The current therapeutic approaches to advanced ovarian cancer.

One hundred and fifty-nine cases of stage III or IV ovarian cancer treated at Kurume University and affiliated hospitals over the decade from 1978 to 1987 were analysed for their clinical outcome in relation to the therapeutic methods. The following results were obtained. 1) Two definite groups of patients were identified, one having a favourable prognosis with all patients surviving for at least three years after the initial treatment and the other, group of patients with poor prognosis who died within two years. There were significant differences in the clinical features of the two groups mentioned, i.e. in the performance status, the clinical stage, the type of operation carried out, the residual tumor, the application of second look laparotomy (SLO), the type of anti-cancer drug given and the use of maintenance chemotherapy. 2) The operations performed were primary surgery, including hysterectomy, bilateral adnexectomy and omentectomy or exploratory laparotomy. There was also a significant difference in the prognosis of those who received primary surgery compared to those given exploratory laparotomy. 3) A significant difference was also noted in the prognosis of cases with residual tumors less than 1 cm in diameter when compared to those which had larger residual tumors. 4) The application of SLO did not affect the prognosis. 5) Favourable results were obtained in the survival rate of cases who received cisplatin and also, 6) Favourable results were obtained in the survival rate of those patients who were given maintenance chemotherapy.