Ovarian cancer treatment reality in northern Rheinland-Pfalz (Germany). Suboptimal surgical treatment as a possible cause for inferior survival.

Background: With regard to incidence, ovarian cancer has the highest mortality of all gynecologic cancers.

Patients And Methods: The treatment of 139 consecutive patients with epithelial ovarian cancer who were treated in an oncology group practice in Koblenz, Germany between 1995 and 2003 was evaluated retrospectively.

Results: The median age of the patients was 61 years (18-84). FIGO stages were distributed as follows: stage I 15.8%, stage II 12.9%, stage III 53.2%, stage IV 16.5%. 49 patients (35.5%) received surgical treatment at a university hospital or a teaching hospital. 89 patients (64.5%) were operated on in a local or district hospital. A macroscopically complete resection was achieved in only 15 patients (10.8%). The residual tumor was <1 cm in 50 patients (36%), >1 cm in 24 patients (17.3%), and >2 cm in 49 patients (35.5%). 93.3% of the patients received postoperative, platinum-based chemotherapy. Median survival since first diagnosis was 42 months (1-346(+)). The 5-year survival rate of the whole cohort was only 28%.

Conclusions: Overall survival in epithelial ovarian cancer was significantly inferior in this patient cohort compared to the results of the FIGO report from 2003. One possible cause may be the suboptimal surgical treatment, with 52.8% of the patients having a postoperative residual tumor larger than 1 cm.