The feasibility of early administration of combination chemotherapy following cytoreductive surgery and second‐look operation in patients with stage III ovarian carcinoma: A pilot study

Vardi, JR; Rafla, S.; Malhotra, Chetna; Tadros, G; T, Charney; Shebes, M; Berkowitz, BJ; Kehoe, JE; Tancer, LM

doi:10.1016/0020-7292(90)90763-b

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“…According to Goldie and Coldman's formula, resistant cell lines can emerge following two logs of growth (19). In a prior publication the authors demonstrated that the immediate administration of chemotherapy treatment to patients with advanced ovarian carcinoma following primary cytoreduction and followed by 11 monthly courses improved results and was accompanied with acceptable side effects (20). The present study reports the different factors affecting the outcome in patients with advanced ovarian cancer treated with immediate combination chemotherapy following primary debulking surgery.…”

mentioning

confidence: 62%

“…Ten patients showed evidence of disease at second look laparotomy (positive second look). Three are alive 20,24 and 78 months after diagnosis respectively. Seven expired 1243 months (average 21 months) after diagnosis.…”

Section: Resultsmentioning

confidence: 99%

“…In an early report we have demonstrated the feasibility of administrating a combination of chemotherapy immediately following maximal debulking surgery (20). In this prospective nonrandomized study we evaluated the relation between the effect of irnmediate combination chemotherapy treatment and several prognostic factors.…”

Section: Discussionmentioning

confidence: 99%

“…Histologic examination of operative specimens and tumor grading was performed by the Department of Pathology in Maimonides Medical Center. Chemotherapy was started immediately following surgery in the Recovery Room as described in our earlier publication (20). Monthly assessment with tumor markers using CA-125 and plasma lipid-associated sialic acid (LASA-P) was used.…”

Section: Methodsmentioning

confidence: 99%

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Tumor debulking followed by immediate combination chemotherapy in advanced ovarian carcinoma: Phase II

Vardi

Tadros

Zamurovic

et al. 1992

Acta Obstet Gynecol Scand

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Fifty-one consecutive, previously untreated patients with FIGO stage III or IV epithelial ovarian carcinoma were enrolled in a prospective study over a period of 7 years (1981-1988). Significant improvement has been noted in patients with advanced ovarian cancer following the administration of modified PAC 1 (adriamycin, cytoxan and cyclophosphamide) immediately following primary debulking surgery (within 24 hours) and repeated for 11 monthly cycles. A second look operation was found as an important prognostic indicator. Thirty-one patients (all Stage III) completed the chemotherapy course and were eligible for second look operation. Of these, 21 patients (68%) showed negative second look. Of the patients with negative second look, 17 of 21 (81%) are alive with a mean survival of 61 months (range 19-103 months) after diagnosis. Among those with positive second look only 3 of 10 are alive with a mean of 41 months after diagnosis. The remaining 20 patients (13 stage III and 7 stage IV) did not undergo second look laparotomy. Only 2 of these 20 patients are alive with a mean of 35 months after diagnosis. Other factors of significant importance were: age and completion of chemotherapy course. Patients appeared to benefit from the combined regimen of optimal debulking surgery, completion of 12 courses of chemotherapy with the first course administered immediately after surgery and second look operation. Tumor type or histologic grade did not seem to influence results. The early use of chemotherapy was well tolerated and toxicity was minimal and acceptable.

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mentioning

confidence: 62%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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