GYNECOLOGIC ONCOLOGY
38, 358-363 (1990)
Aggressive Chemosurgical Debulking in Patients with Advanced Ovarian Cancer LAURA W. NG, M.D., STEPHEN C. RUBIN, M.D. ,’ WILLIAM J. HOSKINS, M.D., WALTER B. JONES, M.D., THOMAS B. HAKES, M.D., MAURIE MARKMAN, M.D., BONNIE REICHMAN, M.D., LOIS ALMADRONES, R.N., M.P.A., AND JOHN L. LEWIS, JR., M.D. Gynecology Service, Department of Surgery and the Department of Medicine, Memorial Sloan-Kettering New York, New York 10021
Cancer Center, 1275 York Avenue,
Received January 22, 1990
From July 1986 to June 1989, 43 evaluable patients with advanced ovarian cancer were treated on protocol with initial cytoreductive surgery, two courses of high-intensity intravenous Cytoxan (1000 mg/m*) and cisplatin (120-200 mg/m*) chemotherapy, and repeat debulking laparotomy in an effort to maximize responseto a subsequent four cycles of intraperitoneal platinum-based chemotherapy. Two patients were stage IIIA, 2 stage IIIB, 28 stage IIIC, and 11 stage IV. Five tumors were grade 1, 9 grade 2, and 29 grade 3. Thirty-eight (88%) patients had bulky tumor (S-25 cm) found at first laparotomy; 25 of these had >lcm residual after initial debulking. Following two cycles of intensive intravenous chemotherapy 18 of these 25 had >l-cm diseasefound at second laparotomy; 12 of 18 underwent secondary cytoreduction to
38, 358-363 (1990)
Aggressive Chemosurgical Debulking in Patients with Advanced Ovarian Cancer LAURA W. NG, M.D., STEPHEN C. RUBIN, M.D. ,’ WILLIAM J. HOSKINS, M.D., WALTER B. JONES, M.D., THOMAS B. HAKES, M.D., MAURIE MARKMAN, M.D., BONNIE REICHMAN, M.D., LOIS ALMADRONES, R.N., M.P.A., AND JOHN L. LEWIS, JR., M.D. Gynecology Service, Department of Surgery and the Department of Medicine, Memorial Sloan-Kettering New York, New York 10021
Cancer Center, 1275 York Avenue,
Received January 22, 1990
From July 1986 to June 1989, 43 evaluable patients with advanced ovarian cancer were treated on protocol with initial cytoreductive surgery, two courses of high-intensity intravenous Cytoxan (1000 mg/m*) and cisplatin (120-200 mg/m*) chemotherapy, and repeat debulking laparotomy in an effort to maximize responseto a subsequent four cycles of intraperitoneal platinum-based chemotherapy. Two patients were stage IIIA, 2 stage IIIB, 28 stage IIIC, and 11 stage IV. Five tumors were grade 1, 9 grade 2, and 29 grade 3. Thirty-eight (88%) patients had bulky tumor (S-25 cm) found at first laparotomy; 25 of these had >lcm residual after initial debulking. Following two cycles of intensive intravenous chemotherapy 18 of these 25 had >l-cm diseasefound at second laparotomy; 12 of 18 underwent secondary cytoreduction to
