CONSOLIDATION TREATMENT WITH INTRAPERITONEAL CISPLATIN IN EPITHELIAL OVARIAN CANCER FOLLOWING NEGATIVE SURGICAL ASSESSMENT

Objective: The goal of this study is to evaluate the efficacy of intraperitoneal (JP) cisplatin as consolidation treatment, in epithelial ovarian cancer patients with pathologically negative surgical reassessment, following first-line platinum-based chemotherapy. Methods: This study included 22 patients with FIGO stage (IIc- IV) epithelial ovarian cancer (EOC) which had no evidence of disease and were assessed by second- look surgery. They were given 3 cycles of intra peritoneal (IP) cisplatin (100 mg/ m2) with 3 weekly intervals as consolidation therapy. Survival was compared to that of a group of contemporaneous patients undergoing observation only, after completion of standard therapy. Results: Median age of these 22 patients was 56 years (30-70 years). Stage distribution was II (3), III (16), and IV (3). Histologic grade was I (1), II (11), III (9), and residual disease at completion of initial surgery was none/microscopic in 4/22 (17%) patients. Median age of 43 patients who did not receive consolidation therapy was 52 years (28-74years). Stage distribution was II (7), III (32), and IV (4). Histologic grade was I (8), II (17), III (15), and not recorded (3). Median follow-up for both groups has been 46 months. Median disease-free survival (DFS) for the observed patients is 28 months and 44 months in the consolidation group. DFS distribution between groups was compared using the log-rank test and found to be significant (p= 0.03) Conclusion: Multivariate analysis revealed that the only significant predictor of improved DFS was protocol treatment (p< 0.01). This study indicates that consolidation IP cisplatin following negative second-look surgery is feasible, severe toxicity was not frequent and may provide a favorable outcome in terms ofDFS compared to nonprotocol patients who underwent observation alone. Further trials will be required to evaluate the role of consolidation treatment and improve its options in ovarian cancer.