[Multidisciplinary treatment of recurrent epithelial ovarian carcinoma and prognostic analysis].

Objective: To investigate individualized and multi-phase management of recurrent epithelial ovarian carcinoma in order to improve survival of the patients.

Methods: From 1998 to 2002, 70 patients with recurrent epithelial ovarian carcinoma were enrolled in the present study. The treatments were divided into: (1) Induction of tumor remission: platinum sensitive patients were treated with paclitaxol + cisplatin (TP) or carboplatin + cyclophosphamide (CP) regimen; platinum resistant patients used Taxol + mitomycin (TM) or etoposide + mitomycin (VM) regimen. Resection of tumors was done in an attempt to reduce the residual tumor with a diameter less than 1 cm. Local radiotherapy was performed for those with residual tumor and who achieved clinical response after chemotherapy or surgery. (2) Consolidation therapy: chemotherapy with lower doses was administrated after disease remission. Interferon was used as immunotherapy during chemotherapy and radiotherapy. Survival analysis was done.

Results: (1) The 1, 2, 3, 4, 5-year survival rates were 67%, 51%, 45%, 38%, 32%. Median survival was 38.57 months. (3) The 1, 2, 3-year progression-free survival rates of the research arm were 41%, 37%, 24%. Median progression-free survival was 12.00 months. (4) Multivariate analysis revealed that platinum-free interval (P < 0.05), Karnofsky performance scale (P < 0.01), residual disease (P < 0.01) and courses of second-line chemotherapy (P < 0.05) were independent prognostic factors. Residual disease (P < 0.05) and courses of second-line chemotherapy (P < 0.01) contributed to progression-free survival.

Conclusions: Individualized and multi-phase treatment of recurrent epithelial ovarian carcinoma is efficacious. Optimal second cytoreduction and second-line chemotherapy are beneficial to improve the survival.