the study was the presence of residual cancer of 1 cm or less, the influence of cytoreductive surgery could be evaluated by comparing outcome in patients presenting with large-volume extrapelvic disease, but who were cytoreduced to small-volume disease. Factors evaluated were age, cell type, grade, size, and location of disease at exploration, size, and location of residual disease after cytoreduction, number of residual nodules, ascites, type of surgery, blood loss, and hospital days. Univariate analysis revealed that age, size of residual disease, mucinous or clear cell histologic type, histologic grade, and number of residual lesions were significant prognostic factors. By univariate analysis patients found to have extrapelvic disease of 1 cm or less had a better recurrence-free interval and survival than those patients with large-volume disease who were cytoreduced to disease of 1 cm or less. Multivariate analysis revealed that older age, histologic grades 2 and 3, and 20 or more residual lesions were unfavorable. The volume of initial extrapelvic disease remained significant when gross disease was present in the omentum and in other extrapelvic sites. This study failed to prove the hypothesis that initial cytoreductive surgery would allow a patient presenting with large-volume ovarian cancer to have the same chance for survival as a patient found to have small-volume disease. Factors other than cytoreductive surgery are important in predicting survival.

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Presented at the 23rd Annual Meeting of the Society of Gynecologic Oncologists, San Antonio, TX, March 15–18, 1992.

☆☆

The following are the participating institutions and the National Cancer Institute grants supporting this study: University of Alabama at Birmingham (CA 12484), The Oregon Health Sciences Center University (unfunded), Duke University Medical Center (CA 12534), Temple University Health Science Center Hospital (CA 27816), University of Rochester Medical Center (CA 12482), Walter Reed Army Medical Center (CA 23501), University of Minnesota Medical School (CA 23088), University of Southern California Medical Center at Los Angeles (CA 37535), University of Mississippi Medical Center (CA 13633), Colorado Foundation for Medical Care (CA 15975), University of California Medical Center at Los Angeles (CA 13630), The Milton S. Hershey School of Medicine of Pennsylvania State University (CA 16386), Georgetown University Hospital (CA 16938), University of North Carolina School of Medicine (CA 23073), University of Iowa Hospitals and Clinics (CA 19502), University of Texas Health Science Center at Dallas (CA 28160), Indiana University Medical Center (CA 21720), Bowman Gray School of Medicine of Wake Forest University (CA 21946), The Albany Medical College of Union University (unfunded), University of California Medical Center at Irvine (CA 23765), Tufts New England Medical Center (CA 37569), Illinois Cancer Council (CA 27806), University of Pittsburgh School of Medicine (unfunded), St. Louis University Medical Center (CA 35571), State University of New York Downstate Medical Center (CA 34477), Latter Day Saints Hospital (unfunded), Eastern Virginia Medical School (unfunded), Cleveland Clinic Foundation (unfunded), University of Utah Medical Center (CA 15469), University of Connecticut Medical Center (unfunded), University of Michigan Medical School (unfunded), University of Puerto Rico (unfunded), Jacksonville University Hospital (unfunded), and University of New Mexico and Cancer Treatment Center.

Reprint requests should be addressed to GOG Administrative Office, Suite 1945, 1234 Market Street, Philadelphia, PA 19107.

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