Abstract
Forty-six patients with recurrent ovarian cancer were reoperated, and cancer samples for the subrenal capsule assay (SRCA) were collected from 23 of them, whereas this test was not done in the remaining 23 control patients. The SRCA was evaluable in 22 cases (96%). Taken together, no significant difference appeared in the 3 years' survival figures between the groups: seven of 22 patients (32%) with the evaluable SRCA and six of 23 control patients (26%) were alive. However, a further analysis of the data revealed that the SRCA guided the selection of chemotherapy only in 15 patients, whereas tumour samples were resistant to all cytostatics tested in six cases and toxic side-effects limited the clinical application of the test results in the remaining one case. Four of the 11 patients (36%) whose further chemotherapy was strictly chosen based on the SRCA and seven of the 24 patients (29%) whose treatment was based on physician's choice survived at least 3 years. Our conclusion is that the SRCA is of limited value in the selection of second-line chemotherapy in recurrent ovarian cancer.
Highlights
I and II Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland
A further analysis of the data revealed that the subrenal capsule assay (SRCA) guided the selection of chemotherapy only in 15 patients, whereas tumour samples were resistant to all cytostatics tested in six cases and toxic side-effects limited the clinical application of the test results in the remaining one case
Four of the 11 patients (36%) whose further chemotherapy was strictly chosen based on the SRCA and seven of the 24 patients (29%) whose treatment was based on physician's choice survived at least 3 years
Summary
Forty-six patients between 25 and 76 years of age with recurrent ovarian cancer were studied (Table I). Thirty-five had responded favourably to the therapy, as assessed by the standard criteria (Miller et al, 1981), whereas in 11 women no response to therapy and/or progression of the disease was seen These 46 patients entered our study with the approval of the local committee of ethics between 5-48 months after primary operation, when they came for a routine second-look (n = 32) and third-look (n = 6) laparotomy or a debulking operation (n = 8). Tumour of size 2 cm or less (after operation no macroscopic tumour in six women), whereas 27 women had tumours larger than 2 cm (after operation no macroscopic tumour in four women and tumour less than 2 cm in six women) At this operation samples of histologically confirmed cancer were collected for the SRCA in 23 patients (operated on Monday-Wednesday), whereas this was not possible in 23 comparable control patients (operated on Thursday-Friday). The results of the SRCA were used in selecting chemotherapy after reoperation, whereas in the control group therapy was chosen based on clinical experience
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