Klin Onkol 1997; 10(4): 116-120.
Abstract: Purpose: In the last 10-15 years, chemotherapy has largely replaced radiation therapy in the treatment of advanced stages of epithelial ovarian carcinoma. Platinum-based chemotherapy has become the recognized standard of adjuvant treatment. In order to assess the influence of those trends on treatment results in our patients, we evaluated the overall and relapse-free survival of all patients with carcinoma of the ovary stage FIGO III and IV, treated over a 10-year period.
Methods and Materials: Between July 1983 and June 1993, 160 patients with epithelial ovarian carcinoma stage FIGO III and IV had been treated in the Institute of Radioation Oncology, Prague. The patients were divided into two groups (first and second half of the 10-year period) according to the date of first treatment - group A (1.7.1983-30.6.1988) and goup B (1.7.1985-30.6.1993). The applied tretment, 2- and 5-year overall and relapse-free survival, as well as other characteristics of the two goups were compared.
Results: Both the pre-treatment characteristics and results of the assessment on introduction laparotomy were similar in both groups. Radicality of the initial surgery was higher in the later treated patients. With respect to the adjuvant treatment, the use of radiotherapy of the whole abdomen and/or pelvis substantially declined and platinum-based chemotherapy increased during the 10-year period. The median overall survival of stage III and IV patients, treated more recently (Group B) improved by about 7,5 months (975 vs 743 days), and there seems to be a light trend towards a better overall and relapse-free survival. However, there was no statistically significant difference in overall and relapse-free survival of the treatment groups compared.
Conclusion: The higher radicality of the initial surgery, gradual abandonment of radiation therapy in the adjuvant treatment of our patients with advanced-stage ovarian carcinoma and a consequent use of platinum-based systemic chemotherapy seem to have only a modest impact on overall and relapse-free survival in patients with and advanced ovarian carcinoma. In order to substantially improve the long-term prognosis, new approaches are needed. Chronic problems with the documentation of the residual abdominal disease after initial laparotomy are highlighted.
