Consolidation intraperitoneal chemotherapy in epithelial ovarian cancer patients following negative second-look laparotomy.

Fifty-six patients with Stage III ovarian carcinoma who had a negative second-look laparotomy following optimum cytoreduction, cisplatin, and cyclophosphamide chemotherapy were enrolled in a pilot study to receive consolidation intraperitoneal (IP) chemotherapy. Forty-one patients received three courses of IP cisplatin (80 mg/m2). Fifteen patients with cisplatin-induced toxicity received three courses of IP mitoxantrone (10 mg/m2). Toxicity was minimal, with only 2 patients suffering peritonitis and 1 patient developing an enterotomy at the time of catheter removal. Median follow-up for the IP cisplatin and IP mitoxantrone group has been 24 and 30 months, respectively. Ten of the 41 patients (24%) who received IP cisplatin and 4/15 (26%) of the IP mitoxantrone patients have recurred (P = ns). Median time to recurrence was 18 months for both groups. This study indicates that consolidation intraperitoneal chemotherapy following negative second-look laparotomy is feasible with either cisplatin or mitoxantrone. However, many of these patients still recurred and prospective trials will be required to determine which (if any) consolidation intraperitoneal treatment is best following a negative second-look laparotomy.