Objective: To determine the long-term outcome in patients with high-risk stage I epithelial ovarian cancer treated with adjuvant platinum-based chemotherapy following comprehensive surgical staging.
Methods: We conducted a retrospective review of patients with stage IA and IB (grades 2 or 3) and stage IC grades) epithelial ovarian cancer treated with platinum-based chemotherapy following comprehensive surgical staging. Clinicopathologic correlations were performed using disease-free survival as the end point.
Results: The mean patient age was 47 years. The distribution by stage was IA in 19 (31%), IB in four (6%), and in 39 (63%). Eighty percent of the patients had grade 2 tumors. The distribution by cell type was as follows: clearcell l 22 (35%), endometrioid 15 (24%), mucinous 11 (18%), serous eight (13%), and undifferentiated six (10%). patients underwent an average of six cycles of platinum-based therapy. With a median follow-up of 40 months among survivors, 15 patients (24%) have relapsed, at median interval of 22 months from diagnosis. Relapses occurred primarily in the peritoneal cavity and retroperitoneal lymph nodes. No patient has been rendered free disease after relapse. Patients with grade 3 tumors had increased risk of relapse as compared to those with grade or 2 tumors (46 versus 8%; P=.002). Patients with clear- tumors had a higher risk of relapse than those with other types (41 versus 15%; P=.05). There was no statistically significant relationship between risk of recurrence and substage. None of 11 patients with stage IA, grade 2 disease recurrence. Actuarial 5-year disease-free survival for entire group of 62 patients was 73%.
Conclusion: Platinum-based chemotherapy for high- stage I ovarian cancer does not appear to improve survival over that previously reported with non-platinum regimens.
© 1993 The American College of Obstetricians and Gynecologists