[Radical peritonectomy in 37 patients with stage II and III ovarian cancer].

AIM

Radical peritonectomy followed by intraperitoneal early chemotherapy and systemic chemotherapy is the treatment of choice of stage II C and III ovarian cancer, due to the low 5-years survival rate (20%) of stage III and IV.

METHODS

The authors present a 5-years experience in 37 patients affected by stage II C and III ovarian cancer treated by Sugarbaker's radical peritonectomy with some surgical technical differences. Intraperitoneal chemotherapy with adriamycin and cisplatin is started and followed after 25 days by a systemic chemotherapy with taxol and carboplatin. A 6-months second-look is performed.

RESULTS

All the patients have been treated with radical peritonectomy with tumoral residual lesser than 2.5 mm; we performed 4 minor hepatectomies, 5 radical cystectomies, 35 resections of rectum and sigmoid colon with hysterectomies, bilateral salpingo-oophorectomies and pelviperitonectomies, 14 right hemicolectomies. We had no postoperative mortality, but we recorded a 40% minor morbidity rate. During the second look we found 7 recurrences (18%), 6 lesser than 6 mm, often located on the mesentery and treated with radical resections. The follow-up range is 2-60 months, 27 patients are still alive. Actually, 22 patients (80% of live patients) are in good health and disease free.

CONCLUSION

Radical surgery associated with early postoperative chemotherapy followed by systemic chemotherapy in the treatment of ovarian cancer makes it possible to achieve the best survival results and long periods of disease free.