Chemotherapy Consisting of Cisplatin, Doxorubicin, and Cyclophosphamide as an Adjunct to Surgery in Stage Ic-II Epithelial Ovarian Carcinoma

Abstract

Twenty-five patients with stage Ic-II ovarian cancer (8 stage Ic and 17 stage IIb-c) were treated with total tumor removal followed by six cycles of chemotherapy consisting of cyclophosphamide, doxorubicin, and cisplatin (CAP-1) i.v. on day 1, every 4 weeks. Of 18 patients in whom a second look was performed, 16 (89%) achieved a pathologically documented complete response and 2 had positive peritoneal washings at second look. Seven patients did not undergo second-look laparotomy. All had no clinical evidence of disease. One patient with stage Ic relapsed and died after 40 months. Nine patients with stage II relapsed, and 8 died after a median of 25 months (range, 18-58 months). The overall relapse rate in all patients was therefore 40% (95% confidence interval: 21-61%). Median follow-up of all patients is 5 years (range, 40-85 months). The 5-year survival of patients with early-stage ovarian cancer treated with cisplatin-based chemotherapy appears to be at least as good as reported with the use of postoperative irradiation or intraperitoneal radioactive phosphate. Optimal treatment of these patients remains to be further defined.