Intentional non-radical surgery and survival in advanced ovarian cancer: Results of a pilot study

Between 1991 and 1993, 31 patients with bulky advanced ovarian carcinoma were entered into a structured protocol where attempts at radical surgery were deemed inappropriate should one or more bowel resections and/or splenectomy be required in order to possibly achieve optimum debulking, Only diagnostic and palliative procedures were undertaken and all patients had >2 cm residual disease. Adjuvant chemotherapy was administered to 29 patients (25 platinum based). Follow-up of the study group was for a minimum of 24 months and a maximum of 55 months. The overall median survival was 16 months and, for those exposed to platinum agents, 17 months, Complete response to chemotherapy was achieved in 11 (35%) of patients. Median survival in this group was 29 months. Two patients are still alive, 39 and 55 months after primary surgery, This series indicates that avoiding multiorgan resection does not adversely impact on survival, and concerns in proceeding with a prospective randomized trial of primary debulking surgery is advanced ovarian carcinoma are unfounded.