Consolidative 32P after second‐look laparotomy for ovarian carcinoma

Abstract

SUMMARY We report our experience with consolidative 32 P after second-look laparotomy. Forty-three patients received consolidative 32 P after platinum-based chemotherapy and a negative (39 patients, 91%) or positive (4 patients) second-look laparotomy. Thirtyone patients (72%) initially had stage III (30 patients) or stage IV (1 patient) disease; 28 patients (65%) had grade 3 tumors. Patients had follow-up from 3.5 to 14.9 years (median, 7.7 years); no patient was lost to follow-up. The 5-year rates of control of disease within the abdomen (local control) for the overall group and the subset of patients with stage II-IV disease and a negative second-look laparotomy were 65% and 69%, respectively. The corresponding 5-year survival rates were 78 and 81%, respectively. Multivariate analyses revealed that tumor found at second-look laparotomy significantly influenced the likelihood of local control and cause-specific survival. Acute side effects included cellulitis (1 patient) and ileus (3 patients). Two patients (5%) experienced severe late complications; both experienced small bowel obstruction that necessitated surgical intervention. Consolidative 32 P appears to reduce the risk of recurrence and improve survival after negative second-look laparotomy. The risk of significant complications is low.

High-dose melphalan-based chemotherapy and autologous stem cell transplantation after second look laparotomy in patients with chemosensitive advanced ovarian carcinoma: long-term results

“…On one hand, even without treatment, these patients are significantly better off than are patients without PCR, with 5-year survival rates reported between 45% and 65%. 30,31 On the other hand, several therapeutic approaches have been assessed after PCR has been obtained: maintenance standard chemotherapy, 31,32 intraperitoneal treatment, 33 radiation therapy, 34 and high-dose chemotherapy with hematopoietic support. Concerning HDC in PCR situations (Table 4), published unicentric studies are rare 16,29 and concern less than 20 patients.…”