SUMMARY There is increased concern over the apparent rise in incidence of patients with carcinoma of the ovary, particularly in older women. In an attempt to identify aetiological factors 300 women with cancer of the ovary diagnosed at laparatomy were studied. A questionnaire was administered to these women (Group A) and to two control groups matched by age. The first control group (Group B) comprised patients in a gynaecological ward and the second (Group C) comprised women on the lists of general practitioners living in the same areas as the index cases. Differences were shown in the obstetric history of the three groups. Fewer of the women in Group A had married and fewer had ever been pregnant and the family size was smaller. Significantly fewer of them recollected an attack of mumps, measles, or rubella. In all, only 81 of the whole series of 900 had used oral contraceptives, 19 of Group A and 31 in each of the control groups, a statistically significant deficiency. These findings support those of other investigations and suggest lines of further inquiry.During the past decade there has been increased interest in the epidemiology of cancer of the ovary. This condition causes over 3000 deaths each year in the United Kingdom and is a more common cause of death than cancer of the cervix. Since 1950 the mortality rate both in the United Kingdom and the United States of America has steadily increased. Detailed analysis of the figures for England and Wales (Registrar General) show that the main increase in death rates for carcinoma of the ovary was in those of 65 years and older (Figure), in contrast to cancer of cervix uteri, for which the rates in this age group appear to be declining.West (1966) reported a study of 175 women with ovarian cancer, compared with the same number of patients with non-malignant conditions of the ovary.He commented that the study by Dorn and Cutler (1959) showed that there was a higher morbidity among never-married women. The only positive finding of West was of a lower incidence of mumpsparotitis among the patients with malignant ovarian tumours. Wynder et al. (1969) also studied 150 women with ovarian cancers and compared them with 300 age-matched hospital controls, 25% of whom had cancer of other sites. He did not find a relationship with pregnancy or marital state, but he did find that the women with ovarian cancer had a less frequent history of mumps than his control groups. The women with ovarian cancer more frequently had an earlier menarche, heavier periods, and dysmenorrhoea. But

No abstract

Seventeen patients were treated with high‐dose melphalan with autologous bone marrow transplant (ABMT) and cyclophosphamide pretreatment. All of the patients had marrow reconstitution. Although there was one death caused by infection, high‐dose melphalan with ABMT causes toxicity that is generally acceptable, and can achieve a high‐response rate, but with responses of short duration in tumors resistant to standard‐dose combination chemotherapy. In other poor‐prognosis tumors that are sensitive to chemotherapy, or can be debulked surgically, or locally irradiated, high‐dose melphalan with ABMT given as late intensification therapy may significantly prolong time to relapse, and ultimately prolong survival.

Summary. In a prospective, multicentre, randomized trial, the efficacy and tolerance of treosulfan alone was compared with that of treosulfan plus cisplatinum in 135 women with advanced ovarian carcinoma. No statistically significant difference was found between the two treatments in terms of median survival. Combined treatment was associated with significantly greater side‐effects and haematological toxicity. Optimal survival with minimal toxicity can be achieved by using treosulfan alone in patients (mainly stages Ic or II) with minimal postoperative residual disease. Patients (likely to be stage III or IV) with greater residual disease should receive treosulfan plus cisplatinum.