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The role of postoperative alkylating agent therapy in early‐stage epithelial ovarian cancer
Author(s) -
MACKINTOSH J.,
LIND M. J.,
ANDERSON H.,
CROWTHER D.,
BUCKLEY C. H.,
TINDALL V. R.
Publication year - 1989
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1989.tb02397.x
Subject(s) - melphalan , medicine , stage (stratigraphy) , cyclophosphamide , surgery , adjuvant therapy , adjuvant , ovarian cancer , chemotherapy , oncology , cancer , paleontology , biology
Summary Forty‐six patients with early (Stage I and II) ovarian cancer referred as free of residual disease after primary surgery, selected for high‐risk features, were treated with adjuvant single‐agent alkylating therapy comprising either intravenous cyclophosphamide (1 g/m2) in 36 patients, or oral melphalan (0·2 mg/kg daily for 5 days) in eight. Cyclophosphamide was repeated every 3 weeks for 10 cycles and melphalan every 6 weeks for 12 cycles. With a median follow‐up of 36+ months, 18 patients have relapsed. The actuarial 5‐year relapse‐free survival was 48% and the overall 5‐year survival was 54%; median survival was 84 months. Pretreatment FIGO stage was the single most important predictor of relapse‐free and overall survival duration. For patients with Stage IA and IB tumours the 5‐year actuarial relapse‐free survival was 89%; for patients with stage 1C and II (all substages), the 5‐year relapsefree survival was 24% (P=0·001). For this latter group adjuvant single alkylating agent therapy was not adequate and alternative therapeutic regimens are required. The problem of suboptimal primary surgical staging is also addressed.